本文選題：柴胡疏肝散 + 臍敷��； 參考：《北京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：近年來由于諸多方面因素的影響,功能性便秘的發(fā)病率在全球范圍內(nèi)逐年上升,而目前西醫(yī)治療方法存在著相對局限且副作用大,遠(yuǎn)期療效較差等方面的問題,本研究旨在觀察柴胡疏肝散加減合臍敷(通便貼)治療功能性便秘的遠(yuǎn)期療效,并探索其用藥時間長短對功能性便秘的遠(yuǎn)期療效的影響,為中醫(yī)治療功能性便秘提供新的思路。方法：1選取符合試驗(yàn)標(biāo)準(zhǔn)的64例患者,均為2015年01月至2015年12月在北京中醫(yī)藥大學(xué)東直門醫(yī)院消化科門診就診的病例,隨機(jī)分為觀察組和對照組,每組均為32例,其中觀察組2例失訪,最終療效評價30例；對照組3例失訪,最終療效評價29例。共觀察59例便秘患者的遠(yuǎn)期療效,兩組患者年齡、性別、病程、治療前癥狀總積分等方面的比較無顯著性差異(P0.05),具有可比性。2對照組使用柴胡疏肝散加減聯(lián)合通便貼臍敷治療。觀察組在對照組的基礎(chǔ)上延長其用藥時間。中藥主方為柴胡疏肝散加減而成,具體藥物組成：北柴胡15g,炒枳殼15g,白芍10g,陳皮l0g,炙香附l0g,川芎l0g,川楝子15g,醋莪術(shù)l0g,酒大黃6g,生甘草6g(北京康仁堂藥業(yè)有限公司生產(chǎn)的免煎顆粒,每日一劑,分2次口服)。通便貼(由大黃、木香、紫蘇梗、薄荷組成,為北京康仁堂藥業(yè)有限公司生產(chǎn)的免煎顆粒,按6：3：1：0.6的比例配成,取適量以黃酒調(diào)成膏狀裝于貼敷膜中)神闕穴位貼敷,每日1次,每次2h。觀察組療程為4周,對照組療程為2周,兩組治療結(jié)束后統(tǒng)計(jì)療效。治療期間均給予一般治療包括合理飲食,增加膳食纖維,良好的生活習(xí)慣,心身調(diào)護(hù)。3采用SPSS20.0統(tǒng)計(jì)軟件分析,對計(jì)量資料符合正態(tài)分布方差齊性組內(nèi)采用配對t檢驗(yàn),組間采用獨(dú)立t檢驗(yàn),對不符合正態(tài)分布方差齊性采用非參數(shù)檢驗(yàn),計(jì)數(shù)資料采用X2檢驗(yàn),P0.05為差異顯著,有統(tǒng)計(jì)學(xué)意義。結(jié)果：兩組患者便秘癥狀總分及各單項(xiàng)癥狀包括排便間隔時間、排便速度、糞便性狀、排便不盡感、排便難度、腹脹、腹痛、暖氣、納差、腸鳴、煩躁易怒評分在治療結(jié)束時及結(jié)束1周、4周、8周時均較治療前均有明顯降低。其中兩組在治療結(jié)束時及治療結(jié)束1周、4周、8周時便秘遠(yuǎn)期癥狀總分、排便間隔時間評分、糞便性狀評分、排便難度評分、排便不盡感評分、腹脹評分及納差評分有顯著性差異(P0.05),觀察組明顯低于對照組；兩組的排便速度評分、暖氣評分、腸鳴評分、煩躁易怒評分方面在治療結(jié)束1周、4周有顯著性差異(P0.05),觀察組明顯低于對照組,但在治療結(jié)束8周,兩組之間無顯著性差異(P0.05)；腹痛評分在治療結(jié)束1周、4周和8周時,兩組之間無顯著性差異(P0.05)。結(jié)論：1柴胡疏肝散加減合臍敷(通便貼)總體治療效果是顯著的,其療效隨時間的推移而持續(xù)發(fā)揮作用,遠(yuǎn)期療效較好。2柴胡疏肝散加減合臍敷(通便貼)用藥時間的長短對于維持遠(yuǎn)期療效有非常重要的影響,用藥4周療程的遠(yuǎn)期療效優(yōu)于用藥2周療程。
[Abstract]:Objective: due to the influence of many factors, the incidence of functional constipation has been increasing year by year in the world in recent years. The purpose of this study was to observe the long term curative effect of Chaihu Shugan San plus subtractive umbilical compress (defecation plaster) in the treatment of functional constipation, and to explore the influence of the duration of medication on the long term curative effect of functional constipation, and to provide a new way of thinking for the treatment of functional constipation in traditional Chinese medicine. Methods from January 2015 to December 2015, 64 patients who met the test criteria were randomly divided into observation group (n = 32) and control group (n = 32) in Dongzhimen Hospital, Beijing University of traditional Chinese Medicine. There were 2 cases in the observation group, 30 cases in the final curative effect evaluation, 3 cases in the control group, 29 cases in the final curative effect evaluation. The long-term effect of 59 patients with constipation was observed. There was no significant difference in age, sex, course of disease and total score of symptoms before treatment between the two groups. The treatment time of the observation group was prolonged on the basis of the control group. The main prescription of traditional Chinese medicine is Chaihu Shugan Powder added or subtracted. Specific drug composition: North Bupleurum 15g, fried Fructus Aurantii 15g, Radix Paeoniae Alba 10g, Chen Pei 10g, broiled Rhizoma Cassiae