自拟健脾燥湿安神方治疗老年慢性腹泻心脾两虚证临床研究

Clinical study on self-made Jianpi Zaoshi Anshen Decoction in the treatment of elderly chronic diarrhea of heart-spleen deficiency

目的评价自拟健脾燥湿安神方治疗老年慢性腹泻心脾两虚证临床疗效。方法将符合入选标准的80例老年慢性腹泻心脾两虚证患者采用随机数字表法分为2组,每组40例。对照组口服匹维溴铵片,观察组服用自拟健脾燥湿安神方,2组均治疗1个月。分别于治疗前后进行中医证候评分,采用肠易激综合征症状严重程度量表(IBS-SSS)评估肠道症状严重程度,观察治疗期间的不良反应,评价临床疗效。结果观察组总有效率为92.5%(37/40)、对照组为75.0%(30/40),2组比较差异有统计学意义(χ^(2)=4.50,P=0.034)。观察组疗后腹痛程度、腹胀程度、腹痛频率、对生活影响评分低于对照组(t值分别为5.32、6.75、4.37、3.55,P值均<0.001),大便溏稀、食少纳呆、腹痛隐隐、体倦乏力评分低于对照组(t值分别为4.38、5.88、7.41、6.00,P值均<0.001)。治疗期间,观察组不良反应发生率为15.0%(6/40)、对照组为25.0%(10/40),2组比较差异无统计学意义(χ^(2)=1.25,P=0.264)。结论自拟健脾燥湿安神方可有效改善老年慢性腹泻心脾两虚证患者的临床症状,提高临床疗效。

Objective TTo evaluate the clinical efficacy of self-made Jianpi Zaoshi Anshen Decoction on elderly patients with chronic diarrhea of heart-spleen deficiency.Methods A total of 80 elderly patients with chronic diarrhea of heart-spleen deficiency who met the inclusion criteria were divided into the two groups by the random number table method,with 40 cases in each group.Control group was given pinaverium bromide tablets while observation group was treated with self-made Jianpi Zaoshi Anshen Decoction,and both groups were treated for 1 months.The TCM syndromes were scored before and after treatment,and Irritable Bowel Syndrome-Symptom Severity Scale(IBS-SSS)was used to evaluate the severity of intestinal symptoms.The adverse reactions during treatment were observed and the clinical efficacy was assessed.Results The total effective rate was 92.5%(37/40)in observation group and was 75.0%(30/40)in control group respectively(χ^(2)=4.50,P=0.034).The scores of abdominal pain,abdominal distension,abdominal pain frequency and impact on life in observation group after treatment were lower than those in control group(t values were 5.32,6.75,4.37,3.55,respectively,all Ps<0.001),and the scores of pond dilute stool,loss of appetite and anorexia,faint abdominal pain and physical fatigue were lower than those in control group(t values were 4.38,5.88,7.41,6.00,respectively,all Ps<0.001).During treatment,the incidence rate of adverse reactions was 15.0%(6/40)in observation group and that in control group was 25.0%(10/40)(χ^(2)=1.25,P=0.264).Conclusion Self-made Jianpi Zaoshi Anshen Decoction for elderly patients with chronic diarrhea of heart-spleen deficiency can control the early disease condition,enhance the clinical efficacy and improve the clinical symptoms.