疏肝益肠方结合艾灸治疗腹泻型肠易激综合征疗效观察

Therapeutic Effect of Shugan Yichang Decoction(疏肝益肠方)Combined with Moxibustion on Diarrhea Predominant Irritable Bowel Syndrome

目的观察疏肝益肠方结合艾灸治疗腹泻型(IBS-D)肠易激综合征的临床疗效。方法选择2019年1月—2019年10月韶关市中医院胃肠科就诊的肝气乘脾型IBS-D患者100例,随机分为治疗组和对照组各50例,治疗组予疏肝益肠方联合艾灸(神阙、关元、足三里、肝俞等穴位)治疗,对照组给予口服马来酸曲美布汀分散片及枯草杆菌二联活菌肠溶胶囊治疗,两组疗程均为2个月。分别观察两组患者治疗后的中医证候疗效、中医证候积分和药物不良反应。结果治疗组患者临床症状总有效率明显高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后的各项中医证候积分均比治疗前降低,但治疗组降低的幅度明显大于对照组,其疗效指数也比对照组高(P<0.05);随访半年,治疗组复发率低于对照组,差异具有统计学意义(P<0.05)。治疗期间,治疗组未出现明显不良反应,对照组出现眩晕2例,头痛、便秘各1例。结论疏肝益肠方结合艾灸治疗腹泻型肠易激综合征100例所得能有效改善临床症状,特别在缓解胸胁胀满、纳食及肠鸣矢气等症状方面具有一定优势,药物不良反应少,复发率较低,值得临床推广应用。

Objective To observe the clinical efficacy of Shugan Yichang Decoction(疏肝益肠方) combined with moxibustion in the treatment of diarrhea predominant irritable bowel syndrome. Methods A total of 100 patients with IBS-D of liver Qi over-restricting spleen type who were treated in the Gastroenterology Department of Shaoguan Hospital of Traditional Chinese Medicine from January 2019 to October 2019 were randomly divided into treatment group and control group with 50 cases in each.The treatment group was treated with Shugan Yichang Decoction combined with moxibustion[Shenque(RN8), Guanyuan(RN4), Zusanli(ST36), Ganshu(BL18) and other acupoints], while the control group was treated with oral trimebutine maleate dispersible tablets and Bacillus subtilis enteric coated capsules. The course of treatment in both groups was 2 months. The curative effect of TCM syndrome, TCM syndrome score and adverse drug reactions of the two groups were observed. Results The total effective rate of clinical symptoms in the treatment group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05). After treatment, the TCM syndrome scores of the two groups were lower than those before treatment, but the reduction of the treatment group was significantly greater than that of the control group, and its curative effect index was also higher than that of the control group(P<0.05).After half a year of follow-up, the recurrence rate of the treatment group was lower than that of the control group, and the difference was statistically significant(P<0.05). During the treatment, there was no obvious adverse reaction in the treatment group, 2 cases of vertigo, 1 case of headache and 1 case of constipation in the control group. Conclusion Shugan Yichang Decoction combined with moxibustion to treat 100 cases of IBS-D can effectively improve the clinical symptoms, especially in relieving chest and flank fullness, food intake, bowel sounds and other symptoms, with less adverse drug reactions and low recurrence rate, which is worthy of clinical application.