本文選題：腹瀉型腸易激綜合征 + 疏肝健脾�。� 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察疏肝健脾法(代表方四逆散合痛瀉要方加味)治療腹瀉型腸易激綜合征的臨床療效,并探討其對腸道菌群的影響。方法:選取腹瀉型腸易激綜合征患者63例,按隨機(jī)分為治療組33例和對照組30例。治療組給予四逆散合痛瀉要方加味,對照組給予匹維溴銨,患者服藥一個療程,四周為一療程,觀察第四周治療后癥狀和總有效率,并采取隨機(jī)數(shù)字表法選取治療組10例觀察治療前后腸道菌群情況。結(jié)果:1.第4周,治療組與對照組兩組患者各癥狀較治療前有明顯改善,治療組總有效率為96.97%,對照組總有效率為80.00%,治療組與對照組相比較,P0.05,有統(tǒng)計學(xué)意義。2.癥狀評分方面,腹痛不適、大便次數(shù)、大便性狀、排便急迫感等評分,治療組與對照組第4周比較P0.05,有統(tǒng)計學(xué)意義,提示治療組在第4周排便次數(shù)、大便性狀上療效優(yōu)于匹維溴銨對照組。余癥狀評分方面,治療組與對照組第4周中,組間差異均為P0.05,無統(tǒng)計學(xué)意義。3.兩組患者治療后焦慮量化評分均數(shù)比較,P0.05,具有統(tǒng)計學(xué)意義。兩組患者治療后抑郁量化評分均數(shù)比較,P0.05,無統(tǒng)計學(xué)意義。提示治療組關(guān)于焦慮方面的療效優(yōu)于匹維溴銨對照組。4.改善腸道菌群(大腸桿菌、乳酸桿菌、雙歧桿菌)方面,治療組菌群在治療前后各配對樣品P0.01,差異具有統(tǒng)計學(xué)意義,且治療后B/E1。結(jié)論:本次臨床研究顯示,四逆散合痛瀉要方加味治療腹瀉型腸易激綜合征,能改善患者腹痛、腹脹、排便次數(shù)、大便性狀、排便急迫感等臨床癥狀及情志方面有積極的影響意義;并對腸道菌群中大腸桿菌、乳酸桿菌、雙歧桿菌有正向的影響。四逆散合痛瀉要方加味組各項療效優(yōu)于匹維溴銨組,用藥過程中未發(fā)現(xiàn)不良反應(yīng),四逆散合痛瀉要方加味治療腹瀉型腸易激綜合征安全、有效,疏肝健脾法的治療思維值得進(jìn)一步研究。
[Abstract]:Objective: to observe the clinical effect of Shugan Jianpi method on diarrhea irritable bowel syndrome (IBS) and its effect on intestinal flora. Methods: 63 cases of diarrhea irritable bowel syndrome were randomly divided into treatment group (n = 33) and control group (n = 30). The treatment group was treated with Sini San and Tongxieyao decoction, while the control group was given piveronium bromide. The patients took a course of treatment and four weeks were a course of treatment. The symptoms and the total effective rate were observed after the fourth week of treatment. The intestinal flora of 10 patients in the treatment group was observed before and after treatment by random digital table. The result is 1: 1. At the 4th week, the symptoms of the treatment group and the control group were obviously improved. The total effective rate of the treatment group was 96.977.The total effective rate of the control group was 80.00.The treatment group was significantly better than the control group (P 0.05). Symptoms score, abdominal pain and discomfort, defecation times, defecation traits, defecation urgency, and so on, the treatment group compared with the control group in the 4th week P0.05, there was statistical significance, suggesting that the treatment group in the 4th week defecation times, The effect of defecation was better than that of control group. The scores of residual symptoms in the treatment group and the control group in the 4th week, the difference between the groups were P0.05, there was no statistical significance. 3. There was significant difference between the two groups in the mean of anxiety score after treatment (P 0.05). There was no significant difference between the two groups (P 0.05). The results suggest that the effect of anxiety in the treatment group is better than that in the control group. 4. In terms of improving intestinal flora (E. coli, Lactobacillus, Bifidobacterium), there was a significant difference between the two groups before and after treatment (P0.01), and the B / E1 after treatment. Conclusion: this clinical study shows that the treatment of diarrhea irritable bowel syndrome with Sini San combined with Tongxiexiyao decoction can improve the abdominal pain, abdominal distension, defecation times and defecation traits. Defecation urgency and other clinical symptoms and emotional aspects have a positive impact on intestinal flora Escherichia coli, Lactobacillus, Bifidobacterium has a positive effect. The curative effect of Sini San combined with Tongxie Youfang Jiawei group was better than that of piveronium bromide group, and no adverse reaction was found in the course of medication. Sini San combined with Tongxiexiyao recipe was safe and effective in the treatment of diarrhea irritable bowel syndrome. The therapeutic thinking of soothing liver and invigorating spleen is worthy of further study.
【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】：R259

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本文編號：2070541