摘要
目的评价肠宁方治疗腹泻型肠易激综合征(IBS-D)肝郁脾虚证患者的临床疗效及安全性。方法将74例IBS-D患者随机分为治疗组和对照组各37例,治疗组予自拟肠宁方煎服治疗,每日1剂。对照组予匹维溴铵片每次50 mg,每日3次口服治疗,两组疗程均为4周。于治疗2周、4周后对腹痛及腹泻应答率进行评估;比较治疗前后肠易激综合征严重程度量表(IBS-SSS)积分及中医证候积分,并判定IBS-SSS疗效及中医证候疗效;观察治疗前后安全性指标,记录不良事件。结果治疗4周治疗组患者腹泻应答率(77. 14%)及腹痛应答率(82. 86%)均明显高于对照组(分别为54. 55%及60. 61%)(P <0. 05)。治疗组治疗4周后IBS-SSS总有效率(82. 86%)高于对照组(60. 61%)(P <0. 05)。中医证候疗效治疗组总有效率(88. 57%)高于对照组(60. 61%)(P <0. 01)。两组患者治疗后腹泻、腹痛、急躁易怒、两胁胀满、纳呆食少、腹胀、肠鸣的单项积分较治疗前均明显下降(P <0. 05),治疗组患者治疗后腹痛、腹泻及急躁易怒积分明显低于对照组(P <0. 05)。两组患者安全指标治疗后均未见明显改变。结论肠宁方治疗IBS-D肝郁脾虚证疗效优于匹维溴铵片,可有效缓解腹痛、腹泻症状,改善患者整体病情及肝郁脾虚证候,安全性好。
Objective To evaluate the clinical efficacy and safety of Changning Recipe(肠宁方)in the treatment of diarrhea-type irritable bowel syndrome(IBS-D)of liver stagnation and spleen deficiency pattern.Methods A total of 74 patients with IBS-D were randomly divided into a treatment group and a control group,with 37 cases in each group.The treatment group was treated with self-made Changning Recipe,1 dose per day.The control group received oral administration of Pivaviron tablets 50 mg each time,3 times a day for 4 weeks.The response rates of abdominal pain and diarrhea were evaluated after 2 weeks and 4 weeks of treatment.The IBS-SSS scores and traditional Chinese medicine(TCM)syndrome scores were compared before and after treatment,and the efficacy of TCM syndrome and IBS-SSS were determined.The safety indicators before and after treatment were observed,and the adverse events were recorded.Results The diarrhea response rate(77.14%)and abdominal pain response rate(82.86%)in the treatment group were significantly higher than those in the control group(54.55%and 60.61%,respectively)(P<0.05).The total effective rate of IBS-SSS(82.86%)in the treatment group after 4 weeks of treatment was higher than that in the control group(60.61%)(P<0.05).The total effective rate of the TCM syndrome treatment group(88.57%)was higher than that of the control group(60.61%)(P<0.01).The single symptom scores of diarrhea,abdominal pain,irritability,distention and fullness in both sides of the chest,poor appetite,bloating,and borborygmus were significantly decreased in both groups after treatment(P<0.05).The scores of abdominal pain,diarrhea and irritability in the treatment group was significantly lower than that of the control group(P<0.05).There was no significant change in the safety indicators of both groups after treatment.Conclusion Changning Recipe is better than Pivobium bromide in the treatment of IBS-D of liver stagnation and spleen deficiency pattern.It can effectively relieve the symptoms of abdominal pain and diarrhea,improve
作者
翁棉伟
陈一斌
曹健
WENG Mianwei;CHEN Yibin;CAO Jian(People's Hospital of Zhongshan City,Guangdong528400;Xiamen Hospital of Traditional Chinese Medicine,Fujian Province)
出处
《中医杂志》
CSCD
北大核心
2019年第19期1663-1667,共5页
Journal of Traditional Chinese Medicine
基金
福建省名老中医专家传承工作室项目(2018WYN021)
关键词
腹泻型肠易激综合征
肠宁方
肝郁脾虚证
罗马Ⅳ标准
diarrhea-type irritable bowel syndrome
Changning Recipe(肠宁方)
liver stagnation and spleen deficiency syndrome
RomeⅣ
