四君子汤加味治疗腹泻型肠易激综合征临床疗效及对生活质量的影响

Effect of Sijunzi Decoction on diarrhea-predominant irritable bowel syndrome and quality of life

目的研究分析四君子汤加味治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)的临床疗效及对生活质量的影响。方法回顾分析2014年4月-2017年10月北京市第一中西医结合医院就诊收治的108例腹泻肠易激综合征患者临床资料,按不同药物治疗方法分为对照和观察组,每组54例,对照组给予助消化、止泻等常规药物治疗,观察组给予四君子汤加味治疗。治疗后比较2组患者5-HT受体水平、临床治疗疗效、不良反应发生情况。结果对照组与观察组5-HT3受体、5-HT4受体水平治疗前比较差异无统计学意义(P>0.05),2组5-HT3受体、5-HT4受体治疗后水平较治疗前均降低,且2组治疗后5-HT3受体、5-HT4受体比较差异具有统计学意义(P<0.05);2组患者治疗后,腹痛、腹胀、排便次数与大便性状改变、乏力、面色枯黄、纳差症状评分与治疗前比较下降(P<0.05),观察组治疗后各症状评分低于对照组,差异具有统计学意义(P<0.05);观察组临床疗效总有效率高于对照组,差异具有统计学意义(P<0.05);2组不良反应发生情况中以恶心、呕吐、咳嗽、便秘为主,其中观察组总发生率为明显低于对照组,差异具有统计学意义(P<0.05);结论四君子汤加味治疗腹泻肠易激综合征有较高的临床疗效,可修复损伤的胃肠黏膜,对患者恶心呕吐、腹泻等症状均有明显的疗效,同时提高患者的生活质量,值得临床推广。

Objective To study the clinical effect of Sijunzi decoction against irritable bowel syndrome(IBS)and its effect on quality of life of patients.Methods The clinical data on 108 cases of irritable bowel syndrome treated in Beijing First Hospital of Integrated Traditional Chinese and Western Medicine between April2014 and October 2017 was retrospectively analyzed.The patients were equally divided into the control group and observation group according to ways of medication.After treatment,the recovery and mental status of the two groups were compared.Results There was no statistically significant difference in levels of 5-HT3 receptor and 5-HT4 receptor between the two groups before treatment(P>0.05).However,after treatment,both levels decreased(P<0.05),and the difference between the two groups was of statistical significance(P<0.05).After treatment,the symptom scores of abdominal pain,abdominal distension,times of defecation and stool changes,asthenia,sessile yellow complexion and tolerance of the two groups were significantly lower,especially in the observation group(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group,with statistically significant difference(P<0.05).Nausea,vomiting,cough and constipation were the main causes of adverse reactions in the two groups,but they were less common in the observation group,and the difference was of statistical significance(P<0.05).Conclusion Sijunzi decoction has a good clinical effect against diarrheal irritable bowel syndrome by repairing the damaged gastrointestinal mucosa and mitigating nausea,vomiting,diarrhea and other symptoms of patients.Meanwhile,it can improve the quality of life of patients and should be made more accessible.