疏肝健脾方加不同风药治疗腹泻型肠易激综合征临床观察

Clinical observation on soothing liver and activating spleen prescription with different carminative herbs in the treatment of diarrhea-predominant irritable bowel syndrome

目的:观察疏肝健脾方加不同风药治疗腹泻型肠易激综合征的临床疗效。方法:将患者按随机数字表法分为治疗1组、治疗2组和对照组,每组50例。治疗1组给予疏肝健脾加防风方加减治疗,治疗2组给予疏肝健脾加柴胡方加减治疗,对照组给予口服匹维溴铵片口服,3组疗程均为4周。分别采用IBS症状尺度表、IBS大便性状问卷评估3组患者治疗后总体临床疗效、大便性状情况。结果:治疗1组、治疗2组分别和对照组IBS-BSS总有效率(分别是84.0%、78.0%、52.0%)比较,差异有统计学意义(P<0.05);治疗1组IBS-BSS总积分及各项积分较治疗前均有下降(P<0.05),治疗2组仅腹痛程度、腹胀程度、排便满意度积分有下降(P<0.05),对照组仅腹痛程度、腹胀程度积分有下降(P<0.05);治疗1组大便性状临床总有效率高于治疗2组及对照组(P<0.05),且治疗1组在10 d中排便的急迫天数低于治疗2组及对照组(P<0.05)。结论:疏肝健脾方加"风药"治疗IBS-D有较好疗效,防风的增效作用值得重视。

Objective： To observe the clinical efficacy of soothing liver and activating spleen prescription with different carminative herbs in treating diarrhea -predominant irritable bowel syndrome （mS -D）. Methods： All pa- tients with IBS-D were randomized into treatment group 1 （50 cases）, which was treated with soothing liver and activating spleen prescription with different carminative herbs, treatment ＇group 2 （50 cases）, treated with soothing liver and activating spleen prescription with Chaihu formula, and the control group （50 cases） treated with pinaverium bromide tablet. The treatment course was 4 weeks for all patients. The total effective rate, the stool property and state were assessed by IBS bowel symptom severity scale 0BS-BSS）, and IBS defecation state questionnaire （IBS-DSQd before and after treatment. Results： There were statistical differences in the total effective rate between treatment group 1 and the control group （84.0% vs 52.0%, P〈 0.05）, between treatment group 2 and the control group （78.0% vs 52.0%, P〈 0.05）. The total score of IBS-BSS and all the points Of treatment group i decreased in comparison with that before the treatment （P〈 0.05）; and the degree of abdominal pain, abdominal distension and defecation were decreased in treatment group 2, while only the degree of abdominal pain and abdominal distension were decreased in the control group （ P〈 0.05）. The total clinical effective rate of stool property in treatment group i was higher than thai of treatment group 2 and the control group as well （P〈 0.05）, and eager days of defecation with 10 days in txeatment group 1 was less than： that of treatment group 2 （P〈 0.05）. Conclusion： Soothing liver and activating spleen prescription with different carminative herbs shows good efficacy in treating IBS-D, and the increased effect of carminative herbs is worthy of attention.