四逆汤加味联合督脉灸治疗“纯阴结”便秘型肠易激综合征临床研究

发布时间：2017-12-26 21:04

本文关键词：四逆汤加味联合督脉灸治疗“纯阴结”便秘型肠易激综合征临床研究　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本课题着重探究临床中应用经方四逆汤加味联合督脉灸治疗"纯阴结"便秘型肠易激综合征的临床疗效,验证经方配合中医外治其可行性及科学性,进一步为中医内外结合治疗"纯阴结"便秘肠易激综合征提供临床理论指导。方法:选取符合纳入标准,经排除标准筛选的患者70例,随机分为治疗组(35例),对照组(35例),治疗组有1例脱落,对照组2例脱落,两组病例均进行调整生活起居,改善饮食结构,适当运动等一般治疗,在一般治疗基础上治疗组加予四逆汤加味联合中医外治督脉灸治疗,方中中药饮片由龙岩市中医院统一购买,并煎煮成200ml袋装中药汤剂,每次1袋,每日2次,分早晚温服,依据患者症状变化和个体差异情况调整中药饮片用量,并联合督脉灸(患者俯卧床上,充分暴露后背,在督脉大椎穴至腰俞穴范围铺上一层纱布,将事先捣成泥状的生姜平铺于督脉上,将纯艾绒沿督脉长轴平铺于姜泥上,点燃艾绒即可,施灸者不可离开,以防烫伤。督脉灸全程中,简便、易行。每周1次,每次1.5-2小时)。对照组在一般治疗基础上给予乳果糖口服液(Abbott Healthcare Products B.V.生产),每次1OmL,口服,每天3次;两组均治疗4周为1疗程,共观察1个疗程。治疗结束后3个月时对两组患者进行回访;观察两组治疗前后及回访时患者临床症状体征方面的变化,比较并评价两组的治疗疗效。结果:1.基线资料差异性比较:两组患者在性别、年龄、病程、症状体征等方面经统计学处理,无显著性差异,具有可比性(P0.05)。2.经过4周的治疗,治疗组与对照组在临床疗效改善方面差异明显,具有统计学意义(P0.05);在大便干结、排便频率症状改善方面两组并无显著差异(P0.05),在排便困难、腹痛、腹胀、四肢不温等症状方面两组均有显著差异(P0.05),且治疗组优于对照组(P0.05);3.在远期疗效方面,治疗组优于对照组,差异有统计学意义(P0.05);4.治疗组予对照组对血、尿、粪常规+OB及肝肾功能等方面均无明显影响。结论:经方四逆汤加味联合督脉灸为治疗"纯阴结"便秘型肠易激综合征的有效中医内外治联合方法,能显著改善患者的临床症状体征、中医症候,远期疗效良好,无明显不良反应。
[Abstract]:Objective: This paper focuses on exploring the clinical curative effect of four inverse decoction combined with Du moxibustion in the treatment of "pure Yin" constipation irritable bowel syndrome clinical application of classical prescriptions in the treatment of the feasibility and scientific verification prescription combined with traditional Chinese medicine, further for TCM internal and external treatment of "pure Yin" constipation irritable bowel syndrome with clinical guidance. Methods: the criteria, 70 cases were excluded by standard screening patients, randomly divided into treatment group (35 cases) and control group (35 cases), the treatment group had 1 cases to fall off, the control group of 2 cases off, two cases were adjusted to daily life, improve diet, exercise and other general treatment on the basis of the general treatment, treatment group were treated with four inverse decoction combined with external treatment of traditional Chinese medicine Du moxibustion in Chinese herbal medicine purchasing by Longyan Hospital of Traditional Chinese Medicine, and decocted into 200ml bagged decoction, 1 bag each time, 2 times a day, morning and evening clothes, on the basis of patient symptoms and changes of amount of individual differences in adjustment of Chinese herbal medicine and, combined with Moxibustion (DU patients prone to bed, fully exposed in the back, Du Dazhui to Yaoshu range covered with a layer of gauze, will advance mashed ginger tile to Du, pure moxa long axis along the Du channel tile to ginger, ignite moxa You can not leave the moxibustion, in order to prevent scald. Du moxibustion process, simple and easy. 1 times a week, each time 1.5-2 hours). The control group was given lactulose oral liquid (Abbott Healthcare Products B.V. production) on the basis of general treatment, each time 1OmL, orally, 3 times a day. The two groups were treated for 4 weeks for 1 courses, a total of 1 courses were observed. After 3 months of treatment, two groups of patients were followed up. The clinical symptoms and signs of two groups before and after treatment were observed, and the therapeutic effects of the two groups were compared and evaluated. Results: 1. baseline data difference comparison: two groups of patients in gender, age, course of disease, symptoms and signs and other aspects of statistical processing, no significant difference, comparable (P0.05). 2. after 4 weeks of treatment, the treatment group and the control group in improving clinical curative effect difference was statistically significant (P0.05); there is no difference between the two groups was significantly improved in dry stool, defecation frequency of symptoms (P0.05), significant differences between the two groups in terms of difficult defecation, abdominal pain, abdominal distension, limbs cold and other symptoms (P0.05), and the treatment group than the control group (P0.05); 3. in the long-term curative effect, the treatment group than the control group, the difference was statistically significant (P0.05); 4. in the treatment group were given to the control group had no obvious effect on blood, urine and stool routine +OB and kidney function etc.. Conclusion: TCM prescription effective four inverse decoction combined with moxibustion for treatment of "pure Yin Du knot constipation type irritable bowel syndrome and treatment method, can significantly improve the patient's clinical symptoms, TCM syndrome, the long-term curative effect is good, no obvious adverse reaction.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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