三和散加减方联合八段锦治疗便秘型肠易激综合征肝郁气滞证的临床疗效

Clinical efficacy of Sanhe San plus and minus prescription combined with Baduanjin in the treatment of constipation irritable bowel syndrome(liver constraint and Qi stagnation syndrome)

目的:观察三和散加减方联合八段锦治疗便秘型肠易激综合征(IBS-C)肝郁气滞证的临床疗效。方法:收集2022年10月—2023年6月门诊收治的80例符合纳入标准的IBS-C患者,将其随机分为对照组和观察组,每组40例。对照组口服枸橼酸莫沙必利分散片,观察组给予三和散加减方。2组均辅助配合八段锦,疗程4周。记录治疗前后患者肠易激综合征(IBS)中医证候评分、每周自发排便数(CSBM)、IBS严重程度积分表(IBS-SSS)、汉密尔顿焦虑、抑郁量表评分(HAMA、HAMD)、生活质量量表(IBS-QOL)、脑肠肽[5羟色氨(5-HT)、血管活性肽(VIP)、P物质(SP)]水平和复发情况。结果:观察组的总有效率为94.74%(36/38),明显优于对照组的74.36%(29/39)(P<0.05);治疗后,2组患者的CSBM频率、IBS-SSS、HAMA、HAMD、IBS-QOL评分及血清5-HT、VIP、SP水平均优于治疗前(P<0.05),且观察组优于对照组;观察组复发率为16.67%(6/36),明显低于对照组的48.28%(14/29)(P<0.01)。结论:三和散加减方联合八段锦治疗肝郁气滞证IBS-C具有减轻患者临床症状、调整脑肠肽、改善情绪、降低复发率等作用。

Objective To observe the clinical efficacy of Sanhe San plus and minus prescription combined with Baduanjin in the treatment of constipation irritable bowel syndrome(liver constraint and Qi stagnation syndrome).Methods Eighty IBS-C patients(admitted from October 2022 to May 2023)were randomly divided into a control group(n=40)and an observation group(n=40)by random method.The control group was treated with mosapride citrate dispersible tablets.The observation group was given Sanhe San plus and minus prescription.Both groups were assisted with Baduanjin.The course of treatment in both groups was four weeks.The scores of IBS syndrome,weekly spontaneous defecation(CSBM),severity score of irritable bowel syndrome(IBS-SSS),Hamilton AnxietvScale(HAMA)and Hamilton Depression Scale(HAMD),quality of life scale(IBS-QOL),brain-gut peptide(5-HT,VIP,SP)and recurrence situation were recorded before and after treatment.Results Compared with the control group(74.36%),the observation group(94.74%)was higher(P<0.05).After treatment,CSBM,IBS-SSS,HAMA,HAMD,IBS-QOL score and the levels of serum 5-HT,VIP,SP were better than before treatment(P<0.05).And the control group is better than the observation group.In the observation groupthe recurrence rate was 16.67%(6/36),which was lower than that in the control group 48.28%(14/29)(P<0.01).Conclusion Sanhe San plus and minus prescription combined with Baduan Jin can effectively reduce clinical symptoms,regulate the level of brain-gut peptides,improve anxiety and depression,and reduce the recurrence rate.