【摘要】：目的本研究旨在通過理論和臨床兩個方面對烏梅丸的組方配伍及治療作用進行系統(tǒng)研究,觀察烏梅丸治療寒熱錯雜型慢性腹瀉的臨床療效及安全性,為中醫(yī)藥防治寒熱錯雜型慢性腹瀉提供科學依據(jù)。方法本研究選擇2015年6月至2016年8月間就診于武漢市中西醫(yī)結(jié)合醫(yī)院消化內(nèi)科門診和住院患者64例,其中治療組32例,脫落1例,對照組32例,脫落3例,均符合中醫(yī)寒熱錯雜型慢性腹瀉診斷,并對患者個人信息、病情資料作詳細記錄。兩組患者在年齡、性別、病程及癥狀等方面無統(tǒng)計學差異,具有可比性(P0.05)。治療組給予中藥烏梅丸湯劑(每日1劑,早晚兩次,飯后30分鐘口服)治療。對照組給予思密達(每次3g,每日2次,兩餐之間口服)治療。兩組患者療程均為6周,同時囑患者本次治療期間忌食辛辣、油膩、生冷等刺激性食物,不可服用其他與本病治療相關(guān)或?qū)Ρ敬沃委熡杏绊懙闹形麽t(yī)藥物,并適量運動,避免情緒波動;每周隨診一次,詳細記錄患者病情變化情況,若患者出現(xiàn)不良反應則及時停止服藥,并對癥處理。兩組患者治療前后均進行生命體征測定、(血液、糞便、尿液)常規(guī)、肝腎功能及十二導心電圖檢查,對安全性進行評價;采取調(diào)查問卷的方式,通過癥狀分數(shù),對臨床療效進行評價。結(jié)果1.近期療效:治療6周后,治療組31例,臨床治愈7例,顯效13例,有效8例,無效3例,總有效率為90.32%;對照組29例,臨床治愈6例,顯效11例,有效9例,無效3例,總有效率為89.66%,兩組比較,無明顯統(tǒng)計學差異(P0.05)。2.遠期療效:治療結(jié)束后4周,治療組31例,臨床治愈8例,顯效12例,有效8例,無效3例,總有效率90.32%;對照組29例,臨床治愈4例,顯效9例,有效11例,無效5例,總有效率82.76%。兩組比較,治療組高于對照組,組間差異具有統(tǒng)計學意義(P0.05)。3.安全性:兩組患者在治療過程中均未出現(xiàn)明顯不良反應或并發(fā)癥。兩組藥物治療后,對患者生命體征、(血液、糞便、尿液)常規(guī)、肝腎功能及十二導心電圖檢查均無明顯影響。結(jié)論1.寒熱錯雜證是慢性腹瀉的重要證型,脾胃氣機升降失常是寒熱錯雜型慢性腹瀉的基本病機。2.辛開苦降法是治療寒熱錯雜型慢性腹瀉的治療大法,烏梅丸是治療寒熱錯雜型慢性腹瀉的有效方劑。3.烏梅丸治療寒熱錯雜型慢性腹瀉的遠期療效明顯優(yōu)于思密達,而且在臨床使用中安全可靠,無明顯不良反應,具有較高的臨床應用價值。
[Abstract]:Objective To systematically study the compatibility and therapeutic effect of Wumei Pills in theory and clinic, and to observe the clinical efficacy and safety of Wumei Pills in the treatment of cold-heat mixed chronic diarrhea. Sixty-four outpatients and inpatients in the Department of Gastroenterology of Wuhan Integrated Traditional Chinese and Western Medicine Hospital were treated during the month. Among them, 32 patients in the treatment group, 1 patient in the abscission group, 32 patients in the control group and 3 patients in the abscission group, all accorded with the diagnosis of chronic diarrhea of mixed cold and heat in traditional Chinese medicine. The treatment group was treated with Wumei Pill Decoction (1 dose daily, twice in the morning and evening, 30 minutes after meals). The control group was treated with Smecta (3 g each time, twice daily, oral between meals). The two groups of patients were treated for 6 weeks. At the same time, patients were instructed not to eat spicy, greasy, cold and other stimulations during the treatment. Sexual foods should not be taken with other Chinese and Western medicines related to the treatment of the disease or have an impact on the treatment of this time, and appropriate exercise to avoid emotional fluctuations; weekly follow-up, a detailed record of the patient's condition changes, if patients have adverse reactions, promptly stop taking drugs, and symptomatic treatment. Results 1. Short-term efficacy: After 6 weeks of treatment, 31 cases in the treatment group, 7 cases were clinically cured, 13 cases were markedly effective, 8 cases were effective, 3 cases were ineffective, the total effective rate was 90.32%; The total effective rate was 89.66%. There was no significant difference between the two groups (P 11 cases, 5 cases ineffective, the total effective rate was 82.76%. Comparing the two groups, the treatment group was higher than the control group, the difference was statistically significant (P 0.05). 3. Safety: There were no obvious adverse reactions or complications in the course of treatment in both groups. Conclusion 1. Cold-heat syndrome is an important type of chronic diarrhea, and abnormal ascending and descending of Spleen-stomach Qi is the basic pathogenesis of cold-heat mixed type of chronic diarrhea. 2. Xinkai Bitter-descending Method is a great method for treating cold-heat mixed type of chronic diarrhea, and Wumei Pill is an effective prescription for treating cold-heat mixed type of chronic diarrhea.3. Wumei Pill is an effective prescription for treating cold-heat mixed type of chronic diarrhea. The long-term effect of treating cold-heat mixed chronic diarrhea is obviously better than smecta, and it is safe and reliable in clinical use, without obvious adverse reactions, and has high clinical application value.
【學位授予單位】：湖北中醫(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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