本文選題：腹瀉型腸易激綜合征 + 腸復安��； 參考：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:觀察腸復安湯治療腹瀉型腸易激綜合征的臨床療效,通過癥狀量表評估各項癥狀改善情況和總體療效;運用超聲方法檢測IBS-D患者近端胃容積前后變化,觀察近端胃運動功能,以求證IBS-D的近端胃運動紊亂,并通過中藥治療前后及與對照組的比較,探討中藥對近端胃功能影響。方法:將符合條件的48例IBS患者隨機分為治療組和對照組,治療組、對照組各24例,予培菲康治療,治療組加用自擬方腸復安湯劑口服,治療療程6周。治療前、治療2周、4周、6周后分別予癥狀評分。兩組病患治療前后分別以超聲檢測近端胃容積。檢測方法是:檢查者空腹8小時以上,飲溫水500ml,即刻測量近端胃容積,記為V1,30min后再次測量胃容積,記為V2,近端胃排空分數計算公式EF=(V1-V2)/V1×100%。比較兩組治療前后的臨床療效及近端胃容積、排空分數變化,另選20例健康者,依上述方法測定近端胃容積值和近端胃排空分數,作為正常對照。結果:入組患者共48例,研究過程中對照組2例因家庭住址較遠回訪困難脫落,治療組1例因工作出差外地無法續(xù)服中藥,中止研究。最終共45例患者完成本次課題研究,進入數據統(tǒng)計分析。臨床療效結果顯示:治療組總有效率91.3%、愈顯率69.57%,對照組總有效率72.73%、愈顯率27.27%,治療組總體療效優(yōu)于對照組,兩組比較差異有統(tǒng)計學意義(P0.05);治療前后癥狀總積分比較,治療組、對照組均明顯低于治療前,差異有統(tǒng)計學意義(P0.01);治療后兩組癥狀積分比較,治療組低于對照組,差異有統(tǒng)計學意義(P0.01);治療組在腹痛、腹瀉、腹脹、多思多慮易緊張、納少脘痞這5項癥狀積分低于對照組,差異有統(tǒng)計學意義(P0.05)。近端胃運動觀察結果顯示:治療前,治療組和對照組近端胃排空分數均高于正常組,差異有統(tǒng)計學意義(P0.05);治療后,治療組和對照組近端胃排空分數分別與正常組比較,無統(tǒng)計學差異(P0.05),治療組與對照組之間亦無統(tǒng)計學差異(P0.05);治療組治療前后比較,P=0.0540.05,對照組治療前后比較,P=0.2760.05,差異均無統(tǒng)計學意義。結論:腸復安湯用于治療IBS-D能夠顯著提高臨床療效,可以很好地減輕IBS-D患者癥狀,同時對本病的情志異常亦有改善作用,說明中醫(yī)藥是治療IBS的有效方法。超聲液體觀察是胃運動功能檢測的重要方法,本次試驗通過該方法再次證實IBS-D的近端胃運動功能存在一定異常;治療后胃排空分數減低,但治療組與治療前及與對照組比較均未見統(tǒng)計學差異,未能證實中藥能改善上消化道運動紊亂,中藥治療IBS-D的作用機制仍需進一步探究。
[Abstract]:Objective: to observe the clinical effect of Changfuan decoction in treating diarrhea irritable bowel syndrome, to evaluate the improvement of symptoms and the overall curative effect by symptom scale, to detect the changes of proximal gastric volume in patients with IBS-D by ultrasonic method. The proximal gastric motility was observed in order to prove the proximal gastric motility disorder of IBS-D. The effects of traditional Chinese medicine on proximal gastric function were compared before and after treatment with traditional Chinese medicine (TCM) and compared with the control group. Methods: 48 patients with IBS were randomly divided into the treatment group and the control group, the treatment group and the control group (n = 24 each) were treated with Peifeikang, and the treatment group was treated with self-made Changfu an decoction orally for 6 weeks. Symptoms were scored before 2 weeks and 4 weeks and 6 weeks after treatment. The proximal gastric volume was measured by ultrasound before and after treatment. The test method was as follows: the examiner had fasting for more than 8 hours, drank warm water 500 ml, immediately measured the proximal gastric volume, and then remeasured the gastric volume after 30 minutes as V1: V2. The formula for calculating the proximal gastric emptying fraction was EF=(V1-V2)/V1 脳 100. The clinical efficacy and the changes of proximal gastric volume and emptying fraction were compared between the two groups before and after treatment. 20 healthy subjects were selected to measure the proximal gastric volume and proximal gastric emptying fraction as normal control. Results: there were 48 patients in the study group. In the course of the study, 2 cases in the control group had difficulty falling off due to their home address, and one case in the treatment group was unable to continue taking Chinese medicine because of work trip. Finally, a total of 45 patients completed the study and entered the statistical analysis of the data. The results showed that the total effective rate of the treatment group was 91.3%, the effective rate of the treatment group was 69.57, the total effective rate of the control group was 72.73 and the effective rate of the treatment group was 27.27. The overall curative effect of the treatment group was better than that of the control group, and the difference between the two groups was statistically significant (P 0.05). The scores of symptoms in the treatment group were significantly lower than those in the control group (P 0.01), and the difference was statistically significant in the treatment group (P < 0.01). The scores of these five symptoms were lower than those of the control group, and the difference was statistically significant (P 0.05). The results of proximal gastric motility observation showed that the scores of proximal gastric emptying in the treatment group and the control group were higher than those in the normal group before treatment, and the difference was statistically significant (P 0.05), and after treatment, the proximal gastric emptying fraction in the treatment group and the control group were compared with those in the normal group, respectively. There was no statistical difference between the treatment group and the control group, and there was no statistical difference between the treatment group and the control group, and there was no significant difference between the treatment group and the control group before and after treatment, and there was no significant difference between the treatment group and the control group before and after treatment. Conclusion: Changfuan decoction can significantly improve the clinical efficacy of IBS-D, can alleviate the symptoms of IBS-D patients, and improve the emotional abnormality of the disease, indicating that Chinese medicine is an effective method for the treatment of IBS. Ultrasonic fluid observation is an important method for detecting gastric motor function. This method has proved that the proximal gastric motility of IBS-D is abnormal, and the gastric emptying fraction is decreased after treatment. However, there was no statistical difference between the treatment group and the control group before treatment and compared with the control group. It was not proved that the Chinese medicine could improve the upper digestive tract movement disorder, and the mechanism of the treatment of IBS-D still needs to be further explored.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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