本文選題：脾腎陽虛 + 功能性便秘�。� 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:觀察溫腎健脾法治療脾腎陽虛型功能性便秘的臨床療效及安全性。方法:1所選研究對(duì)象均來自于2015年5月~2016年10月,河北省中醫(yī)院肛腸門診確診為脾腎陽虛型功能性便秘的患者。2采用前瞻性臨床隨機(jī)對(duì)照的研究方法,將符合本研究納入標(biāo)準(zhǔn)的70例患者,隨機(jī)分為中藥組和對(duì)照組;中藥組35例用溫腎健脾法治療,對(duì)照組35例用聚乙二醇4000治療。中藥組脫落病例1例,對(duì)照組剔除病例1例,終止病例2例,最終參與統(tǒng)計(jì)分析患者共66例,治療組34例,對(duì)照組32例。療程均為4周,治療后隨訪1個(gè)月。3療程結(jié)束后對(duì)兩組病例治療前后主要癥狀消失率、次要癥狀消失率、癥狀總積分、中醫(yī)癥候療效、遠(yuǎn)期療效、安全性指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)分析,做出評(píng)價(jià)。4采用SPSS21.0統(tǒng)計(jì)學(xué)軟件對(duì)數(shù)據(jù)進(jìn)行分析。計(jì)量資料符合正態(tài)分布,表示為均數(shù)±標(biāo)準(zhǔn)差((?)±s),運(yùn)用t檢驗(yàn);不符合正態(tài)分布及方差齊性的運(yùn)用秩和檢驗(yàn);計(jì)數(shù)資料運(yùn)用c2檢驗(yàn)。以P0.05,表示兩組比較有統(tǒng)計(jì)學(xué)意義,具有可比性;以P0.01,表示兩組比較具有顯著性差異。結(jié)果:1經(jīng)統(tǒng)計(jì)學(xué)軟件分析,兩組病例年齡、性別、病程、病情輕重、治療前癥狀總積分無統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。2臨床癥狀的消失率:中藥組患者治療大便性質(zhì),腹中冷痛、喜溫,四肢不溫的消失率優(yōu)于聚乙二醇4000散(P0.05),而兩組患者在排便間隔,排便時(shí)間,排便困難,面色fD白,小便清長方面治療效果相當(dāng)。3臨床癥狀療效評(píng)價(jià):中藥組總有效率為94.12%,對(duì)照組總有效率81.25%,經(jīng)統(tǒng)計(jì)學(xué)分析,兩組總有效率對(duì)比有統(tǒng)計(jì)學(xué)意義(P0.05),提示中藥組在治療脾腎陽虛型功能性便秘療效上優(yōu)于對(duì)照組。4中藥組及對(duì)照組治療前后中醫(yī)癥狀總積比較P0.01,提示中藥組在中醫(yī)癥狀總積分方面治療后較治療前改善顯著。對(duì)照組P0.01,提示對(duì)照組患者在中醫(yī)癥候總積分方面治療后亦改善顯著。中藥組與對(duì)照組在治療后效果比較,經(jīng)秩和檢驗(yàn)P0.01,說明中藥組效果明顯優(yōu)于對(duì)照組,兩組治療后在中醫(yī)癥狀總積分方面存在顯著性差異。5兩組患者治療1個(gè)月隨訪,中藥組復(fù)發(fā)率為20%,對(duì)照組復(fù)發(fā)率為36.84%,P0.05,具有統(tǒng)計(jì)學(xué)意義,說明遠(yuǎn)期療效中藥組優(yōu)于對(duì)照組。6安全性分析:中藥組與對(duì)照組治療前后血常規(guī)、尿常規(guī)、便常規(guī)+潛血試驗(yàn)、肝功、腎功及心電圖等檢查未見明顯異常,所用中藥組(溫腎健脾法)及聚乙二醇4000治療脾腎陽虛功能性便秘未見明顯不良反應(yīng),具有安全性。結(jié)論:1溫腎健脾法能有效改善脾腎陽虛型功能性便秘患者的臨床癥狀。2溫腎健脾法治療脾腎陽虛型功能性便秘與聚乙二醇4000散比較,均能明顯改善其臨床癥狀,總有效率優(yōu)于對(duì)照組。3溫腎健脾法能有效改善脾腎陽虛型功能性便秘患者大便性質(zhì)及中醫(yī)癥候中的腹中冷痛、喜溫,四肢不溫等癥狀,其治療后總積分明顯優(yōu)于對(duì)照組。4溫腎健脾法治療脾腎陽虛型功能性便秘的遠(yuǎn)期療效好,復(fù)發(fā)率低,安全可靠,值得進(jìn)一步深入研究和探討。
[Abstract]:Objective: to observe the clinical efficacy and safety of warming kidney and invigorating spleen in the treatment of functional constipation with deficiency of spleen and kidney yang. Methods from May 2015 to October 2016, the patients with functional constipation of spleen and kidney yang deficiency type were selected from May 2015 to October 2016 in Hebei Provincial traditional Chinese Medicine Hospital. Seventy patients who met the criteria of this study were randomly divided into two groups: the Chinese medicine group (35 cases) and the control group (35 cases) treated with the method of warming the kidney and strengthening the spleen; the control group (35 cases) were treated with polyethylene glycol 4000 (PEG). There were 1 case of shedding in the Chinese medicine group, 1 case of elimination and 2 cases of termination in the control group. 66 cases were involved in the statistical analysis, 34 cases in the treatment group and 32 cases in the control group. The course of treatment was 4 weeks. After 1 month follow up for 1 month, the main symptoms disappeared rate, secondary symptom disappearance rate, symptom total score, TCM symptom curative effect, long-term curative effect, safety index before and after treatment in two groups were analyzed statistically. The data were analyzed by SPSS21.0 statistical software. The measured data accord with normal distribution, which is expressed as mean 鹵standard deviation) 鹵sg, using t test, using rank sum test for nonconforming normal distribution and homogeneity of variance, and using c2 test for counting data. The comparison between the two groups was statistically significant and comparable with P0.05, and the difference between the two groups was significant with P0.01. Results the age, sex, course of disease, severity of illness, total score of symptoms before treatment were not significantly different between the two groups by statistical software analysis, and the rate of disappearance of clinical symptoms was comparable. 2. The Chinese medicine group had the nature of stool treatment, the cold pain in abdomen, the rate of disappearance of clinical symptoms was comparable (P < 0.05). The disappearance rate of non-warm limbs was better than that of polyethylene glycol 4000 powder (P0.05A), and the defecation interval, defecation time, defecation difficulty, and fD white face between the two groups. The total effective rate of the traditional Chinese medicine group was 94.12, and the total effective rate of the control group was 81.255.The total effective rate was statistically analyzed. The total effective rate of the two groups was significantly higher than that of the control group (P 0.01), which indicated that the TCM group was superior to the control group (P 0.01) in the treatment of functional constipation with deficiency of spleen and kidney yang. The total symptom score was significantly improved after treatment than before treatment. P0.01 in the control group suggested that the total score of TCM symptoms in the control group also improved significantly after treatment. Compared with the control group, the effect of TCM group was significantly better than that of the control group by rank sum test (P0.01). There was significant difference in the total score of TCM symptoms between the two groups after treatment. 5 patients in the two groups were followed up for 1 month. The recurrence rate of TCM group was 20, and that of control group was 36.84g / P0.05, which showed that the long-term curative effect of TCM group was better than that of control group (P 0.05). The safety analysis of TCM group was superior to that of control group: blood routine, urine routine, routine occult blood test, liver function before and after treatment in Chinese medicine group and control group. There was no obvious abnormality in renal function and electrocardiogram. The treatment of functional constipation due to deficiency of spleen and kidney with traditional Chinese medicine (warming kidney and invigorating spleen) and polyethylene glycol 4000 was safe. Conclusion the method of warming kidney and invigorating spleen can effectively improve the clinical symptoms of patients with functional constipation with deficiency of spleen and kidney yang. 2 the treatment of functional constipation of deficiency of spleen and kidney yang by warming kidney and strengthening spleen with polyethylene glycol 4000 powder can obviously improve the clinical symptoms of functional constipation. The total effective rate was better than that of the control group. 3. The method of warming the kidney and strengthening the spleen could effectively improve the stool nature of the patients with functional constipation with deficiency of spleen and kidney yang and the symptoms of cold abdominal pain, warm-loving and unwarm limbs in the symptoms of traditional Chinese medicine, etc. The total score after treatment was obviously superior to that of control group (group 4) in the treatment of functional constipation with deficiency of spleen and kidney yang. The long-term curative effect was good, the recurrence rate was low, and the total score was safe and reliable, which was worthy of further study and discussion.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R256.35

