乌梅丸治疗寒热错杂型慢性腹泻的临床观察

发布时间：2018-09-03 15:42

【摘要】：目的本研究旨在通过理论和临床两个方面对乌梅丸的组方配伍及治疗作用进行系统研究,观察乌梅丸治疗寒热错杂型慢性腹泻的临床疗效及安全性,为中医药防治寒热错杂型慢性腹泻提供科学依据。方法本研究选择2015年6月至2016年8月间就诊于武汉市中西医结合医院消化内科门诊和住院患者64例,其中治疗组32例,脱落1例,对照组32例,脱落3例,均符合中医寒热错杂型慢性腹泻诊断,并对患者个人信息、病情资料作详细记录。两组患者在年龄、性别、病程及症状等方面无统计学差异,具有可比性(P0.05)。治疗组给予中药乌梅丸汤剂(每日1剂,早晚两次,饭后30分钟口服)治疗。对照组给予思密达(每次3g,每日2次,两餐之间口服)治疗。两组患者疗程均为6周,同时嘱患者本次治疗期间忌食辛辣、油腻、生冷等刺激性食物,不可服用其他与本病治疗相关或对本次治疗有影响的中西医药物,并适量运动,避免情绪波动;每周随诊一次,详细记录患者病情变化情况,若患者出现不良反应则及时停止服药,并对症处理。两组患者治疗前后均进行生命体征测定、(血液、粪便、尿液)常规、肝肾功能及十二导心电图检查,对安全性进行评价;采取调查问卷的方式,通过症状分数,对临床疗效进行评价。结果1.近期疗效:治疗6周后,治疗组31例,临床治愈7例,显效13例,有效8例,无效3例,总有效率为90.32%;对照组29例,临床治愈6例,显效11例,有效9例,无效3例,总有效率为89.66%,两组比较,无明显统计学差异(P0.05)。2.远期疗效:治疗结束后4周,治疗组31例,临床治愈8例,显效12例,有效8例,无效3例,总有效率90.32%;对照组29例,临床治愈4例,显效9例,有效11例,无效5例,总有效率82.76%。两组比较,治疗组高于对照组,组间差异具有统计学意义(P0.05)。3.安全性:两组患者在治疗过程中均未出现明显不良反应或并发症。两组药物治疗后,对患者生命体征、(血液、粪便、尿液)常规、肝肾功能及十二导心电图检查均无明显影响。结论1.寒热错杂证是慢性腹泻的重要证型,脾胃气机升降失常是寒热错杂型慢性腹泻的基本病机。2.辛开苦降法是治疗寒热错杂型慢性腹泻的治疗大法,乌梅丸是治疗寒热错杂型慢性腹泻的有效方剂。3.乌梅丸治疗寒热错杂型慢性腹泻的远期疗效明显优于思密达,而且在临床使用中安全可靠,无明显不良反应,具有较高的临床应用价值。
[Abstract]:Objective To systematically study the compatibility and therapeutic effect of Wumei Pills in theory and clinic, and to observe the clinical efficacy and safety of Wumei Pills in the treatment of cold-heat mixed chronic diarrhea. Sixty-four outpatients and inpatients in the Department of Gastroenterology of Wuhan Integrated Traditional Chinese and Western Medicine Hospital were treated during the month. Among them, 32 patients in the treatment group, 1 patient in the abscission group, 32 patients in the control group and 3 patients in the abscission group, all accorded with the diagnosis of chronic diarrhea of mixed cold and heat in traditional Chinese medicine. The treatment group was treated with Wumei Pill Decoction (1 dose daily, twice in the morning and evening, 30 minutes after meals). The control group was treated with Smecta (3 g each time, twice daily, oral between meals). The two groups of patients were treated for 6 weeks. At the same time, patients were instructed not to eat spicy, greasy, cold and other stimulations during the treatment. Sexual foods should not be taken with other Chinese and Western medicines related to the treatment of the disease or have an impact on the treatment of this time, and appropriate exercise to avoid emotional fluctuations; weekly follow-up, a detailed record of the patient's condition changes, if patients have adverse reactions, promptly stop taking drugs, and symptomatic treatment. Results 1. Short-term efficacy: After 6 weeks of treatment, 31 cases in the treatment group, 7 cases were clinically cured, 13 cases were markedly effective, 8 cases were effective, 3 cases were ineffective, the total effective rate was 90.32%; The total effective rate was 89.66%. There was no significant difference between the two groups (P 11 cases, 5 cases ineffective, the total effective rate was 82.76%. Comparing the two groups, the treatment group was higher than the control group, the difference was statistically significant (P 0.05). 3. Safety: There were no obvious adverse reactions or complications in the course of treatment in both groups. Conclusion 1. Cold-heat syndrome is an important type of chronic diarrhea, and abnormal ascending and descending of Spleen-stomach Qi is the basic pathogenesis of cold-heat mixed type of chronic diarrhea. 2. Xinkai Bitter-descending Method is a great method for treating cold-heat mixed type of chronic diarrhea, and Wumei Pill is an effective prescription for treating cold-heat mixed type of chronic diarrhea.3. Wumei Pill is an effective prescription for treating cold-heat mixed type of chronic diarrhea. The long-term effect of treating cold-heat mixed chronic diarrhea is obviously better than smecta, and it is safe and reliable in clinical use, without obvious adverse reactions, and has high clinical application value.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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