疏肝健脾法治疗肠易激综合征的研究及对肠道菌群的影响

发布时间：2018-06-26 13:33

本文选题：腹泻型肠易激综合征 + 疏肝健脾　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:观察疏肝健脾法(代表方四逆散合痛泻要方加味)治疗腹泻型肠易激综合征的临床疗效,并探讨其对肠道菌群的影响。方法:选取腹泻型肠易激综合征患者63例,按随机分为治疗组33例和对照组30例。治疗组给予四逆散合痛泻要方加味,对照组给予匹维溴铵,患者服药一个疗程,四周为一疗程,观察第四周治疗后症状和总有效率,并采取随机数字表法选取治疗组10例观察治疗前后肠道菌群情况。结果:1.第4周,治疗组与对照组两组患者各症状较治疗前有明显改善,治疗组总有效率为96.97%,对照组总有效率为80.00%,治疗组与对照组相比较,P0.05,有统计学意义。2.症状评分方面,腹痛不适、大便次数、大便性状、排便急迫感等评分,治疗组与对照组第4周比较P0.05,有统计学意义,提示治疗组在第4周排便次数、大便性状上疗效优于匹维溴铵对照组。余症状评分方面,治疗组与对照组第4周中,组间差异均为P0.05,无统计学意义。3.两组患者治疗后焦虑量化评分均数比较,P0.05,具有统计学意义。两组患者治疗后抑郁量化评分均数比较,P0.05,无统计学意义。提示治疗组关于焦虑方面的疗效优于匹维溴铵对照组。4.改善肠道菌群(大肠杆菌、乳酸杆菌、双歧杆菌)方面,治疗组菌群在治疗前后各配对样品P0.01,差异具有统计学意义,且治疗后B/E1。结论:本次临床研究显示,四逆散合痛泻要方加味治疗腹泻型肠易激综合征,能改善患者腹痛、腹胀、排便次数、大便性状、排便急迫感等临床症状及情志方面有积极的影响意义;并对肠道菌群中大肠杆菌、乳酸杆菌、双歧杆菌有正向的影响。四逆散合痛泻要方加味组各项疗效优于匹维溴铵组,用药过程中未发现不良反应,四逆散合痛泻要方加味治疗腹泻型肠易激综合征安全、有效,疏肝健脾法的治疗思维值得进一步研究。
[Abstract]:Objective: to observe the clinical effect of Shugan Jianpi method on diarrhea irritable bowel syndrome (IBS) and its effect on intestinal flora. Methods: 63 cases of diarrhea irritable bowel syndrome were randomly divided into treatment group (n = 33) and control group (n = 30). The treatment group was treated with Sini San and Tongxieyao decoction, while the control group was given piveronium bromide. The patients took a course of treatment and four weeks were a course of treatment. The symptoms and the total effective rate were observed after the fourth week of treatment. The intestinal flora of 10 patients in the treatment group was observed before and after treatment by random digital table. The result is 1: 1. At the 4th week, the symptoms of the treatment group and the control group were obviously improved. The total effective rate of the treatment group was 96.977.The total effective rate of the control group was 80.00.The treatment group was significantly better than the control group (P 0.05). Symptoms score, abdominal pain and discomfort, defecation times, defecation traits, defecation urgency, and so on, the treatment group compared with the control group in the 4th week P0.05, there was statistical significance, suggesting that the treatment group in the 4th week defecation times, The effect of defecation was better than that of control group. The scores of residual symptoms in the treatment group and the control group in the 4th week, the difference between the groups were P0.05, there was no statistical significance. 3. There was significant difference between the two groups in the mean of anxiety score after treatment (P 0.05). There was no significant difference between the two groups (P 0.05). The results suggest that the effect of anxiety in the treatment group is better than that in the control group. 4. In terms of improving intestinal flora (E. coli, Lactobacillus, Bifidobacterium), there was a significant difference between the two groups before and after treatment (P0.01), and the B / E1 after treatment. Conclusion: this clinical study shows that the treatment of diarrhea irritable bowel syndrome with Sini San combined with Tongxiexiyao decoction can improve the abdominal pain, abdominal distension, defecation times and defecation traits. Defecation urgency and other clinical symptoms and emotional aspects have a positive impact on intestinal flora Escherichia coli, Lactobacillus, Bifidobacterium has a positive effect. The curative effect of Sini San combined with Tongxie Youfang Jiawei group was better than that of piveronium bromide group, and no adverse reaction was found in the course of medication. Sini San combined with Tongxiexiyao recipe was safe and effective in the treatment of diarrhea irritable bowel syndrome. The therapeutic thinking of soothing liver and invigorating spleen is worthy of further study.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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