摘要
目的:探讨加味痛泻要方联合穴位埋线治疗腹泻型肠易激综合征(IBS-D)肝郁脾虚证的临床疗效。方法:将60例IBS-D患者随机分为治疗组和对照组,每组各30例。治疗组予加味痛泻要方联合穴位埋线治疗,对照组予马来酸曲美布汀片治疗,治疗4周后比较2组患者的临床疗效及治疗前后中医证候积分、肠易激综合征症状严重程度量表(IBS-SSS)评分、肠易激综合征生活质量量表(IBS-QOL)评分、汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)评分变化,检测2组患者治疗前后5-羟色胺(5-HT)、P物质(SP)、血管活性肠肽(VIP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,以及不良反应发生率和复发率。结果:总有效率治疗组为93.33%(28/30),对照组为63.33%(19/30),2组比较,差异有统计学意义(P<0.05)。治疗后2组患者中医证候积分,IBS-SSS、HAMA、HAMD评分均低于本组治疗前,IBS-QOL评分高于本组治疗前,且治疗组的改善程度更优(P<0.05)。治疗后2组患者5-HT、SP、VIP、IL-6、IL-8、TNF-α水平低于本组治疗前,且治疗后治疗组低于对照组(P<0.05)。治疗过程中,不良反应发生率治疗组为6.67%(2/30),对照组为3.33%(1/30),2组比较,差异无统计学意义(P>0.05)。停药4周后对2组有效患者进行随访,治疗组的复发率为14.29%(4/28),低于对照组的42.11%(8/19),差异有统计学意义(P<0.05)。结论:加味痛泻要方联合穴位埋线治疗IBS-D疗效确切,能够显著改善患者临床症状,缓解焦虑、抑郁状态,降低脑肠肽及炎性因子水平,且未见明显不良反应,值得临床推广。
Objective:To investigate the clinical effect of modified Tongxieyaofang combined with acupoint thread-embedding therapy in the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)in stagnation of liver Qi and spleen deficiency.Methods:A total of 60 patients with IBS-D were randomly divided into treat-ment group and control group,with 30 patients in each group.The patients in the treatment group were given modified Tongxieyaofang combined with acupoint thread-embedding therapy,and those in the control group were given trimebutine maleate tablets.After 4 weeks of treatment,the two groups were compared in terms of clinical outcome,traditional Chinese medicine(TCM)syndrome score,Irritable Bowel Syndrome-Severity Scoring System(IBSSSS)score,Irritable Bowel Syndrome-Quality of Life(IBS-QOL)score,Hamilton Anxiety Scale(HAMA)score,and Hamilton Depression Scale(HAMD)score before and after treatment,and the levels of 5-hydroxytryptamine(5-HT),substance P(SP),vasoactive intestinal peptide(VIP),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)were measured;the incidence rates of adverse reactions and recurrence rate were also compare between the two groups.Results:There was a significant difference in overall response rate between the treatment group and the control group[93.33%(28/30)vs 63.33%(19/30),P<0.05].After treatment,both groups had significant reductions in TCM syndrome score,IBS-SSS score,HAMA score,and HAMD score and a significant increase in IBS-QOL score,and the treatment group had significantly greater changes than the control group(P<0.05).After treatment,both groups had significant reductions in the levels of 5-HT,SP,VIP,IL-6,IL-8,and TNF-α,and the treatment group had significantly lower levels than the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups during treatment[6.67%(2/30)vs 3.33%(1/30),P>0.05].After 4 weeks of drug withdrawal,follow-up was conducted for the patients with response in the
作者
陈程
张杼惠
王燚霈
朱莹
CHEN Cheng;ZHANG Zhuhui;WANG Yipei;ZHU Ying(Guangdong Second Provincial Traditional Chinese Medicine Hospital(Huangpu Hospital),Guangzhou 510530,Guangdong,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,Hunan,China;The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,Hunan,China)
出处
《湖南中医杂志》
2022年第11期10-14,23,共6页
Hunan Journal of Traditional Chinese Medicine
基金
湖南省中医药科研计划项目(2020043)。
关键词
腹泻型肠易激综合征
肝郁脾虚
加味痛泻要方
穴位埋线
diarrhea-predominant irritable bowel syndrome
stagnation of liver Qi and spleen deficiency
modified Tongxieyaofang
acupoint thread-embedding therapy
