调气清热方治疗气滞肠燥证便秘型肠易激综合征临床观察

Clinical Observation of Regulating-qi and Clearing-heat Decoction in Treating Qi Stagnation and Intestinal Dryness Pattern of Irritable Bowel Syndrome with Constipation

目的:观察调气清热方治疗便秘型肠易激综合征(气滞肠燥证)的临床疗效。方法:选择便秘型肠易激综合征(气滞肠燥证)患者80例,随机分为两组各40例,中药组予调气清热方(蒲公英15 g,紫花地丁15 g,川黄连6 g,枳壳10 g,川厚朴10 g,柴胡6 g,法半夏10 g,浙贝母10 g,生地黄15 g,桃仁10 g,佛手10 g,玄参10 g,火麻仁20 g,杏仁10 g)治疗;西药组服用渗透性清泻剂乳果糖口服溶液。两组疗程均为4周。结果:治疗后中药组与西药组总有效率分别为87.5%、82.5%,中药组疗效优于西药组(P<0.05)。两组治疗后临床症状总积分均明显优于治疗前(P<0.01),且中药组明显优于西药组(P<0.01)。中药组治疗后在排便频率、粪便性状、腹痛或不适、嗳气呃逆、口干口苦、腹胀方面症状积分明显优于治疗前(P<0.01或P<0.05);西药组治疗后在排便频率、粪便性状、腹痛或不适、腹胀方面症状积分明显优于治疗前(P<0.01或P<0.05),而嗳气呃逆、口干口苦的疗效不明显(P>0.05)。治疗后中药组与西药组比较,中药组在粪便性状、腹痛或不适、嗳气呃逆、口干口苦方面症状积分明显优于西药组(P<0.05或P<0.01)。结论:调气清热方治疗便秘型肠易激综合征(气滞肠燥证)疗效确切,尤其在改善粪便性状、腹痛或不适、嗳气呃逆、口干口苦方面疗效更为显著,是值得临床推广的有效中药验方。

Objective：To observe the therapeutic effect of regulating-qi and clearing-heat decoction in treating qi stagnation and intestinal dryness pattern of irritable bowel syndrome with constipation. Methods： Totally 80 selected patients with qi stagnation and intestinal dryness pattern of irritable bowel syndrome with constipation were randomized into treatment group and control group（40 cases for each group）. The treatment group was given with regulating-qi and clearing-heat decoction（composition： Dandelion 15 g,Viola 15 g,Chuan Coptis 6 g,Citrus aurantium 10 g,Magnolia River 10 g,Bupleurum 6 g,France Pinellia 10 g,Zhejiang Fritillaria 10 g,habitat 15 g,peach kernel 10 g,bergamot 10 g,Scrophularia 10 g,hemp Ren 20 g,almonds 10 g）,while the control group was prescribed with permeable laxative of lactulose oral solution. The course of treatment for both groups was 4 weeks. Results： After treatment,the effective rates of treatment group and control group were 87.5% and 82.5% respectively.The curative effect of treatment group was better than that of control group（P〈0.05）. The total symptomatic scores of both groups were significantly improved after treatment,and treatment group was significantly better than control group in the symptomatic scores（P〈0.01）. The symptomatic scores of treatment group were significantly improved in defecation frequency,fecal character,abdominal pain,belching hiccup,dry throat,bitter taste,abdominal distension after treatment（P〈0.01 or P〈0.05）. The symptomatic scores of control group were significantly improved in defecation frequency,fecal character,abdominal pain,abdominal distension（P〈0.01 or P〈0.05）,but not in belching hiccup,dry throat,bitter taste after treatment（P〈0.05）. The symptomatic scores of treatment group in the fecal character,abdominal pain,belching hiccup and dry throat with bitter taste were better than that of control group after treatment（P〈0.01 or P〈0.05）. Conclusion： Regulating-qi and clearing-heat decoction is quite effective in treating qi stagnation and intestinal dryness pattern of irritable bowel syndrome with constipation,especially in the symptoms of fecal character,abdominal pain,belching hiccup and dry throat with bitter taste. It is an experienced Chinese formula for clinical promotion.