热门搜索: 论文 发表 社科期刊 北大核心 南大核心 cssci 科技期刊 教育

当前位置:主页 > 医学论文 > 中医中药论文 >

腹泻型肠易激综合征肝郁脾虚证的临床观察

发布时间:2018-10-11 20:02  文章来源:笔耕文化传播
【摘要】:目的采用临床观察研究,验证自拟处方安肠汤治疗腹泻型肠易激综合征肝郁脾虚型的临床疗效及安全性,并从理论和临床研究两方面系统地探讨疏肝健脾法治疗腹泻型肠易激综合征的临床疗效。方法选取符合纳入标准的60例患者随机分为治疗组和对照组,每30例。治疗组与安肠汤口服,1日1剂,分早晚两次服用。对照组与马来酸曲美布汀胶囊口服,1粒1次,3次/日。两组均连续用药8周为一疗程。8周后分别进行两组中医症候疗效比较、前后IBS-SSS量表积分、前后IBS-QOL量表积分、前后PRO量表积分比较。治疗结束后随访8周,观察患者的复发情况。结果1.综合疗效:治疗组中治愈6例,显效8例,有效12例,无效4例,总有效率86.7%;对照组中治愈2例,显效8例,有效8例,无效12例,总有效率60%。两组疗效经Ridit分析,有显著性差异(P0.05),治疗组总有效率高于对照组。2.治疗组治疗前后IBS-SSS量表积分比较,有显著性差异(P0.01);对照组治疗前后IBS-SSS量表积分比较,有明显差异(P0.05);治疗后对照组与治疗组IBS-SSS量表积分比较,有显著性差异(P0.01)。3.两组治疗前中医各项症状积分比较无明显差异(P0.05),具有可比性;治疗组治疗前、后中医各症状积分均有明显改善(P0.05),对照组除了腹痛较前有不同程度改善,其余症状较前无明显改善(P0.05)。4.治疗前两组中医症候总积分无明显差异(P0.05),具有可比性,治疗前后组内总积分有差异(P0.05),具有可比性,说明两组治疗均有效,治疗后两组总积分比较有显著性差异(P0.05),具有可比性,说明治疗组在缓解中医症候疗效优于对照组。5.治疗前两组IBS-QOL量表8个维度积分组间比较无显著性差异(P0.05),组间具有可比性。对照组仅在健康忧虑、家庭关系2个维度治疗前后积分有差异,其余维度无明显差异,而治疗组仅在家庭关系、异性概念治疗前后积分无显著差异(P0.05),其余均表现出显著性差异(P0.05)。6.治疗前两组PRO量表6个维度积分比较均无显著性差异(P0.05),提示两组该量表的基线具有可比性。治疗后两组量表6个维度的得分均有降低,但治疗组在系统状态、反流、排便、消化不良4个维度积分较对照组表现出显著性差异(P0.05),说明治疗组在系统状态、反流、排便、消化不良4个领域得到了更大的改善。7.复发率比较:两组患者的不良反应症状均较轻,呈一过性出现,停药后缓解,均不影响治疗。随访2个月的过程中,治疗组复发率为11.5%,对照组复发率为44.4%,表明安肠汤治疗腹泻型肠易激综合征能减少复发率,远期疗效好,值得进一步应用与推广。结论安肠汤治疗腹泻型肠易激综合征临床综合疗效优于马来酸曲美布汀胶囊,且远期疗效好,能减少复发率,改善症状,提高患者的生活质量,值得进一步应用与推广。
[Abstract]:Objective to investigate the efficacy and safety of self-prescribed Anchang decoction in the treatment of diarrhea irritable bowel syndrome with liver depression and spleen deficiency. The clinical effect of soothing liver and invigorating spleen in treating diarrhea irritable bowel syndrome was discussed systematically from both theoretical and clinical aspects. Methods 60 patients who met the inclusion criteria were randomly divided into treatment group and control group, every 30 cases. Treatment group and an Chang Tang oral, 1 dose, divided into morning and evening two times. The control group and trimebutine maleate capsule were taken orally once, 3 times a day. After 8 weeks of treatment, the curative effects of TCM symptoms were compared between the two groups. The scores of IBS-SSS scale, IBS-QOL scale and PRO scale were compared before and after 8 weeks. The patients were followed up for 8 weeks to observe the recurrence. Result 1. In the treatment group, 6 cases were cured, 8 cases were effective, 12 cases were effective, 4 cases were ineffective, and the total effective rate was 86.7%, while in the control group, 2 cases were cured, 8 cases were markedly effective, 8 cases were effective, 12 cases were ineffective, and the total effective rate was 60%. Ridit analysis showed a significant difference between the two groups (P0.05). The total effective rate in the treatment group was higher than that in the control group. There were significant differences in IBS-SSS scale scores before and after treatment in the treatment group (P0.01); in the control group, the IBS-SSS scale scores were significantly different before and after treatment (P0.05); after treatment, there was a significant difference in the IBS-SSS scale scores between the control group and the treatment group (P0.01). There is no significant difference between the two groups before treatment (P0.05), there is comparability; before treatment, after the treatment of TCM symptoms were significantly improved (P0.05), in the control group, in addition to abdominal pain, there were different degrees of improvement. There was no significant improvement in other symptoms (P0.05). Before treatment, there was no significant difference (P0.05) in the total score of TCM symptoms between the two groups (P0.05), and the total score was comparable before and after treatment (P0.05), which showed that the two groups were effective. After treatment, there were significant differences (P0.05) in the total integral between the two groups (P0.05), and there was comparability between the two groups (P0.05). It shows that the curative effect of the treatment group in relieving TCM symptoms is better than that in the control group. 5. 5. Before treatment, there was no significant difference between the two groups in the eight dimensional scores of IBS-QOL scale (P0.05), and there was comparability between the two groups. In the control group, there was only significant difference in health anxiety, family relationship between the two dimensions before and after treatment, while there was no significant difference in the other dimensions, while in the treatment group there was no significant difference in the family relationship, heterosexual concept before and after treatment (P0.05), and the others showed significant differences (P0.05). There was no significant difference in the six dimensional scores of PRO scale between the two groups before treatment (P0.05), indicating that the baseline of the two groups was comparable. After treatment, the scores of the six dimensions of the two groups were all decreased, but the scores of the four dimensions in the treatment group were significantly different from those in the control group (P0.05), which indicated that the treatment group was in the system state, reflux, defecation, and had significant difference in the scores of system state, reflux, defecation, and dyspepsia (P0.05). Four areas of indigestion have improved further. 7. 7%. Comparison of recurrence rate: the symptoms of adverse reactions in both groups were mild and transient, remission after withdrawal of drugs did not affect the treatment. During the follow-up of 2 months, the recurrence rate of the treatment group was 11.5 and that of the control group was 44.4, which indicated that Anchang decoction could reduce the recurrence rate of diarrhea irritable bowel syndrome, and the long-term effect was good, which was worthy of further application and popularization. Conclusion Anchang decoction is better than trimebutine maleate capsule in the treatment of diarrhea irritable bowel syndrome. It can reduce the recurrence rate, improve the symptoms and improve the quality of life of the patients. It is worthy of further application and popularization.
【学位授予单位】:广西中医药大学
【学位级别】:硕士
【学位授予年份】:2016
【分类号】:R259