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 徐秋霞;;溫針灸聯(lián)合濟(jì)川煎加減治療陽虛型便秘35例臨床觀察[J];湖南中醫(yī)雜志;2016年09期

2 李尚芝;彭柳青;雒莉芳;;針灸治療慢性功能性便秘的臨床療效研究[J];中國繼續(xù)醫(yī)學(xué)教育;2016年21期

3 李彥哲;;中醫(yī)對(duì)功能性便秘的分型與治療[J];大家健康(學(xué)術(shù)版);2015年11期

4 何豐華;劉玉姿;吳曄;梁莉婕;徐小曼;解則紅;;加減黃芪湯治療氣虛型老年功能性便秘的臨床研究[J];中藥材;2015年02期

5 彭軍良;陸金根;;陸金根教授重用生黃芪治療肛腸疾病的臨床經(jīng)驗(yàn)[J];中國中醫(yī)急癥;2015年01期

6 張瑛;傅睿;祝利民;王翰;陳杏麗;包向東;鄭建功;;益腎增液湯治療老年功能性便秘的中醫(yī)證候療效研究[J];中華中醫(yī)藥學(xué)刊;2014年11期

7 劉斌;王彥志;張萌;劉洋;;牛膝的化學(xué)成分及質(zhì)量標(biāo)準(zhǔn)研究進(jìn)展[J];河南中醫(yī);2014年11期

8 席作武;牛煜惠;;淺析“腸病治肺”療便秘[J];中國中醫(yī)基礎(chǔ)醫(yī)學(xué)雜志;2014年03期

9 陳飛;陳卓;邢雪飛;劉素香;張鐵軍;陳常青;;肉蓯蓉的研究進(jìn)展[J];藥物評(píng)價(jià)研究;2013年06期

10 劉雄;李成明;高建德;吳蓉;;肉蓯蓉的研究進(jìn)展[J];中國中醫(yī)藥科技;2013年05期

相關(guān)會(huì)議論文 前1條

1 吳至久;杜麗娟;劉芳;唐學(xué)貴;;唐學(xué)貴教授治療便秘經(jīng)驗(yàn)拾萃[A];2012醫(yī)學(xué)前沿——中華中醫(yī)藥學(xué)會(huì)肛腸分會(huì)第十四次全國肛腸學(xué)術(shù)交流大會(huì)論文精選[C];2012年

相關(guān)碩士學(xué)位論文 前3條

1 董玉杰;小柴胡湯加減治療腸道氣滯型功能性便秘的臨床觀察[D];北京中醫(yī)藥大學(xué);2014年

2 顧珈裔;三仁潤腸方治療慢傳輸型功能性便秘的臨床研究[D];北京中醫(yī)藥大學(xué);2013年

3 樸沼g，

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