长蛇灸联合西药治疗脾肾阳虚证腹泻型肠易激综合征疗效观察

Therapeutic effect of long-snake moxibustion combined with western medication on diarrhea type irritable bowel syndrome of spleen and kidney yang deficiency

目的:比较长蛇灸联合西药与单纯西药治疗脾肾阳虚证腹泻型肠易激综合征(IBS-D)的临床疗效。方法:将60例脾肾阳虚证IBS-D患者随机分为观察组和对照组,每组30例。对照组予口服盐酸洛哌丁胺胶囊(每次2.0 mg,每天3次)及地衣芽孢杆菌活菌胶囊(每次0.5 g,每天3次)治疗;观察组在对照组基础上予长蛇灸治疗,选取大椎至腰俞段脊柱穴区行隔姜灸,每周1次,两组均连续治疗8周。观察两组患者治疗前后主要症状评分及IBS生活质量问卷(IBS-QOL)评分,并评定临床疗效。结果:治疗后,两组患者腹痛、排便频率、黏液便、胃纳减退症状评分均较治疗前降低(P<0.05),日常社交、日常运动、饮食影响、工作影响、情绪状况、睡眠状况、精神状态及精力改变评分均较治疗前升高(P<0.05);观察组主要症状各项评分均低于对照组(P<0.05),IBS-QOL各项评分均高于对照组(P<0.05)。观察组总有效率为96.7%(29/30),优于对照组的73.3%(22/30,P<0.05)。结论:长蛇灸联合西药可有效治疗脾肾阳虚证腹泻型肠易激综合征,缓解患者临床症状、提高其生活质量,疗效优于单纯口服西药治疗。

Objective To compare the therapeutic effect between long-snake moxibustion combined with western medication and simple medication on diarrhea type irritable bowel syndrome(IBS-D) of spleen and kidney yang deficiency. Methods A total of 60 patients with IBS-D of spleen and kidney yang deficiency were randomized into an observation group and a control group, 30 cases in each one. In the control group, loperamide hydrochloride capsule(2.0 mg each time, 3 times a day) and bacillus licheniformis live capsule(0.5 mg each time, 3 times a day) were given orally. In the observation group, long-snake moxibustion was added on the basis of the treatment in the control group, ginger-partitioned moxibustion was applied from Dazhui(GV 14) to Yaoshu(GV 2) of governor vessel, once a week. The treatment was given for 8 weeks in both groups. The scores of main symptom and IBS quality of life questionnaire(IBS-QOL) were observed before and after treatment, and the therapeutic effect was evaluated in both groups. Results Compared before treatment, the symptom scores of abdominal pain, defecation frequency, mucous stool and appetite reduction were decreased(P<0.05), the scores of daily social intercourse, daily activity, diet, work, emotion, sleep quality, mental state and energy change were increased in both groups(P<0.05). After treatment, each sub-item score of main symptom in the observation group was lower than the control group(P<0.05), each sub-item score of IBS-QOL was higher than the control group(P<0.05). The total effective rate was 96.7%(29/30) in the observation group, which was superior to 73.3%(22/30) in the control group(P<0.05). Conclusion Long-snake moxibustion combined with western medication can effectively treat the IBS-D of spleen and kidney yang deficiency, relieve the clinical symptoms and improve the quality of life, the effect is superior to the simple treatment of oral western medication.