【相似文献】

相关期刊论文 前10条

1 张东平;饶秦文;;肝郁脾虚的现代认识[J];中国社区医师(综合版);2006年17期

2 ;肝郁脾虚的理论与实验研究[J];湖南医学院学报;1979年03期

3 张超良;肝郁脾虚症的治疗一得[J];新中医;1985年01期

4 金益强;李学文;黄秀兰;iJ臣宇;;肝郁脾虚病人小肠吸收功能障碍的观察[J];湖南医学院学报;1979年04期

5 柯利民;;浮肿(肝郁脾虚)治验一则[J];中医药学报;1980年Z1期

6 路志正;;肝郁脾虚指关节肿痛证治[J];山西中医;1986年04期

7 孙飞;彭海燕;;抑木扶土法在HBV相关性肝病中的运用[J];辽宁中医药大学学报;2011年06期

8 陈岚;;浅谈慢性乙型肝炎肝郁脾虚兼血瘀证[J];黑龙江中医药;2011年04期

9 陈照基;陈世禧;甘子华;;痛泻要方合参苓白术散治疗肝郁脾虚腹泻型肠易激综合征随机平行对照研究[J];实用中医内科杂志;2012年10期

10 李聪;谢鸣;赵荣华;么元超;王邦众;;肝郁—脾虚—肝郁脾虚不同证候模型大鼠血液流变学变化及疏肝健脾方的作用[J];广州中医药大学学报;2014年02期

相关会议论文 前10条

1 徐珊;包剑锋;;肝郁脾虚因素对四氯化碳诱发大鼠实验性肝纤维化影响的研究[A];第6届全国疑难及重症肝病大会论文集[C];2011年

2 李铁男;李杨;李季委;;枳术菝葜饮治疗肝郁脾虚腹泻型肠易激综合征23例[A];第二十次全国中西医结合消化系统疾病学术会议暨消化疾病诊治进展学习班论文汇编[C];2008年

