藿香正气散加减联合西药治疗腹泻型肠易激综合征临床研究

Clinical Study on Modified Huoxiang Zhengqi Powder Combined with Western Medicine for Irritable Bowel Syndrome with Diarrhea

目的:观察藿香正气散加减联合西药治疗腹泻型肠易激综合征(IBS-D)的临床疗效,以及对患者降钙素基因相关肽(CGRP)、血管活性肠肽(VIP)水平的影响。方法:选取75例IBS-D患者,采用随机数字表法分为对照组37例和观察组38例。对照组给予马来酸曲美布汀片及双歧杆菌四联活菌片治疗,观察组在对照组基础上给予藿香正气散加减治疗,2组均治疗4周。比较2组临床疗效;比较2组治疗前后症状评分、肠易激综合征生活质量量表(IBS-QOL)评分及CGRP、VIP水平。结果:观察组总有效率为92.11%,高于对照组的72.97%(P<0.05)。治疗后,2组腹痛、腹胀、排便频率、大便性状评分均较治疗前降低,观察组上述4项症状评分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组情绪状况、行为障碍、躯体意识、饮食影响、健康担忧、社会功能、性行为、日常社交评分及总分均较治疗前升高(P<0.05),观察组上述IBS-QOL各项细则评分及总分均高于对照组(P<0.05)。治疗后,2组CGRP、VIP水平均较治疗前降低,观察组CGRP、VIP水平较对照组下降更明显,差异均有统计学意义(P<0.05)。结论:藿香正气散加减联合西药治疗IBS-D,能够改善患者的临床症状,提高其生活质量,降低CGRP、VIP水平。

Objective:To observe the clinical effect of the therapy of modified huoxiang zhengqi powder combined with western medicine on the treatment of irritable bowel syndrome with diarrhea(IBS-D),and its effect on the levels of calcitonin gene-related peptide(CGRP)and vasoactive intestinal peptide(VIP).Methods:A total of 75 patients with IBS-D were selected and divided into the control group and the observation group by random number table method,with 37 and 38 cases in each group respectively.The control group was treated with trimebutine maleate tablets and bifidobacterium quadruple viable tablets,and the observation group was additionally treated with modified huoxiang zhengqi powder based on the treatment of the control group.Both groups were treated for four weeks.The clinical effect in the two groups was compared.The score of symptoms,score of Irritable Bowel Syndrome-Quality of Life Scale(IBS-QOL),and the levels of CGRP and VIP were compared between the two groups before and after treatment.Results:The total effective rate was 92.11%in the observation group,higher than that of 72.97%in the control group(P<0.05).After treatment,the scores of abdominal pain,abdominal distension,defecation frequency and stool trait in both groups were decreased when compared with those before treatment,and the scores of the above four symptoms in the observation group were lower than those in the control group,differences being significant(P<0.05).After treatment,the scores of emotional status,behavioral disorder,body consciousness,dietary influence,health concern,social function,sexual behavior,daily social and the total score of IBSQOL in both groups were increased when compared with those before treatment(P<0.05),the above scores and the total score in the observation group were higher than those in the control group(P<0.05).Each score in IBS-QOL and the total score in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of CGRP and VIP in both groups were decreased when compared with those before treatment,and the levels of CGRP and VIP in the observation group were decreased more significantly than those in the control group,differences being significant(P<0.05).Conclusion:Modified huoxiang zhengqi powder combined with western medicine can improve the clinical symptoms of IBSD patients,improve their quality of life,and reduce the levels of CGRP and VIP.