l0g, Chuanxiong 10g, Chuanxiong 10g, Zedoary Curcuma 10g, Wine rhubarb 6g, Licorice 6g (Beijing Kangrentang Pharmaceutical Industry Co., Ltd.) Tongbian paste (composed of rhubarb, wood incense, perilla pedicel, mint, for the non-fried granules produced by Beijing Kangrentang Pharmaceutical Co., Ltd., according to the ratio of 6: 3: 1: 0.6, apply appropriate amount of rice wine to paste and mount in the film) the Shenque Point Application, once a day, Each time is 2 hours. The course of treatment was 4 weeks in the observation group and 2 weeks in the control group. During the course of treatment, general treatment including reasonable diet, increasing dietary fiber, good living habits, psychosomatic nursing. 3 was analyzed by SPSS20.0 statistical software, and matched t test was used in the group with homogeneity of variance of normal distribution of metrological data. Independent t test was used among groups, nonparametric test was used for homogeneity of variance of nonconforming normal distribution, and X2 test was used for counting data. Results: the total score and individual symptoms of constipation in both groups included defecation interval, defecation speed, fecal traits, defecation, defecation difficulty, abdominal distension, abdominal pain, heating, anorexia, bowel ringing. The scores of irritability and irritability were significantly lower at the end of treatment and at the end of 1 week and 4 weeks and 8 weeks than before treatment. In the two groups, the long-term symptom score, defecation interval score, fecal trait score, defecation difficulty score and defecation sensation score were evaluated at the end of treatment and at the end of 1 week and 4 weeks and 8 weeks after treatment. There was significant difference in abdominal distension score and anorexia score between the two groups (P 0.05), and the observation group was significantly lower than the control group, and the defecation velocity score, warm air score and bowel pain score were significantly lower in the observation group than in the control group. The scores of irritability and irritability in the treatment group were significantly lower than those in the control group at the end of 1 week and 4 weeks, but there was no significant difference between the two groups at the end of 8 weeks, and the abdominal pain score was at the end of 1 week, 4 weeks and 8 weeks after treatment. There was no significant difference between the two groups (P 0.05). Conclusion the overall therapeutic effect of Chaihu Shugan Powder plus subtraction and umbilical compress (defecation plaster) is remarkable, and its effect continues to play an important role with the passage of time. The long term curative effect is better. 2 the time of treatment of chaihu Shugan powder plus subtractive umbilical compress (defecation plaster) is very important to maintain the long term curative effect. The long term curative effect of 4 weeks treatment course is better than that of 2 weeks treatment course.
【學(xué)位授予單位】：北京中醫(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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