调畅心阳、厚肠补土法治疗腹泻型肠易激综合征60例

Regulating Heart-yang and Invigorating the Spleen Methods in the Treatment of Diarrhea-predominant Irritable Bowel Syndrome for 60 Cases

目的观察根据调畅心阳、厚肠补土法而拟定的经验方(桂枝荔芝汤)用于治疗腹泻型肠易激综合征的临床疗效。方法将门诊及住院120例腹泻型肠易激综合征患者随机分为治疗组和对照组,各60例,治疗组以桂枝荔芝汤加减,对照组以痛泻要方加味,2组疗程均为4周,随访1个月。结果在IBS-D临床症状的比较上,2组治疗前后各症状均改善明显(△P<0.05,P<0.05),对照组除"倦怠乏力"外各症状改善明显。2组治疗前症状积分比较无统计学差异(▲P>0.05),具有可比性,治疗组对"腹胀腹痛、脘腹痞满"的改善与对照组比较有显著差异(P<0.05),2组对"大便泄泻、肠鸣矢气、食欲不振"症状的改善疗效相当(▽P>0.05)。治疗组总有效率95.0%与对照组总疗效91.7%比较虽无显著差异(P>0.05),但治疗组愈显率较对照组优(P<0.05),且复发率较对照组低(P<0.05)。结论通过调畅心阳、厚肠补土法而拟定的经验方(桂枝荔芝汤)能够有效改善腹泻型肠易激综合征患者的临床症状和体征,降低复发率,且无明显毒副作用和不良反应。

Objective To observe the clinical curative effect of the Guizhi-Lizhi decoction in the treatment of diarrhea-predominant irritable bowel syndrome. Methods 120 cases of outpatients and inpatients with diarrhea-predominant irritable bowel syndrome were randomly divided into the treatment group and the control group, with 60 cases in each group. The treatment group was treated with GLD, and the control group was treated with Tongxieyao formula. Both groups were treated for four weeks. Results Comparing with the IBS-D clinical symptoms before and after treatment in each group, the symptoms both improved significantly （P〈O.05） , except for the symptom of ＂ fatigue＂ in the control group. There was no statistical difference in symptom scores between the two groups before treatment （P〉0.05） . And the two groups had similar curative effects on symptoms of ＂ diarrhea, bowel vomiting, loss of appetite＂ （P〉0.05） . But the improvement of the ＂ abdominal distention and pain, abdominal fullness＂ in the treatment group comparing with those in the control group were significantly different. At last, there was no significant difference in the total effective rate of 95.0% in the treatment group and 91.7% of the control group （P〉0.05） . However, the improvement rate in the treatment group was superior to that in the control group （P〈0.05） , and the relapse rate in the treatment group was lower than that in the control group （P〈0.05） . Conclusion The experience prescription formulated by regulating heart-yang and invigorating the spleen methods can effectively improve the clinical symptoms and signs of IBS-D patients, reduce the relapse rate and has no obvious toxicity side effects and adverse reactions.