痛泻要方加味治疗肝郁脾虚腹泻型肠易激综合征临床观察

Clinical Observation of Modified Tongxieyao Formula for Liver Depression and Spleen Deficiency Type Diarrhea Predominant Irritable Bowel Syndrome

目的:观察痛泻要方加味方治疗肝郁脾虚腹泻型肠易激综合征的临床效果及不良反应,并与匹维溴铵联合蒙脱石散的疗效进行比较。方法:将确诊的74例肝郁脾虚腹泻型肠易激综合征患者采用完全随机分为2组,治疗组36例,对照组38例,治疗组以痛泻要方加味方治疗,对照组用匹维溴铵联合蒙脱石散治疗,疗程均为4周,比较2组患者的症状改善、临床疗效及复发率。结果:治疗后2组患者在腹泻、腹痛、急躁易怒、食少纳差症状改善以及综合疗效方面,治疗组均优于对照组,差异有统计学意义(P<0.05)。3个月内的复发率治疗组(44.44%)与对照组(61.90%)的差异无统计学意义。结论:痛泻要方加味方在治疗肝郁脾虚腹泻型肠易激综合征方面疗效确切且安全,优于匹维溴铵联合蒙脱石散的临床疗效,在改善患者腹泻、腹痛、急躁易怒、食少纳差症状方面优势明显,在防止疾病复发方面有待未来的进一步研究。

Objective： To observe the clinical efficacy and adverse effect of Modified Tongxieyao Formula for diarrhea pre- dominant irritable bowel syndrome （IBS-D） of liver depression and spleen deficiency pattern, and comparing the effect of combi- ning Pinaverium Bromide and Montmorillonite Powder. Methods： 74 patients diagnosed with IBS-D of liver depression and spleen deficiency pattern were randomly divided into two groups, 36 in treatment group and 38 in controlled group. Patients in the treatment group were treated by Modified Tongxieyao Recipe while those in the controlled group were given combination of Pinaverium Bromide and Montmorillonite Powder. Treatment in both groups lasted for 4 weeks, and the clinical efficacy and the recurrence rate were evaluated afterwards. Results ： After treatment, the comprehensive effect, including alleviation of symptoms like diarrhea, abdominal pain, irritability, poor appetite and so on, was superior to that of the controlled group, with statistical significance （P 〈 0. 05 ）. There was no statistical significance between the treatment group （ 44. 44% ） and the controlled group （61. 90% ） regarding to recurrence rate within 3 months. Conclusion： Modified Tongxieyao Formula is indeed effective for treatment of diarrhea predominant irritable bowel syndrome （IBS-D） of liver depression and spleen deficiency pattern, and su- perior to therapeutic effect of combination of Pinaverium Bromide and Montmorillonite Powder regarding to symptoms alleviation like diarrhea, abdominal pain, irritability, poor appetite and so on. Yet there is no significant difference in recurrence prevention between the 2 groups.