本文選題：麥門冬湯合增液承氣湯　切入點(diǎn)：肺腸同治　出處：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：研究目的:評價麥門冬湯合增液承氣湯加味“肺腸同治”治療阿片類藥物所致陰虛便秘的的臨床療效和安全性,探討阿片類藥物所致陰虛便秘的治療方法,為中醫(yī)藥治療阿片類藥物所致陰虛便秘提供新思路和新方法。研究方法:采用臨床研究的方法,以隨機(jī)對照法進(jìn)行臨床研究,設(shè)立樣本診斷標(biāo)準(zhǔn),納入標(biāo)準(zhǔn),排除標(biāo)準(zhǔn)及中止臨床試驗(yàn)標(biāo)準(zhǔn)。觀察云南省中醫(yī)醫(yī)院(2015年12月至2016年12月)住院及門診病人63例,治療組31例,對照組32例,治療組:麥門冬湯合增液承氣湯加味(由云南省中醫(yī)醫(yī)院煎藥室煎藥機(jī)煎制,一劑煎2袋,150ml/袋)日一劑,早晚各一次,1次1袋)。對照組:聚乙二醇4000散(10g*10袋(福松),博福-益普生制藥有限公司,10g,2次/天,水沖服)。分別記錄兩組治療前、治療后的便秘評分、中醫(yī)證候評分、疼痛評分(NRS評分)、生活質(zhì)量評分(KPS評分),評價療效并做統(tǒng)計學(xué)分析。研究結(jié)果:1.在改善阿片類藥物所致陰虛便秘的便秘癥狀上,兩組在便秘總療效上對比無統(tǒng)計學(xué)差異(P0.05),治療組和對照組對改善阿片類藥物所致的陰虛便秘療效基本相同;兩組各項(xiàng)便秘癥狀評分治療前后對比,均P0.01,具有顯著統(tǒng)計學(xué)差異,兩組治療后各項(xiàng)便秘癥狀評分對比,均P0.05,無統(tǒng)計學(xué)差異,提示兩組均能顯著改善各項(xiàng)便秘癥狀(排便時間間隔、糞便性質(zhì)、排便費(fèi)力程度、排便不盡感、排便直腸梗阻感/阻塞感),且療效基本相同。2.在改善阿片類藥物所致陰虛便秘的中醫(yī)證候上,兩組在中醫(yī)證候總療效上對比具有顯著統(tǒng)計學(xué)差異(P0.01),治療組在改善阿片類藥物所致陰虛便秘的中醫(yī)證候上優(yōu)于對照組。治療組各項(xiàng)中醫(yī)證候評分治療前后對比,除形體消瘦P0.05,無統(tǒng)計學(xué)差異,其余各項(xiàng)中醫(yī)證候評分均P0.01,具有顯著統(tǒng)計學(xué)差異,提示除形體消瘦外,治療組能顯著改善使用阿片類藥物所致陰虛便秘引起的頭暈、耳鳴、失眠、潮熱盜汗、腰膝酸軟、五心煩熱。而對照組各項(xiàng)中醫(yī)證候評分治療前后對比,均P0.05,無統(tǒng)計學(xué)差異,提示對照組治療前后各項(xiàng)中醫(yī)證候無明顯改善;兩組中醫(yī)證候單項(xiàng)評分治療后對比,除形體消瘦、失眠外,P0.05,無統(tǒng)計學(xué)差異,其余各項(xiàng),均P0.05,具有統(tǒng)計學(xué)差異,提示治療組在改善頭暈、耳鳴、潮熱盜汗、膝膝酸軟、五心煩熱上優(yōu)于對照組。3.在改善患者疼痛(NRS評分)上,兩組治療前后比較均無統(tǒng)計學(xué)差異(P0.05),說明兩組治療前后疼痛控制情況無明顯變化,提示兩組對阿片類藥物止痛作用無明顯影響。4.在改善患者生存質(zhì)量(KPS評分)上,治療組治療前后比較有統(tǒng)計學(xué)差異(P0.05),提示治療組用藥后生活質(zhì)量較前顯著提高。對照組治療前后對比無統(tǒng)計學(xué)差異(P0.05),提示對照組用藥前后患者生活質(zhì)量無明顯變化;兩組治療后比較,有顯著統(tǒng)計學(xué)差異(P0.01),提示治療組優(yōu)于對照組。5.在各項(xiàng)安全性指標(biāo)觀察內(nèi)容上,治療組和對照組治療前后對比無統(tǒng)計學(xué)差異(P0.05),提示兩組均有良好的安全性。結(jié)論:麥門冬湯合增液承氣湯加味方可有效緩解因使用阿片類藥物引起的陰虛便秘,并可顯著改善除形體消瘦外的中醫(yī)證候(頭暈、耳鳴、失眠、潮熱盜汗、腰膝酸軟、五心煩熱),提高患者生活質(zhì)量。
[Abstract]:Objective: To evaluate the Hezeng Maimendong Decoction fluid Chengqi Decoction "lung intestine" in the treatment of opioid induced constipation due to yin deficiency of the clinical efficacy and safety, to explore the methods of treatment of opioid induced constipation due to yin deficiency, provide treatment of opioid induced constipation due to yin deficiency of new ideas and new methods for TCM research. Methods: the clinical study, clinical study with randomized method, setting up the sample diagnostic criteria, inclusion criteria, exclusion criteria and standards for clinical trials suspended. To observe the traditional Chinese Medicine Hospital of Yunnan province (December 2015 to December 2016) 63 inpatients and outpatients, 31 cases in the treatment group, 32 cases in the control group, the treatment group: Maimendong Decoction Hezeng fluid Chengqi Decoction (Decoction by the office of the Yunnan Provincial Hospital of traditional Chinese medicine decocting machine for frying, frying a dose of 2 bags, 150ml/ bags) a day, sooner or later each time, 1 times 1 bags). The control group: polyethylene glycol 4000 powder (10g*10 bag (Fu Song) , Beaufour lpsen Pharmaceutical Co. Ltd, 10g, 2 times / day). The water flushes the clothing in two groups were recorded before treatment, after treatment of constipation score, TCM syndrome score, pain score (NRS score), quality of life score (KPS score), curative effect evaluation and do statistical analysis. Results: 1. in the improvement of opioid induced constipation due to yin deficiency constipation symptoms, two groups in the total curative effect on constipation compared no significant difference (P0.05), the treatment