【摘要】：目的:系統(tǒng)評(píng)價(jià)參苓白術(shù)散治療腹瀉型腸易激綜合征的有效性安全性及觀察參苓白術(shù)散治療腹瀉型腸易激綜合征臨床療效。方法:1.系統(tǒng)評(píng)價(jià)部分:運(yùn)用系統(tǒng)評(píng)價(jià)方法,檢索參苓白術(shù)散治療腹瀉型腸易激綜合征的隨機(jī)對(duì)照試驗(yàn),篩選合格研究,評(píng)價(jià)研究質(zhì)量,應(yīng)用國(guó)際循證醫(yī)學(xué)協(xié)作網(wǎng)提供的統(tǒng)計(jì)軟件Revman5.3統(tǒng)計(jì)數(shù)據(jù),應(yīng)用Jadad評(píng)分法進(jìn)行質(zhì)量評(píng)價(jià)。臨床按試驗(yàn)措施的不同分亞組對(duì)所收集數(shù)據(jù)進(jìn)行異質(zhì)性檢驗(yàn)和Meta-分析。2.臨床研究部分:選擇觀察對(duì)象共60例,隨機(jī)分為試驗(yàn)組和對(duì)照組,試驗(yàn)組30例,對(duì)照組30例。試驗(yàn)組給予參苓白術(shù)散水煎劑;對(duì)照組給予匹維溴銨片合培菲康膠囊,4周為一療程。一療程后觀察臨床療效。結(jié)果:1.系統(tǒng)評(píng)價(jià)部分:經(jīng)篩選最終納入18項(xiàng)研究,共1446例,根據(jù)試驗(yàn)措施不同分為兩組,結(jié)果顯示參苓白術(shù)散在治療D-IBS臨床總有效率、臨床癥狀總積分、腹痛、腹瀉方面的療效均優(yōu)于對(duì)照組,均有統(tǒng)計(jì)學(xué)意義和臨床意義且無(wú)嚴(yán)重不良反應(yīng)。上述結(jié)果說明參苓白術(shù)散加減治療D-IBS較為安全可靠,為臨床用藥提供了參考。2.臨床研究部分:臨床綜合療效方面,實(shí)驗(yàn)組總有效率96.7%,對(duì)照組總有效率86.7%,試驗(yàn)組總有效率高于對(duì)照組,經(jīng)分析,兩組存在顯著性差異(P0.05),在臨床綜合療效改善方面試驗(yàn)組優(yōu)于對(duì)照組。試驗(yàn)組與對(duì)照組比較,證候總積分比較有顯著差異(P0.05),說明在中醫(yī)證候總積分改善方面,試驗(yàn)組優(yōu)于對(duì)照組。結(jié)論:1.通過系統(tǒng)評(píng)價(jià)分析參苓白術(shù)散加減能提高D-IBS的臨床療效,但由于本系統(tǒng)評(píng)價(jià)納入研究質(zhì)量低且樣本量小,藥物安全性不明確,尚需高質(zhì)量隨機(jī)對(duì)照試驗(yàn)進(jìn)一步評(píng)價(jià)。2.臨床研究表明參苓白術(shù)散治療腹瀉型腸易激綜合征優(yōu)于匹維溴銨片合培菲康膠囊。
[Abstract]:Aim: to evaluate the efficacy and safety of Shenling Baizhu Powder in the treatment of diarrhea irritable bowel syndrome and to observe the clinical efficacy of Shenling Baizhu Powder in the treatment of diarrhea irritable bowel syndrome. Methods: 1. In the part of systematic evaluation, the randomized controlled trials of Shenling Baizhu Powder in the treatment of diarrhea irritable bowel syndrome were searched, qualified studies were screened, and the quality of the study was evaluated. The Revman5.3 statistical data provided by the International Collaborative Network for evidence-based Medicine (EBM) were used to evaluate the quality by using the Jadad scoring method. Clinical heterogeneity test and Meta- analysis of collected data according to different subgroups of trial measures. 2. Clinical study: 60 cases were randomly divided into experimental group and control group, 30 cases in experimental group and 30 cases in control group. The experimental group was given Shenling Baizhu powder decoction, and the control group was given Peiwei ammonium bromide tablet and Peifeikang capsule for 4 weeks as a course of treatment. The clinical curative effect was observed after a course of treatment. Results: 1. In the part of systematic evaluation: 1446 cases were divided into two groups according to different test measures. The results showed that Shenling Baizhu powder was effective in the treatment of D-IBS, the total score of clinical symptoms, abdominal pain, and total score of clinical symptoms, and the results showed that Shenling Baizhu powder was effective in the treatment of D-IBS. The curative effect of diarrhea was better than that of control group, with statistical and clinical significance and no serious adverse reaction. The above results indicate that Shenling Baizhu Powder is safe and reliable in the treatment of D-IBS, which provides a reference for clinical use of drugs. 2. Clinical research part: the clinical comprehensive curative effect aspect, the experimental group total effective rate is 96.7%, the control group total effective rate is 86.7%, the experimental group total effective rate is higher than the control group, through the analysis, the two groups have significant difference (P0.05), The experimental group was superior to the control group in the improvement of clinical comprehensive curative effect. Compared with the control group, there was significant difference between the experimental group and the control group (P0.05), which indicated that the experimental group was better than the control group in the improvement of the total integral of TCM syndrome. Conclusions: 1. Through the systematic evaluation and analysis of Shenling Baizhu Powder can improve the clinical efficacy of D-IBS, but due to the low quality and small sample size of this system evaluation study, drug safety is not clear, it needs to be further evaluated by high-quality randomized controlled trial. 2. Clinical studies show that Shenling Baizhu Powder is superior to Pivoxil tablets in the treatment of diarrhea-type irritable bowel syndrome.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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