柴胡桂枝干姜汤加减联合西药治疗腹泻型肠易激综合征重叠功能性消化不良临床研究

Clinical Study on Modified Chaihu Guizhi Ganjiang Tang Combined with Western Medicine for Diarrhea-Predominant Irritable Bowel Syndrome Complicated with Functional Dyspepsia

目的:观察柴胡桂枝干姜汤加减联合西药治疗腹泻型肠易激综合征(D-IBS)重叠功能性消化不良(FD)的临床疗效,以及对患者生活质量和心理状态的影响。方法:选取86例D-IBS重叠FD肝郁脾虚证患者,按随机数字表法分为对照组和治疗组各43例。对照组给予西药治疗,治疗组在对照组基础上给予柴胡桂枝干姜汤加减治疗,2组均治疗4周。比较2组治疗前后症状、肠易激综合征生活质量量表(IBS-QOL)、焦虑自评量表(SAS)及抑郁自评量表(SDS)评分,评估2组临床疗效。结果:治疗后,2组餐后饱胀不适、上腹痛、早饱、嗳气、纳差评分均较治疗前降低(P<0.05),治疗组餐后饱胀不适、上腹痛、早饱、嗳气、纳差评分均低于对照组(P<0.05)。治疗组总有效率95.35%,高于对照组76.74%(P<0.05)。治疗后,2组烦躁不安、挑食、躯体意念、社会功能、行为障碍评分均较治疗前降低(P<0.05),治疗组烦躁不安、挑食、躯体意念、社会功能、行为障碍评分均低于对照组(P<0.05)。治疗后,2组SAS、SDS评分均较治疗前降低(P<0.05),治疗组SAS、SDS评分均低于对照组(P<0.05)。结论:柴胡桂枝干姜汤加减联合西药治疗D-IBS重叠FD肝郁脾虚证疗效显著,可有效缓解患者的临床症状,改善其生活质量和心理状态。

Objective:To observe the clinical effect of modified Chaihu Guizhi Ganjiang Tang combined with western medicine for diarrhea-predominant irritable bowel syndrome(D-IBS) complicated with functional dyspepsia(FD) of liver stagnation and spleen deficiency syndrome,and its effect on quality of life and psychological state of patients. Methods:A total of 86 cases of patients with D-IBS complicated with FD of liver stagnation and spleen deficiency syndrome were selected and divided into the control group and the treatment group according to the random number table method, with 43 cases in each group. The control group was treated with western medicine,and the treatment group was additionally treated with modified Chaihu Guizhi Ganjiang Tang based on the treatment of the control group. Both groups were treated for four weeks. Before and after treatment, the scores of symptoms, Quality of Life Scale of Irritable Bowel Syndrome(IBS-QOL), Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were compared between the two groups. The clinical effects in the two groups were evaluated.Results: After treatment, the scores of postprandial distension and discomfort, epigastric pain, early satiety,belching and poor appetite in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the treatment group were lower than those in the control group(P<0.05). The total effective rate was 95.35% in the treatment group,higher than that of 76.74% in the control group(P<0.05). After treatment, the scores of dysphoria, food avoidance, body image, social reaction, and interference with activity in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of dysphoria,food avoidance,body image,social reaction,and interference with activity in the treatment group were lower than those in the control group(P<0.05).After treatment,the scores of SAS and SDS in the two groups were decreased when compared with those before treatment(P<0.05), and the above scores in the treatment group were lower than those in the control group(P<0.05). Conclusion:The therapy of modified Chaihu Guizhi Ganjiang Tang combined with western medicine has a significant curative effect in the treatment of D-IBS complicated with FD of liver stagnation and spleen deficiency syndrome, which can effectively relieve the clinical symptoms of patients,and improve their quality of life and psychological state.