安肠汤治疗对肝郁脾虚证腹泻型肠易激综合征患者症状体征及生活质量的影响

Effect of Anchang Decoction on symptoms,signs and quality of life of diarrhea irritable bowel syndrome patients with liver depression and spleen deficiency syndrome

目的:探究安肠汤治疗对肝郁脾虚证腹泻型肠易激综合征(IBS)患者症状体征及生活质量的影响。方法:将2019年6月—2020年6月我院消化科就诊的92例肝郁脾虚证腹泻型IBS患者作为受试对象,随机数字表法分为观察组及对照组,各46例,均接受低FODMAPs饮食结构并口服匹维溴铵片治疗,观察组在其基础上给予安肠汤治疗。比较2组临床疗效,并记录其治疗前、治疗8周后的症状体征积分[中医证候积分、肠易激综合征症状严重程度问卷(IBS-SSS)评分]、炎性因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、直肠动力[肛管静息压(ARP)、肛门括约肌最大收缩压(AMCP)、直肠静息压(RRP)、直肠最低敏感量]及生活质量[肠易激综合征患者生活质量量表(IBS-QOL)]变化。结果:治疗8周后,观察组总有效率为91.30%,对照组为73.91%,观察组优于对照组(P<0.05);治疗后观察组中医证候总积分、IBS-SSS评分、IL-1β、TNF-α、CRP水平、IBS-QOL各维度评分明显低于对照组(P<0.05),ARP、直肠最低敏感量明显高于对照组(P<0.05)。结论:对肝郁脾虚证腹泻型IBS患者在常规治疗的基础上联合安肠汤治疗可有效改善其临床症状体征,降低炎性因子水平,促进直肠功能的恢复,且有利于生活质量的提高,值得推广。

Objective:To explore the effect of Anchang Decoction on symptoms,signs and quality of life of patients with diarrhea irritable bowel syndrome with liver depression and spleen deficiency syndrome.Methods:From June 2019 to June 2020,92 patients with diarrhea IBS with liver depression and spleen deficiency syndrome in the department of Gastroenterology were selected as subjects.They were divided into observation group and control group by random number table method,with 46 cases in each group.All of them were treated with low-FODMAPS diet and piveronium bromide tablets orally,and the observation group was treated with Anchang decoction on the basis of them.Results:After 8 weeks of treatment,the total effective rate was 91.30%in the observation group and 73.91%in the control group,the observation group was better than the control group(P<0.05).After treatment,the total score of TCM syndrome,IBS-SSS score,IL-1β,TNF-α,CRP level and IBS-QOL score in the observation group were significantly lower than those in the control group(P<0.05),and the minimum sensitivity of ARP and rectum were significantly higher than those in the control group(P<0.05).Conclusion:On the basis of conventional treatment for patients with diarrhea IBS with liver-depression and spleen-deficiency syndrome combined with Anchang Decoction can effectively improve their clinical symptoms and signs,reduce the level of inflammatory factors,promote the recovery of rectal function,and improve the quality of life,which is worthy of promotion.