本文選題：腹瀉型腸易激綜合征 + 肝郁脾虛證　； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過運用痛瀉要方加味方治療腹瀉型腸易激綜合征(肝郁脾虛證)患者,并與西藥匹維溴銨進(jìn)行對照,觀察其對IBS-D患者臨床癥狀的改善情況,以客觀評價痛瀉要方加味方的療效,以便推廣其應(yīng)用。方法:選擇60例符合納入標(biāo)準(zhǔn)的IBS-D患者,將其隨機(jī)分為2組,治療組30例和對照組30例,以28天為一療程,治療1個療程,治療組采用加味方治療,對照組采用匹維溴銨50mg tid治療;通過問卷調(diào)查方式,記錄療程開始前及結(jié)束后受試者臨床癥狀積分,停藥1月后進(jìn)行隨訪,并觀察不良反應(yīng),比較兩組癥狀總積分、各項癥狀積分以及遠(yuǎn)期療效,客觀評估痛瀉要方加味方治療IBS-D的臨床效果。結(jié)果:1.綜合療效方面:治療4周后,治療組總有效率為93.33%,對照組為.66.67%,二者相比有統(tǒng)計學(xué)意義,說明在綜合療效方面治療組明顯優(yōu)于對照組;2.改善癥狀方面:主癥方面,治療組和對照組均能顯著改善大便次數(shù)、大便性狀、腹痛或者腹部不適、胸脅脹滿竄痛,且在改善這些癥狀方面均有較好的遠(yuǎn)期療效,除了在改善大便次數(shù)的遠(yuǎn)期療效上兩組療效相當(dāng),其余相比治療組療效均明顯優(yōu)于對照組;在次癥方面,兩組在改善腸鳴矢氣及腹脹上均有較好療效,對照組在改善便下粘液及情志抑郁或煩躁上療效不明顯,除了腹脹治療4周后以及腸鳴矢氣治療后的隨訪顯示兩組療效相當(dāng),在其他次要癥狀上治療組療效均明顯優(yōu)于對照組;3.遠(yuǎn)期療效方面:停藥1月后,治療組總有效率86.67%,對照組為53.33%,二者相比有統(tǒng)計學(xué)意義,說明在遠(yuǎn)期療效方面治療組明顯優(yōu)于對照組。由此可以得出結(jié)論,痛瀉要方加味方對改善IBS-D患者臨床癥狀療效顯著,并且具有良好的遠(yuǎn)期療效。
[Abstract]:Objective: to observe the improvement of clinical symptoms of IBS-D patients by using Tongxieyoufang Jiawei recipe to treat diarrhea irritable bowel syndrome (liver-stagnation and spleen deficiency syndrome), and to compare it with piveronium bromide, a western medicine. Objective to evaluate the curative effect of Tongxie Youfang Jiawei prescription in order to popularize its application. Methods: sixty patients with IBS-D were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with 50mg tid, the clinical symptom scores before and after the course of treatment were recorded by questionnaire, and the adverse reactions were observed and compared between the two groups. Objective to evaluate the clinical effect of Tongxie decoction Jiawei prescription in treating IBS-D. The result is 1: 1. Comprehensive curative effect: after 4 weeks of treatment, the total effective rate of the treatment group was 93.3333 and that of the control group was .66.67. there was statistical significance between the two groups, which indicated that the treatment group was obviously superior to the control group in the comprehensive curative effect. Improvement of symptoms: both the treatment group and the control group could significantly improve the number of defecation, defecation traits, abdominal pain or abdominal discomfort, chest and flank full of pain, and had good long-term effect in improving these symptoms, the treatment group and the control group were able to improve the number of defecation times, defecation traits, abdominal pain or abdominal discomfort. In addition to the long-term effect of improving the number of defecation, the two groups had the same curative effect, and the other two groups were obviously superior to the control group in the treatment group. In terms of secondary symptoms, both groups had better results in improving the bowel sagittal qi and abdominal distension. In the control group, there was no obvious effect on the improvement of mucus and mood depression or irritability, except for 4 weeks after abdominal distension treatment and after the treatment of bowel sagittal qi treatment, the two groups had the same curative effect, and the treatment group was obviously superior to the control group in other secondary symptoms. Long-term curative effect: after one month, the total effective rate of the treatment group was 86.67 and that of the control group was 53.33, which showed that the treatment group was obviously superior to the control group in the long-term curative effect. It can be concluded that Tongxieyoufang Jiawei prescription is effective in improving the clinical symptoms of IBS-D patients and has good long-term effect.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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