奠土汤加味联合艾灸治疗脾肾阳虚证腹泻型肠易激综合征临床研究

Clinical Study on Modified Diantu Decoction Combined with Moxibustion for DiarrheaPredominant Irritable Bowel Syndrome with Spleen-Kidney Yang Deficiency Syndrome

目的:观察奠土汤加味联合艾灸治疗脾肾阳虚证腹泻型肠易激综合征的临床疗效。方法:选取116例腹泻型肠易激综合征患者为研究对象,按随机数字表法分为对照组和观察组各58例。对照组予马来酸曲美布汀胶囊治疗,观察组在对照组的基础上加用奠土汤加味联合艾灸治疗。2组连续治疗4周。比较2组治疗前后肠易激综合征症状严重程度评分(IBS-SSS)、脾肾阳虚证证候评分及临床疗效。结果:观察组总有效率为94.83%,显著高于对照组的81.03%,组间比较,差异有统计学意义(P<0.05)。治疗前,2组腹痛程度、腹痛频率、腹胀程度、排便满意度、对生活影响等IBS-SSS评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项评分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。治疗前,2组腹痛、腰膝酸软、食欲不振、形寒肢冷等证候评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项评分均较治疗前降低(P<0.05),且观察组各项评分均低于对照组(P<0.05)。结论:在西医常规治疗的基础上,加用奠土汤加味联合艾灸治疗脾肾阳虚证腹泻型肠易激综合征,能有效改善患者的症状体征和中医证候,提高临床治疗效果。

Objective:To observe the clinical effect of modified Diantu Decoction combined with moxibustion for diarrhea-predominant irritable bowel syndrome with spleen-kidney yang deficiency syndrome.Methods:A total of 116 cases of patients with diarrhea-predominant irritable bowel syndrome were selected as the study subjects and divided into the control group and the observation group according to the random number table method,with 58 cases in each group.The control group was treated with Trimebutine Maleate Capsules,and the observation group was treated with modified Diantu Decoction combined with moxibustion based on the treatment of the control group.Both groups were treated for four weeks.The Irritable Bowel Syndrome Symptom Severity Score(IBS-SSS)and syndrome scores of spleenkidney yang deficiency syndrome as well as the clinical effects in the two groups were compared.Results:The total effective rate was 94.83%in the observation group,significantly higher than that of 81.03%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of the IBS-SSS scores including abdominal pain,abdominal pain frequency,abdominal distension,degree of defecation satisfaction and impact on life between the two groups(P>0.05).After treatment,the above scores in the two groups were decreased when compared with those before treatment(P<0.05),and each score in the observation group was lower than that in the control group(P<0.05).Before treatment,there was no significant difference being found in the comparison of traditional Chinese medicine(TCM)syndrome scores including abdominal pain,soreness and weakness of waist and knees,lack of appetite,cold body and limbs between the two groups(P>0.05).After treatment,the above scores in the two groups were decreased when compared with those before treatment(P<0.05),and each score in the observation group was lower than that in the control group(P<0.05).Conclusion:Based on routine western medicine treatment,the additional application of modified Diantu Decoction combined with moxibustion for diarrhea-predominant irritable bowel syndrome with spleen-kidney yang deficiency syndrome can effectively improve symptoms,signs and TCM syndromes of patients,and enhance the clinical effect.