本文選題：膽囊切除術(shù)后腹瀉(PCD) + 肝郁脾虛　； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:觀察驗(yàn)方抑肝扶脾湯治療肝郁脾虛型膽囊切除術(shù)后腹瀉(PCD)的臨床療效及其對(duì)改善患者生活質(zhì)量的影響,探討驗(yàn)方抑肝扶脾湯的作用機(jī)理和特點(diǎn),為PCD的診療提供依據(jù)和積累經(jīng)驗(yàn)。方法:采用平行對(duì)照的臨床試驗(yàn)設(shè)計(jì)方法,選擇符合肝郁脾虛型膽囊切除術(shù)后腹瀉標(biāo)準(zhǔn)的患者60例,隨機(jī)分為治療組和對(duì)照組,每組各30例。治療前在性別、年齡和癥狀輕重等方面,實(shí)驗(yàn)組與對(duì)照組應(yīng)具有可比性。治療組予口服中藥煎劑,中藥煎劑為徐進(jìn)康導(dǎo)師經(jīng)驗(yàn)方,對(duì)照組予口服雙歧三聯(lián)活菌膠囊聯(lián)合硫糖鋁片。兩組均以4周為1個(gè)療程,連續(xù)治療2個(gè)療程,觀察兩組在治療前后癥狀及生活質(zhì)量改善情況。結(jié)果:(1)臨床療效比較:治療組與對(duì)照組均有較好的臨床療效,治療組效果更明顯,比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。在主癥大便次數(shù)、糞質(zhì)改變上兩組治療均有效,治療組效果明顯,比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);在次癥腸鳴、腹痛腹脹方面,兩組均有療效,但治療組與對(duì)照組比較無(wú)優(yōu)越性,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);在次癥脘腹痞滿方面,兩組都有療效,但試驗(yàn)組療效更佳,對(duì)比存在統(tǒng)計(jì)學(xué)差異(P0.05);在食欲不振、暖氣方面,治療組能很好地緩解癥狀,而對(duì)照組治療前后無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)PCD與生活質(zhì)量相關(guān)性比較:疾病臨床癥候總評(píng)分與生活質(zhì)量量表總評(píng)分成正相關(guān)(0r1),治療組在緩解PCD患者臨床癥狀、提高生活質(zhì)量方面效果明顯優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:驗(yàn)方抑肝扶脾湯能明顯緩解肝郁脾虛型膽囊切除術(shù)后腹瀉患者排便次數(shù)多、腹痛、痞滿等臨床癥狀,并能減輕患者消極情緒,提高患者生活質(zhì)量,臨床綜合療效好。
[Abstract]:Objective: to observe the clinical effect of Yigan Fu spleen decoction in treating diarrhea after cholecystectomy with liver stagnation and spleen deficiency and its effect on improving the quality of life of patients, and to explore the mechanism and characteristics of the effect of Yigan Fu spleen decoction. To provide the basis and accumulated experience for the diagnosis and treatment of PCD. Methods: 60 patients with diarrhea after cholecystectomy with liver stagnation and spleen deficiency were randomly divided into treatment group and control group with 30 cases in each group. Before treatment, the sex, age and severity of symptoms should be comparable between the experimental group and the control group. The treatment group was treated with oral Chinese medicine decoction, the traditional Chinese medicine decoction was Xujinkang tutor's experience prescription, and the control group was given orally bifidobacterium triple viable bacteria capsule combined with sucralfate tablet. The two groups were treated with 4 weeks as a course of treatment and 2 consecutive courses of treatment. The improvement of symptoms and quality of life was observed before and after treatment in both groups. Results comparison of clinical efficacy: treatment group and control group have better clinical effect, treatment group is more obvious, the difference is statistically significant (P 0.05). The two groups were effective in the number of major bowel movements and the change of fecal quality, the effect of the treatment group was obvious, the difference was statistically significant (P 0.05), the two groups had curative effect on the secondary bowel pain and abdominal distention, but the treatment group had no superiority compared with the control group. The difference was not statistically significant (P 0.05); in terms of epigastric fullness, both groups had curative effects, but the experimental group had a better curative effect, and there was a statistical difference between the two groups (P 0.05). In terms of loss of appetite and warm air, the treatment group was able to relieve symptoms very well. In the control group, there was no statistical significance before and after treatment. There was no significant correlation between P0.05 PCD and quality of life: the total score of disease clinical symptoms was positively correlated with the total score of quality of life scale (QOL), and the treatment group was relieving the clinical symptoms of PCD patients. The effect of improving the quality of life was obviously better than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: Yigan Fu spleen decoction can relieve the clinical symptoms of diarrhea after cholecystectomy with liver stagnation and spleen deficiency, such as more defecation times, abdominal pain and fullness, and can relieve the negative emotion of the patients, improve the quality of life of the patients, and the clinical comprehensive curative effect is good.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

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