加味黄芪汤治疗气虚型老年功能性便秘的临床观察

发布时间：2017-12-31 03:39

本文关键词：加味黄芪汤治疗气虚型老年功能性便秘的临床观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的:本研究旨在观察加味黄芪汤治疗气虚型老年功能性便秘的临床疗效,并从理论和临床研究两个方面探讨加味黄芪汤治疗老年功能性便秘的机制,为中医治疗气虚型老年功能性便秘提供科学的依据。研究方法:本项研究对象均选取2014年9月-2015年12月武汉市中西医结合医院符合老年功能性便秘病证属气虚型诊断的门诊病人60例,其年龄在60-80周岁之间。对患者的一般情况和病情等详细记录,按照随机原则,分为治疗组和对照组,剔除脱落病例,治疗组26例,对照组24例,两组患者在性别、年龄、治疗前症状积分、病程等方面比较,无明显的统计学差异(P0.05)。治疗组给予口服加味黄芪汤的中药汤剂治疗,每日一剂,分早、中、晚三次于餐前30min口服;对照组单纯给予西药,莫沙必利5mg po tid,餐后30min口服,治疗期间患者忌生冷刺激食物并停用其他相关药物,疗程4周,采用问卷调查形式对患者在治疗后第一周、第二周、第三周、第四周的症状进行评分,运用SPSS 21.0软件进行统计分析,评价其疗效。研究结果:治疗4周后,治疗组26例,临床治愈6例,显效10例,有效8例,无效2例,总有效率92.31%;对照组24例,临床治愈1例,显效6例,有效11例,无效6例,总有效率78.26%,比较两组治疗后的总有效率,有明显统计学差异(P0.05)。比较上述两组在治疗后的症状总积分,亦有明显差异,具有统计学意义(P0.05),在改善症状方面如明显缩短排便时间、减少排便时间间隔、改善粪便性状、减轻排便困难程度、排便不尽感等方面治疗组优于对照组,有显著性差异(P0.05)。治疗结束停药4周后随访受试者的远期临床疗效,治疗组26例,复发4例,未复发22例,复发率15.38%;对照组24例,复发15例,未复发9例,复发率62.50%,统计学分析后,说明这两组之间差异有显著统计学意义(P0.05),最终可以说明治疗组是优于对照组的。治疗组和对照组的病人均未出现不良反应。研究结论:加味黄芪汤治疗气虚型老年功能性便秘疗效显著,而且在改善个别症状方面,如明显缩短排便时间、减少排便时间间隔、改善粪便性状、减轻排便困难程度和排便不尽感等方面明显优于对照组,随访的长期疗效亦优于对照组,并且未见不良反应,值得推广于临床应用。
[Abstract]:Objective: to observe the clinical effect of Jiawei Huangqi decoction in treating senile functional constipation with deficiency of qi, and to explore the mechanism of Jiawei Huangqi decoction in treating senile functional constipation from two aspects of theory and clinical research. To provide a scientific basis for TCM treatment of senile functional constipation with deficiency of qi. The subjects of this study were selected from September 2014 to December 2015 in Wuhan City Integrated traditional Chinese and Western Medicine Hospital in accordance with the elderly functional constipation syndrome diagnosis of Qi-deficiency type of outpatient patients 60 cases. According to the random principle, the patients were divided into treatment group and control group, excluding shedding cases, 26 cases in treatment group and 24 cases in control group. There was no significant difference in sex, age, symptom score before treatment and course of disease between the two groups (P 0.05). The treatment group was treated with oral Chinese medicine decoction of modified Astragalus decoction once a day. Early, middle and late oral administration 30 minutes before meal; The control group was given only western medicine, mosapride 5 mg po tid, oral for 30 minutes after meal. During the treatment period, the patients should not give birth to cold stimulation food and stop other related drugs. The course of treatment was 4 weeks. The symptoms of the patients in the first week, the second week, the third week and the fourth week after treatment were scored by questionnaire, and the statistical analysis was carried out with SPSS 21. 0 software. Results: after 4 weeks of treatment, 26 cases in the treatment group were clinically cured, 10 cases were markedly effective, 8 cases were effective, 2 cases were ineffective, and the total effective rate was 92.31 cases. In the control group, 1 case was clinically cured, 6 cases were markedly effective, 11 cases were effective, 6 cases were ineffective, and the total effective rate was 78.26. The total effective rate was compared between the two groups after treatment. There was significant statistical difference (P 0.05). The total symptom score of the above two groups after treatment was also significantly different (P 0.05). The treatment group was superior to the control group in improving symptoms, such as shortening defecation time, reducing defecation interval, improving fecal traits, reducing defecation difficulty and defecation feeling. There was a significant difference between the two groups (P 0.05). The long-term clinical effect of the subjects followed up 4 weeks after the end of the treatment. In the treatment group, there were 26 cases of recurrence, 4 cases of recurrence, 22 cases of no recurrence, and the recurrence rate was 15.38%. In the control group, there were 24 cases of recurrence, 15 cases of recurrence and 9 cases of non-recurrence. The recurrence rate was 62.50%. After statistical analysis, the difference between the two groups was statistically significant (P 0.05). Finally, it can be concluded that the treatment group is superior to the control group. The patients in the treatment group and the control group have no adverse reactions. Conclusion: the effect of modified Huangqi decoction on senile functional constipation of qi deficiency type is significant. And in improving individual symptoms, such as significantly shorten defecation time, reduce defecation time interval, improve fecal traits, reduce defecation difficulties and defecation feeling, and so on is obviously superior to the control group. The long-term effect of follow-up is better than that of control group, and no adverse reaction is found, so it is worth popularizing in clinical application.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.35

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