首页|香柴舒郁汤联合益生菌治疗肝郁气滞证便秘型肠易激综合征的临床疗效观察

香柴舒郁汤联合益生菌治疗肝郁气滞证便秘型肠易激综合征的临床疗效观察

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目的:观察香柴舒郁汤联合益生菌治疗肝郁气滞证便秘型肠易激综合征(constipation-predominant irritable bowel syndrome，IBS-C)的临床疗效。方法:将诊断为肝郁气滞证IBS-C的90例患者随机分为对照组和治疗组，每组各45例。对照组予双歧杆菌三联活菌肠溶胶囊治疗，治疗组在对照组基础上加用香柴舒郁汤治疗。连续治疗4周，观察两组患者治疗前、治疗4周后中医证候积分改善情况，采用汉密尔顿焦虑量表(Hamilton anx-iety scale，HAMA)、汉密尔顿抑郁量表(Hamilton depression scale，HAMD)评估患者精神心理状况;检测肠道菌群变化，并比较两组患者的临床有效率和不良反应发生率。结果:治疗后两组患者的中医证候均改善，且治疗组腹痛腹胀、排便频率、大便性状、嗳气频作、胸闷不舒、两胁胀痛改善效果优于对照组(P＜0。05)，而在排便状况方面两组改善效果差异无统计学意义(P＞0。05);两组患者的HAMA、HAMD评分均有不同程度降低，且治疗组评分降低更显著(P＜0。05);两组患者的肠道双歧杆菌、乳杆菌水平均升高而肠杆菌水平下降，且治疗组双歧杆菌及乳杆菌水平高于对照组，肠杆菌水平低于对照组(P＜0。05);两组不良反应发生率比较差异无统计学意义(P＞0。05);治疗组总有效率为92。86％，高于对照组的73。81％(P＜0。05)。结论:香柴舒郁汤联合益生菌治疗肝郁气滞证IBS-C临床疗效显著，同时可有效舒缓患者的不良情绪，优化肠道菌群，且安全性较高。
Clinical observation of Xiangchai Shuyu Decoction combined with probiotics in treating constipation irritable bowel syndrome with liver depression and Qi stagnation syndrome
Objective:To observe the clinical effect of Xiangchai Shuyu Decoction combined with constipation-predominant irritable bowel syndrome(IBS-C)with liver depression and Qi stagnation.Methods:Ninety patients with IBS-C with liver depression and Qi stagnation syndrome were randomly divided into the control group and the treatment group,45 patients in each group.The control group was treated with Bifidobacterium triple live bacteria enteric-coated capsules,while the treatment group was treated with Xiangchai Shuyu Decoction on the basis of the control group.After 4 weeks'continuous treatment,the improvement of Traditional Chinese Medicine(TCM)syndrome score in the two groups was observed before and after 4 weeks'treatment.The mental and psychological status of patients was evaluated by Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD),and the changes of intestinal flora were detected.The clinical effective rate and incidence of untoward effects were compared between the two groups.Results:The TCM syndromes of all patients in both groups had improved after treatment,and the improvement effects of abdominal pain,abdominal distension,defecation frequency,stool characteristics,frequent belching,chest tightness and hypochondriac pain in the treatment group was superior to that of the control group(P＜0.05),while there was no difference in defecation status between the two groups(P＞0.05).The scores of HAMA and HAMD in both groups were decreased in different degrees,and the score in the treatment group was more significantly decreased(P＜0.05).The levels of intestinal bifidobacteria and lac-tobacilli in both groups increased,while the levels of enterobacteriaceae decreased.The levels of bifidobacteria and lactobacilli in the treatment group were higher than those in the control group,while the levels of enterobacteriace-ae were lower than those in the control group(P＜0.05).Comparing the occurrence rate of untoward effects of two groups,there was no obvious difference(P＞0.05).The aggregate effective rate of the treatment group was 92.86％,up from 73.81％in the control group(P＜0.05).Conclusion:Xiangchai Shuyu Decoction combined with probiotics has a significant clinical effect on IBS-C with liver-Qi stagnation syndrome,and can effectively re-lieve bad mood,optimize intestinal flora,and safe.

Xiangchai Shuyu Decoctionconstipation-predominant irritable bowel syndromesyndrome of liver depression and Qi stagnationprobioticsintestinal flora

董慧鑫、霍永利、杨倩、娄莹莹、佘延芬

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河北中医学院(石家庄,050091)

河北中医学院第一附属医院脾胃病科

香柴舒郁汤 便秘型肠易激综合征 肝郁气滞证 益生菌 肠道菌群

国家重点研发计划项目国家科技部重点研发计划中医药专项第五批全国中医临床优秀人才研修项目

2019YFC17121032022YFC3500601国中医药人教函20221号

2024

10.3969/j.issn.1671-038X.2024.01.11

中国中西医结合消化杂志
华中科技大学同济医学院,中国中西医结合学会消化系统疾病专业委员会,中华中医药学会脾胃病专业委员会

中国中西医结合消化杂志

CSTPCD
影响因子：1.363
ISSN：1671-038X
年,卷(期)：2024.32(1)
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