益气固肠方治疗腹泻型肠易激综合征的临床研究及对结肠粘膜电镜下超微结构的影响

发布时间：2018-04-24 01:06

本文选题：益气固肠方 + 腹泻型肠易激综合征(IBS-D)　；参考：《河北医科大学》2016年硕士论文

【摘要】：目的:系统观察益气固肠方治疗腹泻型肠易激综合征(IBS-D)的临床疗效,并与匹维溴铵进行比较;在电镜下观察肠黏膜超微结构的变化,探讨可能的作用机制。科学论证益气固肠方治疗IBS-D的临床疗效,以期建立更为理想有效的治疗方案。方法:选择符合纳入标准的腹泻型肠易激综合征患者共120例,采用随机对照的方法,分为治疗组(益气固肠方组)和对照组(匹维溴铵组),每组60例,治疗组和对照组病例按1:1随机分配,两组之间在年龄、性别、病程及疾病严重程度方面无统计学差异。分别在治疗前、治疗后15天、30天、45天、60天,记录两组患者IBS-SSS积分,对其一般资料进行统计学描述,通过积分变化综合评价益气固肠方治疗IBS-D的临床疗效。分别在治疗前、治疗后30天、60天在直肠镜下分别钳取两组D-IBS患者距肛缘8CM直肠黏膜标本,在透射电镜下观察肠黏膜杯状细胞、浆细胞超微结构的变化。结果:1肠易激综合征症状严重程度量表(IBS symptom severity scale,IBSSSS),中药治疗组治疗后该表总积分较治疗前有明显降低(P0.01),且显著优于西药对照组(P0.01);2中药治疗组患者较西药对照组患者在电镜下观察肠黏膜杯状细胞、浆细胞超微结构的变化有明显改善;3不良反应:两组当中均未发现不良反应。结论:益气固肠方治疗腹泻型肠易激综合征临床疗效确切,能明确缓解肠易激综合征患者的临床症状,其机理可能与益气固肠方能改变肠黏膜杯状细胞、浆细胞超微结构有关。
[Abstract]:Objective: to observe the clinical effect of Yiqi Guchang recipe in treating diarrhea irritable bowel syndrome (IBS-D) and compare it with piveronium bromide, observe the ultrastructure of intestinal mucosa under electron microscope, and explore the possible mechanism. To prove the clinical effect of Yiqi Guchang recipe in treating IBS-D scientifically and to establish a more ideal and effective treatment scheme. Methods: a total of 120 patients with diarrhea irritable bowel syndrome were selected and randomly divided into treatment group (Yiqi Gu Chang Fang group) and control group (pivemine bromide group, 60 cases in each group). The cases of treatment group and control group were randomly assigned at 1:1. There was no significant difference in age, sex, course of disease and severity of disease between the two groups. Before and 15 days after treatment, 45 days and 60 days after treatment, the IBS-SSS scores of the two groups were recorded, the general data were statistically described, and the clinical efficacy of Yiqi Guchang recipe in treating IBS-D was comprehensively evaluated by integral changes. Before and 30 days after treatment, the rectal mucosa specimens of two groups of D-IBS patients from 8CM to anal margin were collected under rectum microscope, and the ultrastructure of goblet cells and plasma cells in intestinal mucosa were observed under transmission electron microscope. Results the symptom severity scale of IBS symptom severity scaleof IBS SSSS, the total integral of IBS in the treatment group was significantly lower than that before treatment, and significantly better than that in the western medicine control group compared with the western medicine control group, the Chinese medicine treatment group was better than the western medicine control group. The goblet cells of intestinal mucosa were observed under electron microscope. The changes of plasma ultrastructure showed significant improvement of the adverse reactions: no adverse reactions were found in the two groups. Conclusion: Yiqi Guchang recipe is effective in the treatment of diarrhea irritable bowel syndrome and can relieve the clinical symptoms of irritable bowel syndrome. The mechanism may be related to the change of goblet cells and ultrastructure of plasma cells.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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