痛泻药方加减对肠易激综合征肝郁脾虚型腹泻患者的临床研究

The clinical research of Pain laxative side addition and subtraction of irritable bowel syndrome quality of life in patients with liver and spleen deficiency diarrhea

目的探讨痛泻药方加减对肠易激综合征(IBS)肝郁脾虚型腹泻患者的临床疗效。方法 2012年1月至2014年1月该院就诊符合罗马Ⅱ诊断标准的84例IBS腹泻患者(中医辨证分型为肝郁脾虚型),根据随机数字表法分为观察组和对照组,各42例,对照组患者给予得舒特治疗,观察组患者采用痛泻药方加减治疗,2组患者均治疗2个月。比较2组患者的临床疗效及血浆血管活性肠肽(VIP)、生长抑素(SS)、胆囊收缩素(CCK)的变化情况。结果观察组患者总有效率为90.48%,对照组为71.43%,差异有统计学意义(P<0.05)。观察组患者治疗后腹泻频率、大便形状、腹痛、肠鸣音及临床症状总评分显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血浆VIP、SS、CCK水平显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后心理维度、生理维度、社会适应性以及生存质量总评分显著高于对照组,差异有统计学意义(P<0.05)。结论痛泻药方加减能有效降低IBS肝郁脾虚型腹泻患者血浆VIP、SS、CCK水平,改善患者临床症状,提高生活质量。

Objective To investigate the effects of clinical efficacy and quality of life of pain laxative side addition and subtraction of irritable bowel syndrome（IBS）of patients with liver and spleen deficiency diarrhea.Methods 84 cases of diarrhea IBS patients（TCM syndrome type of liver and spleen deficiency）were divided into observation group（n=42）and the control group（n=42）from January 2012 to January 2014.The control group were treated with Dicetel symptomatic.The observation group were treated with laxative side Treating pain.Two groups were treated for two months.The levels of somatostatin（SS）,cholecystokinin（CCK）,plasma vasoactive intestinal peptide（VIP）of two groups were compared.Results The total effective rate of control group and observation group were90.48% and 71.43%（P〈0.05）.The diarrhea frequency,stool form,abdominal pain,bowel sounds and clinical symptoms of the total score of observation group were lower than the control group（P〈0.05）.The levels of VIP,SS,CCK of observation group were lower than the control group（P〈0.05）.The Psychological dimension,therapy,physical dimensions,social adaptability and overall quality of life scores of the observation group were higher than those of the control group（P〈0.05）.Conclusion Pain laxative side addition and subtraction can effectively reduce the liver and spleen deficiency in patients with IBS with diarrhea plasma VIP,SS,CCK levels,improve clinical symptoms,improve quality of life for patients.