验方抑肝扶脾汤干预胆囊术后肝郁脾虚型腹泻的临床研究

发布时间：2018-05-14 03:32

本文选题：胆囊切除术后腹泻(PCD) + 肝郁脾虚　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察验方抑肝扶脾汤治疗肝郁脾虚型胆囊切除术后腹泻(PCD)的临床疗效及其对改善患者生活质量的影响,探讨验方抑肝扶脾汤的作用机理和特点,为PCD的诊疗提供依据和积累经验。方法:采用平行对照的临床试验设计方法,选择符合肝郁脾虚型胆囊切除术后腹泻标准的患者60例,随机分为治疗组和对照组,每组各30例。治疗前在性别、年龄和症状轻重等方面,实验组与对照组应具有可比性。治疗组予口服中药煎剂,中药煎剂为徐进康导师经验方,对照组予口服双歧三联活菌胶囊联合硫糖铝片。两组均以4周为1个疗程,连续治疗2个疗程,观察两组在治疗前后症状及生活质量改善情况。结果:(1)临床疗效比较:治疗组与对照组均有较好的临床疗效,治疗组效果更明显,比较差异有统计学意义(P0.05)。在主症大便次数、粪质改变上两组治疗均有效,治疗组效果明显,比较差异有统计学意义(P0.05);在次症肠鸣、腹痛腹胀方面,两组均有疗效,但治疗组与对照组比较无优越性,差异无统计学意义(P0.05);在次症脘腹痞满方面,两组都有疗效,但试验组疗效更佳,对比存在统计学差异(P0.05);在食欲不振、暖气方面,治疗组能很好地缓解症状,而对照组治疗前后无统计学意义(P0.05)。(2)PCD与生活质量相关性比较:疾病临床症候总评分与生活质量量表总评分成正相关(0r1),治疗组在缓解PCD患者临床症状、提高生活质量方面效果明显优于对照组,差异具有统计学意义(P0.05)。结论:验方抑肝扶脾汤能明显缓解肝郁脾虚型胆囊切除术后腹泻患者排便次数多、腹痛、痞满等临床症状,并能减轻患者消极情绪,提高患者生活质量,临床综合疗效好。
[Abstract]:Objective: to observe the clinical effect of Yigan Fu spleen decoction in treating diarrhea after cholecystectomy with liver stagnation and spleen deficiency and its effect on improving the quality of life of patients, and to explore the mechanism and characteristics of the effect of Yigan Fu spleen decoction. To provide the basis and accumulated experience for the diagnosis and treatment of PCD. Methods: 60 patients with diarrhea after cholecystectomy with liver stagnation and spleen deficiency were randomly divided into treatment group and control group with 30 cases in each group. Before treatment, the sex, age and severity of symptoms should be comparable between the experimental group and the control group. The treatment group was treated with oral Chinese medicine decoction, the traditional Chinese medicine decoction was Xujinkang tutor's experience prescription, and the control group was given orally bifidobacterium triple viable bacteria capsule combined with sucralfate tablet. The two groups were treated with 4 weeks as a course of treatment and 2 consecutive courses of treatment. The improvement of symptoms and quality of life was observed before and after treatment in both groups. Results comparison of clinical efficacy: treatment group and control group have better clinical effect, treatment group is more obvious, the difference is statistically significant (P 0.05). The two groups were effective in the number of major bowel movements and the change of fecal quality, the effect of the treatment group was obvious, the difference was statistically significant (P 0.05), the two groups had curative effect on the secondary bowel pain and abdominal distention, but the treatment group had no superiority compared with the control group. The difference was not statistically significant (P 0.05); in terms of epigastric fullness, both groups had curative effects, but the experimental group had a better curative effect, and there was a statistical difference between the two groups (P 0.05). In terms of loss of appetite and warm air, the treatment group was able to relieve symptoms very well. In the control group, there was no statistical significance before and after treatment. There was no significant correlation between P0.05 PCD and quality of life: the total score of disease clinical symptoms was positively correlated with the total score of quality of life scale (QOL), and the treatment group was relieving the clinical symptoms of PCD patients. The effect of improving the quality of life was obviously better than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: Yigan Fu spleen decoction can relieve the clinical symptoms of diarrhea after cholecystectomy with liver stagnation and spleen deficiency, such as more defecation times, abdominal pain and fullness, and can relieve the negative emotion of the patients, improve the quality of life of the patients, and the clinical comprehensive curative effect is good.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】