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理脾祛湿方治疗脾虚湿盛型腹泻型肠易激综合征的临床观察

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[目的]观察理脾祛湿方治疗脾虚湿盛型腹泻型肠易激综合征(IBS-D)的临床疗效.[方法]将70例脾虚湿盛型IBS-D患者随机分为观察组和对照组,每组各35例.对照组给予马来酸曲美布汀片口服治疗,观察组给予理脾祛湿方治疗,连续治疗4周.观察2组患者治疗前后中医证候积分、肠易激综合征严重程度量表(IBS-SSS)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、肠易激综合征生活质量量表(IBS-QOL)评分及血清白细胞介素6(IL-6)水平变化情况,并评价2组患者的中医证候疗效和安全性.[结果](1)脱落情况方面:治疗过程中,观察组自行退出1例,脱落(因故未按疗程治疗)3例,失访1例;对照组自行退出3例,失访2例.最终2组各有30例患者完成全部疗程的治疗.(2)中医证候疗效方面:治疗4周后,观察组的总有效率为93.93%(28/30),对照组为80.00%(24/30),组间比较,观察组的中医证候疗效明显优于对照组(P<0.05).(3)量表评分方面:治疗后,2组患者的中医证候积分、IBS-SSS评分、HAMA评分、HAMD评分和IBS-QOL评分均较治疗前明显下降(P<0.05),且观察组的下降幅度均明显优于对照组(P<0.05).(4)血清炎症因子水平方面:治疗后,2组患者血清IL-6水平均较治疗前下降(P<0.05),且观察组的下降幅度明显优于对照组,差异有统计学意义(P<0.05).(5)安全性方面:治疗过程中,2组患者均无明显不良反应发生,具有较高的安全性.[结论]理脾祛湿方治疗脾虚湿盛型IBS-D患者临床疗效确切,可显著缓解患者肠道症状,降低患者肠道炎症反应,改善患者焦虑、抑郁情绪,提高患者生活质量.
Clinical Observation on Lipi Qushi Recipe in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome of Spleen Deficiency and Dampness Superabundance Type
Objective To observe the clinical efficacy of Lipi Qushi Recipe in the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)of spleen deficiency and dampness superabundance type.Methods Seventy IBS-D patients with spleen deficiency and dampness superabundance type were randomly divided into an observation group and a control group,with 35 patients in each group.The control group was given oral use of Trimebutine Maleate Tablets,and the observation group was given Lipi Qushi Recipe.The two groups were treated for 4 consecutive weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,irritable bowel syndrome severity scoring system(IBS-SSS)scores,Hamilton anxiety scale(HAMA)scores,Hamilton depression scale(HAMD)scores,irritable bowel syndrome quality of life scale(IBS-QOL)scores,and serum interleukin 6(IL-6)level of the two groups were observed before and after the treatment.After treatment,the TCM syndrome efficacy and safety of the two groups were evaluated.Results(1)During the treatment process,one case quitted spontaneously,3 cases fell off(failing in following the treatment schedule for some reasons),and one case lost to follow-up in the observation group;in the control group,3 cases quitted spontaneously and 2 cases lost to follow-up.Eventually,there were 30 patients in each of the two groups completing the full course of treatment.(2)After 4 weeks of treatment,the total effective rate for TCM syndrome efficacy in the observation group was 93.93%(28/30),and that in the control group was 80.00%(24/30).The intergroup comparison showed that the efficacy of TCM of the observation group was significantly superior to that of the control group(P<0.05).(3)After treatment,the TCM syndrome scores,IBS-SSS scores,HAMA scores,HAMD scores and IBS-QOL scores of the two groups were significantly decreased compared with the pre-treatment scores(P<0.05),and the degree of the decrease in the observation group was significantly superior to that in the control group(P<0.05).(4)After treatment,the serum IL-6 level of patients in the two groups was decreased compared with that before treatment(P<0.05),and the degree of the decrease in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.05).(5)In the course of treatment,no obvious adverse reactions occurred in the two groups of patients,with a high safety.Conclusion Lipi Qushi Recipe exerts certain effect for the treatment of IBS-D patients with spleen deficiency and dampness superabundance type,which can significantly alleviate the intestinal symptoms of the patients,reduce the intestinal inflammatory reaction of the patients,improve the anxiety and depression emotions,and improve the quality of life of the patients.

diarrhea-predominant irritable bowel syndrome(IBS-D)spleen deficiency and dampness superabundance typeLipi Qushi Recipequality of lifeanxietydepressioninflammatory factors

陈钰凤、范明、马玉婷

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广州中医药大学第五临床医学院,广东广州 510405

广东省第二中医院,广东广州 510095

腹泻型肠易激综合征(IBS-D) 脾虚湿盛 理脾祛湿方 生活质量 焦虑 抑郁 炎症因子

2024

广州中医药大学学报
广州中医药大学

广州中医药大学学报

CSTPCD
影响因子:1.055
ISSN:1007-3213
年,卷(期):2024.41(1)
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