痛泻要方联合穴位注射治疗肝郁脾虚型IBS临床观察

发布时间：2018-03-17 15:33

本文选题：肠易激综合征　切入点：痛泻要方　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：采用痛泻要方加减联合穴位注射治疗肝郁脾虚腹泻型肠易激综合征患者,并评价痛泻要方加减联合穴位注射的临床疗效。方法：采用随机对照研究方法,将符合诊断标准及纳入标准的60例腹泻型肠易激综合征(肝郁脾虚证)患者,按其就诊顺序随机分为治疗组和对照组,分别30例。治疗组采用痛泻要方加减水煎口服,并联合药物穴位注射进行治疗；对照组采用匹维溴铵口服,每次50mg,每日3次,同时采用金双歧口服,每次4片,每日3次；两组均辅以饮食调理、心理治疗,以两周为一个疗程,共两个疗程。两个疗程后观察两组治疗前后临床疗效、中医证候积分、主要症状单项疗效、HAMA、HAMD评分及不良反应的出现情况,并运用统计学软件进行分析比较。结果：1.临床总体疗效评价：治疗组与对照组总有效率分别为93.33%、66.67%,差异有统计学意义(P0.05),治疗组总体疗效优于对照组。2.治疗前后中医症候总积分比较：治疗前,两组症候总积分对比无统计学差异(P0.05),具有可比性。治疗后,两组中医症候总积分均较治疗前明显减少(P0.01),治疗组症候总积分明显低于对照组(P0.01),统计学差异显著。3.治疗前后各单项症状症候积分比较：治疗前,治疗组与对照组各单项症状症候积分无统计学差异,具可比性。治疗后,治疗组排便次数增多、便溏不爽、腹痛欲泻、胁肋胀痛、情绪抑郁或急躁、失眠等症状较对照组有明显差异(P0.01、P0.05),提示治疗组在以上症状的疗效方面明显优于对照组；对照组腹胀、肠鸣矢气、食少纳呆等症状的症候积分与治疗组相比差异无统计学意义(P0.05),提示两组在腹胀、肠鸣矢气、食少纳呆的治疗上疗效相当。4.治疗前后HAMA、HAMD评分比较：两组HAMA、HAMD评分于治疗前相比具可比性(P0.05),而治疗后,其评分均较之前显著降低(P0.01),尤以治疗组降低明显。结论：两组治疗方法均能有效改善腹泻型肠易激综合征(肝郁脾虚证)患者的临床症状,治疗组的症状改善程度、范围优于对照组,证明口服痛泻要方联合穴位注射治疗腹泻型肠易激综合征(肝郁脾虚证)疗效显著,且中药加穴位注射治疗是一种不良反应少、疗效可靠的综合治疗方法。
[Abstract]:Objective: to treat the patients with irritable bowel syndrome of liver stagnation and spleen deficiency diarrhea by adding and subtracting Tongxieyao recipe and acupoint injection, and to evaluate the clinical effect of Tongxieyoufang plus or subtraction combined with acupoint injection. Methods: a randomized controlled study was carried out. Sixty patients with diarrhea irritable bowel syndrome (liver depression and spleen deficiency syndrome) were randomly divided into treatment group and control group. In the control group, 50 mg of piveronium, 3 times a day, 4 tablets of gold bifid, 3 times a day, were given orally, and the two groups were treated with diet and psychotherapy. Two weeks were used as a course of treatment for two courses of treatment. After two courses of treatment, the clinical efficacy, TCM syndromes score, main symptom single curative effect and the occurrence of adverse reactions were observed. The total effective rate of treatment group and control group was 93.33 and 66.67 respectively, the difference was statistically significant (P 0.05). The overall curative effect of treatment group was better than that of control group. 2. Before and after treatment, the total effective rate of traditional Chinese medicine was better than that of control group (P < 0.05). Total symptom score comparison: before treatment, There was no statistical difference in the total score of symptoms between the two groups (P 0.05), which was comparable. The total score of TCM symptoms in the two groups was significantly lower than that before treatment, and the total score of symptoms in the treatment group was significantly lower than that in the control group (P 0.01), the statistical difference was significant. 3. Comparison of the scores of each single symptom before and after treatment: before and after treatment, There was no statistical difference between the treatment group and the control group in the scores of individual symptoms and symptoms. After treatment, the number of defecation in the treatment group increased, and the loose stools, abdominal pain and diarrhea, flank pain, emotional depression or impatience, The symptoms of insomnia were significantly different from those of the control group, indicating that the curative effect of the treatment group was obviously better than that of the control group, the abdominal distension and the sagittal qi of the intestine in the control group were better than those in the control group. There was no significant difference in symptom score between the treatment group and the treatment group, suggesting that the two groups were in abdominal distension, bowel ringing and sagittal qi. The therapeutic efficacy of the two groups was similar. 4. Comparison of Hamah Hamd scores before and after treatment: the Hama Hamd scores in the two groups were comparable to those before and after treatment (P 0.05), but after treatment, there was no significant difference between the two groups. The scores were significantly lower than those before, especially in the treatment group. Conclusion: both treatment methods can effectively improve the clinical symptoms of diarrhea irritable bowel syndrome (liver depression and spleen deficiency syndrome), and the treatment group can improve the degree of symptoms. The range is superior to the control group, which proves that the treatment of diarrhea type irritable bowel syndrome (liver-stagnation and spleen deficiency syndrome) by oral Tongxieyao recipe combined with acupoint injection is effective, and the Chinese medicine plus acupoint injection therapy is a kind of comprehensive treatment method with less adverse reactions and reliable curative effect.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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