参苓白术散联合西药治疗脾虚湿盛证腹泻型肠易激综合征临床研究

Clinical Study on Shenling Baizhu San Decoction Combined with Western Medicine for Diarrhea-Predominant Irritable Bowel Syndrome with Spleen Deficiency and Prevalence of Dampness Syndrome

目的:观察参苓白术散联合西药治疗脾虚湿盛证腹泻型肠易激综合征(IBS-D)的临床疗效。方法:选取120例脾虚湿盛证IBS-D患者作为研究对象,采用随机数字表法分为2组各60例。对照组采用双歧杆菌乳杆菌三联活菌片常规治疗,试验组在对照组基础上加用参苓白术散治疗。比较2组临床疗效,以及治疗前后中医证候积分、T淋巴细胞亚群水平。结果:试验组总有效率为96.67%,对照组为83.33%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组主、次症等中医证候积分均较治疗前下降(P<0.05),且试验组主、次症积分均低于对照组(P<0.05)。治疗后,2组T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前上升(P<0.05),CD8^(+)水平较治疗前下降(P<0.05);且试验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(P<0.05),CD8^(+)水平低于对照组(P<0.05)。结论:参苓白术散联合双歧杆菌乳杆菌三联活菌片治疗IBS-D疗效显著,可有效改善患者的中医证候及免疫功能。

Objective:To observe the clinical effect of Shenling Baizhu San Decoction combined with western medicine for diarrhea-predominant irritable bowel syndrome(IBS-D) with spleen deficiency and prevalence of dampness Syndrome.Methods:A total of 120 cases of IBS-D patients with spleen deficiency and prevalence of dampness were selected as the study objects,and divided into two groups according to the random number table method,with 60 cases in each group.The control group was treated with Live Combined Bifidobacterium and Lactobacillus Tablets,and the trial group was additionally treated with Shenling Baizhu San Decoction based on the treatment of the control group.Traditional Chinese medicine(TCM) syndrome scores and levels of T-lymphocyte subsets before and after treatment,and clinical effects were compared between the two groups.Results:The total effective rate was 96.67% in the trial group and 83.33% in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores including main symptoms and secondary symptoms in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of main symptoms and secondary symptoms in the trial group were lower than those in the control group(P<0.05).After treatment,the levels of T-lymphocyte subsets including CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were increased when compared with those before treatment(P<0.05),and the levels of CD8^(+)were decreased(P<0.05);the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the trial group were higher than those in the control group(P<0.05),and the level of CD8^(+)in the trial group was lower than that in the control group(P<0.05).Conclusion:The therapy of Shenling Baizhu San Decoction combined with Live Combined Bifidobacterium and Lactobacillus Tablets has a significant therapeutic effect on IBS-D patients,which can effectively improve TCM syndrome and immune function of patients.