通腑宽中汤联合耳穴贴压治疗功能性便秘（脾虚气滞证）的临床研究

发布时间：2018-03-01 10:12

本文关键词： 通腑宽中汤耳穴贴压功能性便秘脾虚气滞证临床研究　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察中药通腑宽中汤联合耳穴贴压治疗功能性便秘(脾虚气滞证)的临床疗效,探讨其临床优势及安全性,为推广安全易行、低廉经济、简便有效的中医药疗法提供依据。方法:按诊断标准,纳入90例病例,随机分为3组。综合组30例,给予通腑宽中汤,日一剂,并配合耳穴贴压;中药组30例,给予通腑宽中汤,日一剂;西药组30例,给予乳果糖(杜密克)口服,一次1袋,一天2次,治疗疗程均为4周,收集三组治疗前后临床综合疗效、中医症状疗效评分、焦虑抑郁评分、便秘生活质量评分,运用SPSS17.0软件对数据进行统计分析。结果:1.临床综合疗效比较,综合组、中药组、西药组的总有效率分别为93.3%、86.7%、76.7%,综合组总有效率明显高于中药组和西药组,三组间临床综合疗效经秩和检验后,P0.05,有统计学意义。2.便秘主要症状积分比较,治疗后三组均能改善便秘症状,但综合组和中药组在改善排便间隔时间、排便时间、不尽感方面效果明显优于西药组(P0.01或P0.05),且在排便时间、不尽感方面综合组优于中药组(P0.05);在改善粪便性状、难易程度方面三组无明显差异(P0.05)。3.便秘次要症状积分比较,治疗后综合组和中药组在改善便秘乏力、气短、倦怠懒言、腹胀、胁肋胀痛、食少纳呆、焦虑抑郁、嗳气、肠鸣矢气、舌象方面均优于西药组(P0.01或P0.05),且在改善腹胀、胁肋胀痛、焦虑抑郁、嗳气方面综合组优于中药组(P0.05);在其余方面三组无明显差异(P0.05)。4.焦虑、抑郁自评量表评分比较,综合组和中药组治疗前后SAS、SDS评分比较,均有明显差异(P0.01或P0.05);西药组治疗前后SAS、SDS评分比较,无统计学差异(P0.05)。综合组与中药组治疗后SAS、SDS评分组间比较,综合组优于中药组(P0.05)。说明综合组在改善患者焦虑、抑郁情绪方面优于中药组、西药组。5.生活质量问卷评分比较,综合组和中药组治疗前后便秘生活质量评分比较,均有明显差异(P0.01或P0.05);西药组治疗前后便秘生活质量评分比较,无统计学差异(P0.05)。综合组与中药组治疗后便秘生活质量评分组间比较,综合组优于中药组(P0.05)。说明综合组在改善便秘生活质量方面优于中药组、西药组。结论:通腑宽中汤联合耳穴贴压治疗功能性便秘(脾虚气滞证)疗效确切,可以更好地改善患者便秘症状、便秘生活质量、焦虑抑郁情绪。
[Abstract]:Objective: to observe the clinical effect of Tongfu Kuanzhong decoction combined with auricular point plaster on functional constipation (spleen deficiency qi stagnation syndrome), and to explore its clinical advantages and safety. Methods: according to the diagnostic criteria, 90 cases were randomly divided into 3 groups. 30 cases in the comprehensive group were treated with Tongfu Kuanzhong decoction, one dose per day, combined with auricular point pressing, 30 cases in the traditional Chinese medicine group, 30 cases in the traditional Chinese medicine group, 30 cases in the treatment group, 30 cases in the control group, 30 cases in the control group. In the western medicine group, 30 cases were given lactulose (Dumik) orally, 1 bag once, 2 times a day, the course of treatment was 4 weeks. Anxiety and depression score, constipation quality of life score, using SPSS17.0 software for statistical analysis of the data. Results: 1. Clinical comprehensive efficacy comparison, comprehensive group, traditional Chinese medicine group, The total effective rate of the western medicine group was 93.3g / 86.7and 76.77.The total effective rate of the combined group was significantly higher than that of the traditional Chinese medicine group and the western medicine group. The clinical comprehensive efficacy of the three groups was significantly higher than that of the traditional Chinese medicine group and the western medicine group (P 0.05) after rank sum test, which had statistical significance .2.Compared with the main symptoms of constipation. After treatment, the symptoms of constipation were improved in the three groups, but the effects of the combined group and the Chinese medicine group in improving the defecation interval, defecation time and feeling were obviously better than those in the western medicine group (P0.01 or P0.05), and the defecation time was better in the combined group and the traditional Chinese medicine group. There was no significant difference among the three groups in improving fecal traits and easy degree of feces. The scores of secondary symptoms of constipation were compared. After treatment, the comprehensive group and the traditional Chinese medicine group improved constipation fatigue, shortness of breath, burnout and abdominal distension. The symptoms of hypochondriac pain, low food intake, anxiety and depression, belching, sagittal qi and tongue appearance were better than those of western medicine group (P0.01 or P0.05), and could improve abdominal distension, flank pain, anxiety and depression. In terms of belching, the comprehensive group was better than the traditional Chinese medicine group (P 0.05), but there was no significant difference among the other three groups (P 0.05). The scores of anxiety and depression self-rating scale (SAS) were compared, and the scores of SAS SDS before and after treatment were compared between the comprehensive group and the traditional Chinese medicine group. There was no significant difference in SDS scores between the western medicine group and the traditional Chinese medicine group before and after treatment (P 0.01 or P 0.05). The comprehensive group was better than the traditional Chinese medicine group in improving the anxiety of the patients. The scores of quality of life questionnaire before and after treatment were significantly different between the comprehensive group and the traditional Chinese medicine group (P 0.01 or P 0.05), and the quality of life score before and after treatment in the western medicine group was higher than that in the traditional Chinese medicine group (P 0.01 or P 0.05), while in the western medicine group, the quality of life score before and after treatment was higher than that in the western medicine group. There was no statistical difference (P 0.05). The comprehensive group was superior to the traditional Chinese medicine group in improving the constipation quality of life in the improvement of constipation quality of life between the comprehensive group and the traditional Chinese medicine group (P 0.05), which indicated that the comprehensive group was better than the traditional Chinese medicine group in improving the constipation quality of life. Conclusion: the treatment of functional constipation (spleen deficiency qi stagnation syndrome) with Tongfu-Kuanzhong decoction combined with auricular point plaster can improve the constipation symptoms, constipation quality of life and anxiety and depression.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R256.35

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