补中益气汤联合督灸治疗轻中度贫血痔的临床疗效观察

Clinical Observation of Buzhong Yiqi Decoction Combined with Governor Vessel Moxibustion for the Treatment of Hemorrhoids with Mild to Moderate Anemia

【目的】观察补中益气汤联合督灸治疗轻中度贫血痔脾虚气陷证患者的临床疗效。【方法】将60例轻中度贫血痔脾虚气陷证患者随机分为治疗组和对照组,每组各30例。对照组患者给予督灸治疗,治疗组患者给予补中益气汤联合督灸治疗,疗程为1个月。观察2组患者治疗前后中医证候积分、贫血相关指标[血红蛋白(HGB)、红细胞计数(RBC)、红细胞压积(HCT)、平均红细胞体积(MCV)、网织红细胞计数(RET)]、血浆2,3-二磷酸甘油酸(2,3-DPG)浓度的变化情况,评价2组患者的中医证候疗效。【结果】(1)中医证候疗效方面:治疗1个月后,治疗组的总有效率为93.3%(28/30),对照组为56.7%(17/30),治疗组的中医证候疗效明显优于对照组(P<0.01)。(2)中医证候积分方面:治疗后,治疗组患者的中医证候积分较治疗前明显降低(P<0.01),而对照组降低不明显(P>0.05);组间比较,治疗组对中医证候积分的降低作用明显优于对照组(P<0.01)。(3)贫血相关指标方面:治疗后,治疗组患者的HGB、HCT、RET水平均较治疗前升高(P<0.01),而对照组均无明显升高(P>0.05);组间比较,治疗组的HGB、RBC、HCT、RET水平均明显高于对照组(P<0.01)。(4)血浆2,3-DPG浓度方面:治疗后,2组轻度贫血痔患者及对照组中度贫血痔患者血浆2,3-DPG浓度均无明显升高(P>0.05),而治疗组中度贫血痔患者血浆2,3-DPG浓度较治疗前明显升高(P<0.01);组间比较,治疗组的轻度和中度贫血痔患者血浆2,3-DPG浓度均明显高于对照组(P<0.01)。【结论】补中益气汤联合督灸治疗轻中度贫血痔脾虚气陷证患者疗效确切,可有效改善患者中医证候和贫血相关指标,提高血浆2,3-DPG浓度,增加血氧释放量,改善组织缺氧状态。

Objective To observe the clinical effect of Buzhong Yiqi Decoction combined with governor vessel moxibustion on hemorrhoids with mild to moderate anemia. Methods Sixty hemorrhoids patients with mild to moderate anemia and differentiated as the syndrome of spleen deficiency with sinking of qi were randomized into treatment group and control group, and each group had 30 cases. The control group was treated with governor vessel moxibustion, and the treatment group was treated with Buzhong Yiqi Decoction combined with governor vessel moxibustion. The treatment for the two groups covered one month. Before and after treatment,the changes of TCM syndrome scores, anemia related indexes of hemoglobin(HGB), red blood cell(RBC) count,hematocrit(HCT), mean corpuscular volume(MCV) and reticulocyte(RET)count, and plasma 2, 3-diphosphoglycerate(2,3-DPG)concentration were observed. After treatment,the efficacy for TCM syndrome in the two groups was observed. Results(1)After one month of treatment,the total effective rate for TCM syndrome in the treatment group was 93.3%(28/30), and that in the control group was 56.7%(17/30). The intergroup comparison showed that the efficacy for TCM syndrome in the treatment group was superior to that in the control group(P<0.01).(2)After treatment,TCM syndrome scores in the treatment group were obviously decreased as compared with those before treatment(P<0.01),while the decrease of TCM syndrome scores in the control group was not significantly(P>0.05). The intergroup comparison showed that the efficacy for decreasing TCM syndrome scores in the treatment group was superior to that in the control group(P<0.01).(3)After treatment,HGB,HCT and RET in the treatment group were increased as compared with those before treatment(P < 0.01), but the control group showed no obvious increase of the above indexes(P>0.05). The intergroup comparison showed that the levels of HGB,RBC,HCT and RET in the treatment group were higher than those in the control group(P<0.01).(4)After treatment, 2,3-DPG concentration in the mild anemia patients of the two groups and in the moderate anemia patients of the control group was not obviously higher than that before treatment(P>0.05),but the concentration was obviously increased in the moderate anemia patients of the treatment group(P<0.01). The intergroup comparison showed that the treatment group had higher 2,3-DPG concentration in mild to moderate anemia patients than the control group(P<0.01). Conclusion Buzhong Yiqi Decoction combined with governor vessel moxibustion exerts certain effect for the treatment of hemorrhoids with mild to moderate anemia differentiated as the syndrome of spleen deficiency with sinking of qi. The combined therapy is effective on improve TCM syndromes and anemia related indicators,increasing plasma 2,3-DPG concentration,promoting blood oxygen release,and improving the hypoxic condition of the tissues.