本文關(guān)鍵詞： 通腑寬中湯 耳穴貼壓 功能性便秘 脾虛氣滯證 臨床研究　出處：《山東中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察中藥通腑寬中湯聯(lián)合耳穴貼壓治療功能性便秘(脾虛氣滯證)的臨床療效,探討其臨床優(yōu)勢及安全性,為推廣安全易行、低廉經(jīng)濟、簡便有效的中醫(yī)藥療法提供依據(jù)。方法:按診斷標準,納入90例病例,隨機分為3組。綜合組30例,給予通腑寬中湯,日一劑,并配合耳穴貼壓;中藥組30例,給予通腑寬中湯,日一劑;西藥組30例,給予乳果糖(杜密克)口服,一次1袋,一天2次,治療療程均為4周,收集三組治療前后臨床綜合療效、中醫(yī)癥狀療效評分、焦慮抑郁評分、便秘生活質(zhì)量評分,運用SPSS17.0軟件對數(shù)據(jù)進行統(tǒng)計分析。結(jié)果:1.臨床綜合療效比較,綜合組、中藥組、西藥組的總有效率分別為93.3%、86.7%、76.7%,綜合組總有效率明顯高于中藥組和西藥組,三組間臨床綜合療效經(jīng)秩和檢驗后,P0.05,有統(tǒng)計學(xué)意義。2.便秘主要癥狀積分比較,治療后三組均能改善便秘癥狀,但綜合組和中藥組在改善排便間隔時間、排便時間、不盡感方面效果明顯優(yōu)于西藥組(P0.01或P0.05),且在排便時間、不盡感方面綜合組優(yōu)于中藥組(P0.05);在改善糞便性狀、難易程度方面三組無明顯差異(P0.05)。3.便秘次要癥狀積分比較,治療后綜合組和中藥組在改善便秘乏力、氣短、倦怠懶言、腹脹、脅肋脹痛、食少納呆、焦慮抑郁、噯氣、腸鳴矢氣、舌象方面均優(yōu)于西藥組(P0.01或P0.05),且在改善腹脹、脅肋脹痛、焦慮抑郁、噯氣方面綜合組優(yōu)于中藥組(P0.05);在其余方面三組無明顯差異(P0.05)。4.焦慮、抑郁自評量表評分比較,綜合組和中藥組治療前后SAS、SDS評分比較,均有明顯差異(P0.01或P0.05);西藥組治療前后SAS、SDS評分比較,無統(tǒng)計學(xué)差異(P0.05)。綜合組與中藥組治療后SAS、SDS評分組間比較,綜合組優(yōu)于中藥組(P0.05)。說明綜合組在改善患者焦慮、抑郁情緒方面優(yōu)于中藥組、西藥組。5.生活質(zhì)量問卷評分比較,綜合組和中藥組治療前后便秘生活質(zhì)量評分比較,均有明顯差異(P0.01或P0.05);西藥組治療前后便秘生活質(zhì)量評分比較,無統(tǒng)計學(xué)差異(P0.05)。綜合組與中藥組治療后便秘生活質(zhì)量評分組間比較,綜合組優(yōu)于中藥組(P0.05)。說明綜合組在改善便秘生活質(zhì)量方面優(yōu)于中藥組、西藥組。結(jié)論:通腑寬中湯聯(lián)合耳穴貼壓治療功能性便秘(脾虛氣滯證)療效確切,可以更好地改善患者便秘癥狀、便秘生活質(zhì)量、焦慮抑郁情緒。
[Abstract]:Objective: to observe the clinical effect of Tongfu Kuanzhong decoction combined with auricular point plaster on functional constipation (spleen deficiency qi stagnation syndrome), and to explore its clinical advantages and safety. Methods: according to the diagnostic criteria, 90 cases were randomly divided into 3 groups. 30 cases in the comprehensive group were treated with Tongfu Kuanzhong decoction, one dose per day, combined with auricular point pressing, 30 cases in the traditional Chinese medicine group, 30 cases in the traditional Chinese medicine group, 30 cases in the treatment group, 30 cases in the control group, 30 cases in the control group. In the western medicine group, 30 cases were given lactulose (Dumik) orally, 1 bag once, 2 times a day, the course of treatment was 4 weeks. Anxiety and depression score, constipation quality of life score, using SPSS17.0 software for statistical analysis of the data. Results: 1. Clinical comprehensive efficacy comparison, comprehensive group, traditional Chinese medicine group, The total effective rate of the western medicine group was 93.3g / 86.7and 76.77.The total effective rate of the combined group was significantly higher than that of the traditional Chinese medicine group and the western medicine group. The clinical comprehensive efficacy of the three groups was significantly higher than that of the traditional Chinese medicine group and the western medicine group (P 0.05) after rank sum test, which had statistical significance .2.Compared with the main symptoms of constipation. After treatment, the symptoms of constipation were improved in the three groups, but the effects of the combined group and the Chinese medicine group in improving the defecation interval, defecation time and feeling were obviously better than those in the western medicine group (P0.01 or P0.05), and the defecation time was better in the combined group and the traditional Chinese medicine group. There was no significant difference among the three groups in improving fecal traits and easy degree of feces. The scores of secondary symptoms of constipation were compared. After treatment, the comprehensive group and the traditional Chinese medicine group improved constipation fatigue, shortness of breath, burnout and abdominal distension. The symptoms of hypochondriac pain, low food intake, anxiety and depression, belching, sagittal qi and tongue appearance were better than those of western medicine group (P0.01 or P0.05), and could improve abdominal distension, flank pain, anxiety and depression. In terms of belching, the comprehensive group was better than the traditional Chinese medicine group (P 0.05), but there was no significant difference among the other three groups (P 0.05). The scores of anxiety and depression self-rating scale (SAS) were compared, and the scores of SAS SDS before and after treatment were compared between the comprehensive group and the traditional Chinese medicine group. There was no significant difference in SDS scores between the western medicine group and the traditional Chinese medicine group before and after treatment (P 0.01 or P 0.05). The comprehensive group was better than the traditional Chinese medicine group in improving the anxiety of the patients. The scores of quality of life questionnaire before and after treatment were significantly different between the comprehensive group and the traditional Chinese medicine group (P 0.01 or P 0.05), and the quality of life score before and after treatment in the western medicine group was higher than that in the traditional Chinese medicine group (P 0.01 or P 0.05), while in the western medicine group, the quality of life score before and after treatment was higher than that in the western medicine group. There was no statistical difference (P 0.05). The comprehensive group was superior to the traditional Chinese medicine group in improving the constipation quality of life in the improvement of constipation quality of life between the comprehensive group and the traditional Chinese medicine group (P 0.05), which indicated that the comprehensive group was better than the traditional Chinese medicine group in improving the constipation quality of life. Conclusion: the treatment of functional constipation (spleen deficiency qi stagnation syndrome) with Tongfu-Kuanzhong decoction combined with auricular point plaster can improve the constipation symptoms, constipation quality of life and anxiety and depression.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R256.35

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