3 张晓刚;吕志平;;慢性乙型肝炎隐证型可能是肝郁脾虚证的前期阶段[A];中华中医药学会第十三届内科肝胆病学术会议论文汇编[C];2008年

4 商志伟;司银楚;杨学智;牛欣;;在校大学生亚健康肝郁脾虚状态的脉诊属性辨识[A];全国第十二次中医诊断学术年会论文集[C];2011年

5 郑逢民;季海锋;;自拟柴郁诃子汤治疗肝郁脾虚腹泻型肠易激综合征56例[A];创新创业与科学发展——瑞安市第十届自然科学优秀论文集[C];2011年

6 江海松;;陈意治疗肝郁脾虚、湿热内蕴证的几点体会[A];中华中医药学会中医、中西医结合治疗常见病研讨会论文集[C];2007年

7 程远;;应用腹针治疗中风后郁证肝郁脾虚候的随机对照研究[A];2005全国中医脑病学术研讨会论文汇编[C];2005年

8 李铁男;李杨;李季委;;枳术菝葜饮治疗肝郁脾虚腹泻型肠易激综合征34例[A];第二十一届全国中西医结合消化系统疾病学术会议暨国家级中西医结合消化系统疾病新进展学习班论文汇编[C];2009年

9 程远;唐启盛;;针刺治疗老年期中风后郁证肝郁脾虚候的随机对照临床研究[A];中华中医药学会老年神经病专题学术研讨会论文专辑[C];2006年

10 王济;顾立刚;王庆国;彭桂英;李瑞生;王秀茜;;肝郁脾虚因素促进DEN诱发大鼠实验性肝癌的研究[A];全国中医药科研与教学改革研讨会论文集[C];2002年

相关重要报纸文章 前2条

1 陈金伟;中医细治抑郁症[N];医药经济报;2007年

2 秦志仁 上海市中医医院;针药合用治呃逆[N];中国中医药报;2014年

相关硕士学位论文 前10条

1 赵欢欢;自拟肝郁脾虚方治疗失眠的临床疗效观察[D];福建中医药大学;2015年

2 马金生;慢性应激肝郁脾虚模型大鼠下丘脑弓状核NPY及其受体Y1变化机制研究[D];河北医科大学;2015年

3 宁麟;疏肝健脾消脂方治疗肝郁脾虚兼痰瘀互结型NAFLD临床观察[D];广州中医药大学;2016年

4 张一博;清肝燥湿解毒汤治疗慢性乙型病毒性肝炎肝郁脾虚兼湿热型的临床观察[D];黑龙江中医药大学;2016年

5 高超;糖肝煎联合电针治疗肝郁脾虚、湿热蕴结型单纯性肥胖的临床疗效观察[D];湖北中医药大学;2016年

6 林春李;腹泻型肠易激综合征肝郁脾虚证的临床观察[D];广西中医药大学;2016年

7 高希文;从肝郁脾虚论治甲状腺功能亢进症的临床研究[D];山东中医药大学;2015年

8 王济;肝郁脾虚因素对肿瘤生长和Th1/Th2细胞亚群平衡影响的研究[D];北京中医药大学;2003年

9 陆霜红;龙柴方治疗慢性乙型肝炎肝郁脾虚,湿热内阻证的临床研究[D];南京中医药大学;2009年

10 俞桥;舒肝健脾活血颗粒治疗慢性乙型肝炎(肝郁脾虚血瘀证)的临床研究[D];湖北中医学院;2008年



本文编号:2265068


论文下载
论文发表
教材专著
专利申请


    下载步骤:1.微信扫码 2.备注编号 2265068. 3.下载文档
    注:1.必须备注编号,否则无法下载;2.扫码后10分钟即可下载,如有问题,点击微信联系客服。


    本文链接:http://www.bigengculture.com/zhongyixuelunwen/2265068.html