首都医科大学学报 ›› 2009, Vol. 30 ›› Issue (4): 436-440.doi: 10.3785/j.issn.1006-7795.2009.04.007

• 中医药专题 • 上一篇    下一篇

基于随证加减的疏肝健脾法治疗腹泻型肠易激综合征近期和中期疗效评价

张声生, 许文君, 陈贞, 陈誩   

  1. 首都医科大学附属北京中医医院消化中心
  • 收稿日期:2009-06-18 修回日期:1900-01-01 出版日期:2009-08-21 发布日期:2009-08-21

Short-term and Medium-term Clinical Effect of Liver Dispersing with Spleen Strengthening on Irritable Bowel Syndrome Dominated by Diarrhea

ZHANG Sheng-sheng, XU Wen-jun, CHEN Zhen, CHEN Jing   

  1. Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University
  • Received:2009-06-18 Revised:1900-01-01 Online:2009-08-21 Published:2009-08-21

摘要: 目的 观察基于随证加减的疏肝健脾法治疗腹泻型肠易激综合征(irritable bowel syndrome-diarrhea predominant,IBS-D)的近期和中期疗效。方法 107例IBS-D采用随机数字表法将患者分为疏肝健脾中药组和匹维溴胺西药组,分别予基于随证加减的疏肝健脾方及匹维溴胺治疗。疗程4周,随访3个月。重点观察患者症状及生活质量变化。结果 1 治疗4周结束后,疏肝健脾组西医症状总有效率为90.6%,匹维溴胺组为70.4%,2者相比差异有统计学意义(P<0.000);在改善排便次数和大便性状等主要单项症状方面疏肝健脾组明显优于匹维溴胺组,差异有统计学意义(P<0.000);2 治疗结束第1个月及第3月随访,疏肝健脾组在西医症状积分改善情况上明显优于匹维溴胺组,差异有统计学意义(P<0.008);3 疏肝健脾组治疗4周后能显著提高患者生活质量,疗效可持续至随访的3个月,疗效优于匹维溴胺组,差异有统计学意义(P<0.000)。结论 应用疏肝健脾法随证加减治疗IBS-D具有较好的近期和中期疗效,能够较持久地改善患者生活质量。

关键词: 肠易激综合征, 腹泻型, 疏肝健脾法

Abstract: Objective To observe the short-term and medium-term clinical effect of the therapy of liver dispersing with spleen strengthening on irritable bowel syndrome dominated by diarrhea(IBS-D). Methods One hundred and seven patients with IBS-D were divided randomly into 2 groups, 53 of them were treated with the decoction of liver dispersing with spleen strengthening(herb group), and the other 54 were treated with Pinaverium Bromide(Pinaverium Bromide group). The course of treatment was 4 weeks, and there was a 3-month follow-up. The scores of symptoms and IBS-quality of life(QOL) were recorded twice in every 2 weeks, and 1st and 3rd month after treatment. Results 1) After the 4 weeks treatment, the total effective rate on symptoms of the herb group was 90.6%,while the Pinaverium Bromide group was 70.4%(P<0.05). Also, the former had better effect on the frequency of defecation and characters of stool(P<0.05). 2) As the improvement in the scores of symptom, the herb group had better effect than Pinaverium Bromide group(P<0.05) at the 1st and 3rd month follow-ups. 3) According to IBS-QOL, the herb group significantly improved the patients' quality of life, which was better than Pinaverium Bromide group at the 4th week(P<0.05), and the effect sustained to the 3rd month. Conclusion The therapy of liver dispersing with spleen strengthening on IBS-D had predominant effect in short-term and medium-term, and improved the quality of life, which lasted till the 3rd month.

Key words: irritable bowel syndrome, diarrhea predominant, the therapy of liver dispersing with spleen strengthening

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