group and the control group of yin deficiency constipation improved efficacy of opioid induced constipation is basically the same; the two groups the symptom score were compared before and after treatment, P0.01, significant statistical differences between two groups after the treatment of the symptoms of constipation score comparison, P0.05, no significant difference, suggesting that the two groups can significantly improve the symptoms of constipation (defecation interval, stool properties, defecation, defecation imcompletely, bowel obstruction, rectal obstruction /), TCM syndrome and the curative effect is basically the same as.2. in improving opioid induced constipation due to yin deficiency, two groups in the total curative effect of TCM syndrome compared with significant difference (P0.01), TCM treatment group in improving opioid induced constipation due to yin deficiency than those in the control group. The treatment group before and after comparison in addition to the treatment of TCM syndrome score, emaciation P0.05, no significant difference, the rest of the TCM syndrome scores of P0.01, the difference was statistically significant, suggesting that in addition to emaciation, the treatment group can significantly improve the use of opioid induced constipation due to yin deficiency caused by dizziness, tinnitus, insomnia, night sweats, hot flashes, Yaoxisuanruan, five tired of heat. While the control group before and after comparison, the TCM syndrome score in the treatment of P0.05, no significant difference, suggesting that the control of the TCM syndrome has no obvious improvement group before and after treatment were compared between the two groups; single TCM syndrome score after treatment In addition, emaciation, insomnia, P0.05, no significant difference, the rest of the P0.05, are, statistically, suggesting that the treatment group in improving dizziness, tinnitus, hot flashes, night sweats, knee knees, Fanre than the control group.3. in improving the pain (NRS score), the two groups before and after treatment were compared no statistical difference (P0.05), that pain control had no obvious change before and after treatment in two groups, two groups of opioid analgesic effect had no obvious effect in improving the quality of life of patients.4. (KPS score), the treatment group before and after treatment were statistically significant difference (P0.05), the treatment group after treatment compared with the quality of life the control group increased significantly. Compared before and after treatment showed no significant difference (P0.05), suggesting that the quality of life in patients with no significant changes in control group before and after treatment; the two groups after treatment, there was statistically significant difference (P0.01), the treatment group than in control group. 5. to observe the content in the security index, treatment group and control group before and after treatment compared with no significant difference (P0.05), suggesting that the safety of two groups were good. Conclusion: Maimendong Decoction Hezeng Chengqi Decoction liquid can effectively relieve constipation due to yin deficiency caused by the use of opioids, and can significantly improve the TCM in addition to the syndrome of emaciation (dizziness, tinnitus, insomnia, night sweats, hot flashes, Yaoxisuanruan, five upset hot), improve the quality of life of patients.

【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R256.35

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