痛泻要方加减治疗肝郁脾虚型泄泻患者的临床疗效分析及对VIP、CCK水平的影响

Analysis of Clinical Efficacy of Tongxie Yaofang in Treating Patients with Diarrhea of Liver Depression and Spleen Deficiency and Its Influence on VIP and CCK Levels

目的运用痛泻要方联合得舒特治疗肝郁脾虚型泄泻,观察其临床疗效及不良反应,并测定VIP、CCK水平,从而探讨痛泻要方治疗郁脾虚型泄泻的机制。方法收集2017年1月-2018年12月在该院脾胃科门诊就诊的肝郁脾虚型泄泻患者80例。随机分为西药组40例和中西药组40例,西药组给予口服得舒特50 mg,3次/d,共治疗4周,中西药组在西药组基础上联合痛泻要方加减进行治疗。比较两组临床疗效及不良反应发生情况,以及治疗前后VIP、CCK水平的变化。结果中西药组疗效总有效率85.00%,显著高于西药组47.50%(χ^2=14.345,P<0.05);治疗4周后,中西药组在腹痛、泄泻、郁怒或紧张等常见症状改善方面显著优于西药组(P<0.05);与治疗前相比,治疗后两组患者血VIP下降幅度均差异有统计学意义(P<0.05),与西药组进行比较,中西药组下降的幅度更明显(P<0.05),中西药组cck水平比西药组上升的更明显(P<0.05)。治疗后,两组患者均无严重不良反应(χ^2=0.344,P>0.05)。结论痛泻要方联合得舒特治疗肝郁脾虚型泄泻患者具有良好的临床疗效,中西药联合在改善患者临床症状、降低患者VIP水平,提高CCK水平方面更具优势。

Objective To treat diarrhea of liver stagnation and spleen deficiency with Tongxie Yaofang combined with Dicetel, observe its clinical efficacy and adverse reactions, and determine the levels of VIP and CCK, so as to explore the mechanism of Tongxie Yaofang in treating spleen deficiency and diarrhea. Methods Eighty patients with diarrhea of liver stagnation and spleen deficiency who were treated in the spleen and stomach clinic of the hospital from January 2017 to December 2018 were collected. They were randomly divided into western medicine group(40 cases) and western medicine group(40 cases). Western medicine group was given oral Dicetel50 mg, 3 times/day for a total of 4 weeks. The Chinese and Western medicine group was combined with the western medicine group to treat the diarrhea. The clinical efficacy and adverse reactions of the two groups were compared, as well as the changes of VIP and CCK levels before and after treatment. Results The total effective rate of the Chinese and Western medicine group was 85.00%, which was significantly higher than that of the western medicine group(47.50%)(χ^2=14.345, P<0.05);after 4 weeks of treatment, the Chinese and Western medicine group was significantly better than the western medicine group in the improvement of common symptoms such as abdominal pain, diarrhea, anger or nervousness(P<0.05);compared with before treatment, the two groups of patients after treatment, the decrease of blood VIP was statistically significant different(P<0.05). Compared with the western medicine group, the decline of the Chinese and Western medicine group was more significant(P<0.05), and the Chinese and Western medicine group was more significant than the western medicine group in cck level(P<0.05). After treatment, there were no serious adverse reactions in the two groups(χ^2=0.344, P>0.05). Conclusion Tongxie Yaofang combined with Dicetel has a good clinical effect in treating patients with diarrhea of liver stagnation and spleen deficiency. The combination of Chinese and Western medicine has advantages in improving clinical symptoms, reducing VIP level and increasing CCK level.