摘要
目的:观察全国名老中医药专家张继泽教授创制的疏肝安肠汤治疗肝郁脾虚型腹泻型肠易激综合征(Diarrhea-type Irritable Bowel Syndrome,IBS-D)的疗效。方法:16例肝郁脾虚型IBS-D患者口服疏肝安肠汤,每次200 mL,一日2次,6周为一个疗程。观察患者治疗前后临床症状、疾病疗效、中医证候、血清脑肠肽等指标。结果:治疗第2周时,疾病总有效率为68.75%(11/16),中医证候总有效率为56.25%(9/16)。治疗第6周时,疾病总有效率为100%,中医证候总有效率为100%。患者血清5-羟色胺(5-hydroxytryptamine,5-HT)、促肾上腺皮质激素释放因子(Corticotropin-releasing Factor,CRF)较治疗前下降(P<0.05),神经肽Y(Neuropeptide-Y,NPY)较治疗前上升(P<0.05),血清P物质(Substance-P,SP)、胆囊收缩素(Cholecystokinin,CCK)、降钙素基因相关肽(Calcitonin Gene Related Peptide,CGRP)、血管活性肠肽(Vasoactive Intestinal Peptide,VIP)治疗前后的差异无统计学意义(P>0.05)。结论:疏肝安肠汤治疗IBS-D起效快,1个疗程(6周)后疾病总有效率高,中医证候(泄泻、情绪异常、食欲下降、肠鸣、腹痛、腹胀)改善明显,明确了疏肝安肠汤对于“肝郁”(情绪异常)、“脾虚”(泄泻、食欲下降)的核心疗效。通过检测治疗前后血清脑肠肽的变化,认为其作用机制可能与调节脑肠肽5-HT、CRF、NPY的水平有关。
Objective:To observe the therapeutic effect of the Shugan Anchang decoction(疏肝安肠汤)created by Professor ZHANG Jize,a famous TCM expert,on diarrhea-predominant irritable bowel syndrome with liver depression and spleen deficiency.Methods:A total of 16 cases of diarrhea-predominant irritable bowel syndrome were treated with the Shugan Anchang decoction,which was taken orally,200 mL each time,twice a day.6 weeks was a course of treatment.Clinical symptoms,clinical curative effect,TCM syndromes and serum brain-gut peptides were observed before and after treatment.Results:After 2 weeks of treatment,the total efficiency of disease was 68.75%(11/16),and the total efficiency of TCM syndrome was 56.25%(9/16).After 6 weeks of treatment,both the total efficiency of disease and TCM syndrome were 100%.The serum levels of 5-hydroxytryptamine(5-HT)and corticotropin-releasing factor(CRF)were decreased compared with those before treatment(P<0.05).The serum levels of Neuropeptide Y(NPY)were higher than before treatment(P<0.05).There was no significant difference in serum substance P(SP),cholecystokinin(CCK),calcitonin gene related peptide(CGRP)and vasoactive intestinal peptide(VIP)before and after treatment(P>0.05).Conclusion:The Shugan Anchang decoction is effective in the treatment of diarrhea-predominant irritable bowel syndrome,and the total efficiency of disease after 6 weeks is high.TCM syndromes(diarrhea,emotional abnormality,appetite,borborygmus,loss of abdominal pain,abdominal distension)are improved significantly than before treatment.The core curative effect of the Shugan Anchang decoction on“liver depression”(emotional abnormality)and“spleen deficiency”(diarrhea and loss of appetite)is clarified.The mechanism may be related to the regulation of brain-gut peptides by detecting the changes of serum brain-gut peptides.
作者
周玉宏
李述捷
万凌峰
张继泽
ZHOU Yuhong;LI Shujie;Wan Lingfeng;ZHANG Jize
出处
《中医临床研究》
2022年第27期61-64,共4页
Clinical Journal Of Chinese Medicine
基金
江苏省高层次卫生人才“六个一工程”拔尖人才项目(LGY2017077)
江苏省中医药局-中国中医科学院江苏分院开放课题专项资金资助项目(FY201703)
国家中医药管理局全国名老中医药专家张继泽传承工作室项目(国中医药人教发[2015])。
关键词
疏肝安肠汤
肠易激综合征
腹泻
名老中医
The Shugan Anchang decoction
Irritable bowel syndrome
Diarrhea
Distinguished veteran doctors of TCM
