【摘要】：目的：觀察生白術(shù)潤腸湯治療肺脾氣虛型功能性便秘的臨床有效性及安全性。方法：從2014年5月至2015年10月在武漢市中西醫(yī)結(jié)合醫(yī)院中醫(yī)部李恩寬名醫(yī)工作室門診就診的患者中,選取符合要求的48例患者,采用隨機(jī)分組法隨機(jī)分為兩組,治療組和對照組各24例。治療組給予經(jīng)驗(yàn)效方生白術(shù)潤腸湯(方藥組成：生白術(shù)100g、黃芪30g、黨參30g、生地20g、升麻6g、陳皮10g),對照組給予乳果糖口服液治療,5日為1療程,治療4療程,隨訪4周,觀察兩組治療前后便秘癥狀、中醫(yī)癥候積分、復(fù)發(fā)率等指標(biāo)改變情況,比較兩種方案對肺脾氣虛型功能性便秘的治療效果。結(jié)果：1、臨床總體療效評價：兩組用藥均能改善功能性便秘臨床癥狀,治療組臨床療效的有效率高于對照組,差異有統(tǒng)計(jì)學(xué)意義。2、持續(xù)穩(wěn)定性療效：療程結(jié)束后隨訪4周,治療組復(fù)發(fā)率低于對照組,二者之間有統(tǒng)計(jì)學(xué)差異,表明治療組中藥湯劑持續(xù)穩(wěn)定性好。3、單項(xiàng)癥狀療效：便秘癥狀改善方面,兩組患者大便性狀、排便頻率、排便時間等觀察指標(biāo)癥狀總積分較治療前均有所下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其中中藥治療組在改善排便頻率、排便時間、排便不盡感及阻塞感、腹脹腹痛等觀察指標(biāo)方面優(yōu)于西藥對照組(P0.05),差異有統(tǒng)計(jì)學(xué)意義。在改善大便性狀、排便困難指數(shù)方面與對照組相當(dāng),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。中藥治療組對氣短、自汗、便后乏力、神疲懶言等中醫(yī)癥候觀察指標(biāo)改善優(yōu)于西藥對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論：生白術(shù)潤腸湯治療功能性便秘,中醫(yī)辨證屬肺脾氣虛證的患者有明顯的療效,不僅可以明顯改善患者氣短、自汗、神疲乏力等中醫(yī)癥狀,且對大便性狀、排便頻率、排便時間、腹脹腹痛等便秘癥狀有不同程度的改善。從而提高了患者生活質(zhì)量,緩解了患者焦慮情緒。生白術(shù)潤腸湯為功能性便秘的治療提供了新的思路及方劑,是一種有效率高、穩(wěn)定性好,適合臨床廣泛使用的湯劑,值得進(jìn)一步深入研究和探討。
[Abstract]:Objective: to observe the clinical efficacy and safety of Shengzhu Runchang decoction in the treatment of functional constipation with deficiency of lung and spleen qi. Methods: from May 2014 to October 2015, 48 patients who met the requirements were randomly divided into two groups. There were 24 cases in the treatment group and 24 cases in the control group. The treatment group was given the experiential effect of Fang Sheng Baizhu Runchang decoction (prescription composition: 100 g of Atractylodes macrocephala, 30 g of Astragalus membranaceus, 30g of Codonopsis, 20g of Shengdi, 6g of Shengma, 10g of Chen Pei). The control group was treated with lactulose oral liquid, 5 days as a course of treatment, 4 courses of treatment, followed up for 4 weeks. To observe the changes of constipation symptom, TCM symptom score and recurrence rate before and after treatment, and to compare the therapeutic effect of the two schemes on functional constipation with deficiency of lung and spleen qi. Results: 1. Overall clinical efficacy evaluation: both groups were able to improve the clinical symptoms of functional constipation, the effective rate of clinical efficacy in the treatment group was higher than that in the control group, the difference was statistically significant. The effect of sustained stability was: follow up for 4 weeks after the end of the course of treatment. The recurrence rate of the treatment group was lower than that of the control group, and there was statistical difference between the two groups, which indicated that the treatment group had good stability of traditional Chinese medicine decoction, the curative effect of single symptom: the improvement of constipation symptom, the defecation character and defecation frequency of the two groups, The total score of observation indexes such as defecation time was lower than that before treatment, and the difference was statistically significant (P0.05). The Chinese medicine treatment group in improving defecation frequency defecation time defecation and obstruction feeling abdominal distention abdominal pain and other observation indicators than the western medicine control group (P0.05) the difference was statistically significant. In improving defecation traits, defecation difficulty index was similar to the control group, the difference was not statistically significant (P0.05). The improvement of TCM symptom observation index in TCM treatment group was better than that in western medicine control group (P0.01). Conclusion: the treatment of functional constipation with Shengbaizhu Runchang decoction has obvious curative effect on the patients with syndrome differentiation of deficiency of lung and spleen qi. It can not only obviously improve the symptoms of short breath, self-sweating, fatigue and so on, but also can improve the defecation character and defecation frequency. Defecation time, abdominal distention and abdominal pain and other constipation symptoms have different degrees of improvement. Thus, the quality of life of the patients was improved, and the anxiety of the patients was alleviated. Shengbaizhu Runchang decoction provides a new way of thinking and prescription for the treatment of functional constipation. It is a kind of decoction with high effective rate, good stability and suitable for wide clinical use. It is worthy of further study and discussion.
【學(xué)位授予單位】：湖北中醫(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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