本文選題：腸易激綜合征　切入點：痛瀉要方　出處：《成都中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：采用痛瀉要方加減聯(lián)合穴位注射治療肝郁脾虛腹瀉型腸易激綜合征患者,并評價痛瀉要方加減聯(lián)合穴位注射的臨床療效。方法：采用隨機對照研究方法,將符合診斷標準及納入標準的60例腹瀉型腸易激綜合征(肝郁脾虛證)患者,按其就診順序隨機分為治療組和對照組,分別30例。治療組采用痛瀉要方加減水煎口服,并聯(lián)合藥物穴位注射進行治療；對照組采用匹維溴銨口服,每次50mg,每日3次,同時采用金雙歧口服,每次4片,每日3次；兩組均輔以飲食調(diào)理、心理治療,以兩周為一個療程,共兩個療程。兩個療程后觀察兩組治療前后臨床療效、中醫(yī)證候積分、主要癥狀單項療效、HAMA、HAMD評分及不良反應(yīng)的出現(xiàn)情況,并運用統(tǒng)計學軟件進行分析比較。結(jié)果：1.臨床總體療效評價：治療組與對照組總有效率分別為93.33%、66.67%,差異有統(tǒng)計學意義(P0.05),治療組總體療效優(yōu)于對照組。2.治療前后中醫(yī)癥候總積分比較：治療前,兩組癥候總積分對比無統(tǒng)計學差異(P0.05),具有可比性。治療后,兩組中醫(yī)癥候總積分均較治療前明顯減少(P0.01),治療組癥候總積分明顯低于對照組(P0.01),統(tǒng)計學差異顯著。3.治療前后各單項癥狀癥候積分比較：治療前,治療組與對照組各單項癥狀癥候積分無統(tǒng)計學差異,具可比性。治療后,治療組排便次數(shù)增多、便溏不爽、腹痛欲瀉、脅肋脹痛、情緒抑郁或急躁、失眠等癥狀較對照組有明顯差異(P0.01、P0.05),提示治療組在以上癥狀的療效方面明顯優(yōu)于對照組；對照組腹脹、腸鳴矢氣、食少納呆等癥狀的癥候積分與治療組相比差異無統(tǒng)計學意義(P0.05),提示兩組在腹脹、腸鳴矢氣、食少納呆的治療上療效相當。4.治療前后HAMA、HAMD評分比較：兩組HAMA、HAMD評分于治療前相比具可比性(P0.05),而治療后,其評分均較之前顯著降低(P0.01),尤以治療組降低明顯。結(jié)論：兩組治療方法均能有效改善腹瀉型腸易激綜合征(肝郁脾虛證)患者的臨床癥狀,治療組的癥狀改善程度、范圍優(yōu)于對照組,證明口服痛瀉要方聯(lián)合穴位注射治療腹瀉型腸易激綜合征(肝郁脾虛證)療效顯著,且中藥加穴位注射治療是一種不良反應(yīng)少、療效可靠的綜合治療方法。
[Abstract]:Objective: to treat the patients with irritable bowel syndrome of liver stagnation and spleen deficiency diarrhea by adding and subtracting Tongxieyao recipe and acupoint injection, and to evaluate the clinical effect of Tongxieyoufang plus or subtraction combined with acupoint injection. Methods: a randomized controlled study was carried out. Sixty patients with diarrhea irritable bowel syndrome (liver depression and spleen deficiency syndrome) were randomly divided into treatment group and control group. In the control group, 50 mg of piveronium, 3 times a day, 4 tablets of gold bifid, 3 times a day, were given orally, and the two groups were treated with diet and psychotherapy. Two weeks were used as a course of treatment for two courses of treatment. After two courses of treatment, the clinical efficacy, TCM syndromes score, main symptom single curative effect and the occurrence of adverse reactions were observed. The total effective rate of treatment group and control group was 93.33 and 66.67 respectively, the difference was statistically significant (P 0.05). The overall curative effect of treatment group was better than that of control group. 2. Before and after treatment, the total effective rate of traditional Chinese medicine was better than that of control group (P < 0.05). Total symptom score comparison: before treatment, There was no statistical difference in the total score of symptoms between the two groups (P 0.05), which was comparable. The total score of TCM symptoms in the two groups was significantly lower than that before treatment, and the total score of symptoms in the treatment group was significantly lower than that in the control group (P 0.01), the statistical difference was significant. 3. Comparison of the scores of each single symptom before and after treatment: before and after treatment, There was no statistical difference between the treatment group and the control group in the scores of individual symptoms and symptoms. After treatment, the number of defecation in the treatment group increased, and the loose stools, abdominal pain and diarrhea, flank pain, emotional depression or impatience, The symptoms of insomnia were significantly different from those of the control group, indicating that the curative effect of the treatment group was obviously better than that of the control group, the abdominal distension and the sagittal qi of the intestine in the control group were better than those in the control group. There was no significant difference in symptom score between the treatment group and the treatment group, suggesting that the two groups were in abdominal distension, bowel ringing and sagittal qi. The therapeutic efficacy of the two groups was similar. 4. Comparison of Hamah Hamd scores before and after treatment: the Hama Hamd scores in the two groups were comparable to those before and after treatment (P 0.05), but after treatment, there was no significant difference between the two groups. The scores were significantly lower than those before, especially in the treatment group. Conclusion: both treatment methods can effectively improve the clinical symptoms of diarrhea irritable bowel syndrome (liver depression and spleen deficiency syndrome), and the treatment group can improve the degree of symptoms. The range is superior to the control group, which proves that the treatment of diarrhea type irritable bowel syndrome (liver-stagnation and spleen deficiency syndrome) by oral Tongxieyao recipe combined with acupoint injection is effective, and the Chinese medicine plus acupoint injection therapy is a kind of comprehensive treatment method with less adverse reactions and reliable curative effect.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.1

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