抑肝法和扶脾法对肠易激综合征腹泻型患者心理因素的影响比较

Comparison on Influences on Psychological Factors between Methods of Inhibiting Liver and Strengthening Spleen in Patients with Irritable Bowel Syndrome with Diarrhea( IBS-D)

目的:探讨抑肝法及扶脾法治疗肠易激综合征腹泻型(IBS-D)的临床疗效及对心理因素的影响。方法:纳入IBS-D患者49例,采用随机对照观察,治疗组(30例)口服痛泻要方合二术煎,对照组(19例)口服参苓白术散,疗程1个月,患者治疗前后填写IBS病情尺度调查表(IBS-SSS)及焦虑自评量表(SAS)、抑郁自评量表(SDS)。治疗后比较2组患者的病情尺度积分、焦虑情绪、抑郁情绪变化情况,比较2组疗效。结果:2组患者治疗前后IBS-SSS积分、SAS评分、SDS评分方面均有不同程度的改善,2组总有效率比较,差异无统计学意义(P>0.05);治疗前后组内及组间SAS、SDS标准值比较无统计学意义(P>0.05)。结论:抑肝法、扶脾法两种治法在改善肠易激综合征腹泻型临床症状方面有相近的效果,两种治法治疗后患者焦虑、抑郁感受均较治疗前有所下降,但抑肝法在改善患者心理状态方面并未显示出更优越的作用。

Objective：To investigate the effects and the influences of methods of inhibiting liver and strengthening spleen on psychologi-cal factors of patients with irritable bowel syndrome of diarrhea type（IBS-D）.Methods：Forty nine patients with IBS-D were randomly divided into treatment group （n =30）and control group （n =19）.Patients in the treatment group were given modified Tongxie Yaofang accompanied with Erzhu Jian.The control group gave patients Shenling Baizhu powder.The course of treatment was 1 month.Every pa-tient filled the irritable bowel severity scoring system （IBS-SSS）,self-rating anxiety scale （SAS）and self-rating depression scale （SDS）.The curative effect of the two groups was compared.Results：No statistical significances were noted in the effective rate be-tween two groups（P 〉0.05）.The scores of SAS and SDS were significantly decreased at the end of the treatment in both groups（P 〈0.05）,and no statistical significances were noted in the scores of SAS and SDS between two groups before and at the end of the treat-ment（P 〉0.05）.Conclusion：The two methods of inhibiting liver and strengthening spleen can alleviate the symptoms of IBS-D.The depressive and anxious emotions were improved at the end of the treatment in each group,but the therapeutic method of inhibiting liver doesnt show better effects on improving the psychological status.