生白术润肠汤治疗功能性便秘肺脾气虚证的临床观察

发布时间：2018-10-05 11:39

【摘要】：目的：观察生白术润肠汤治疗肺脾气虚型功能性便秘的临床有效性及安全性。方法：从2014年5月至2015年10月在武汉市中西医结合医院中医部李恩宽名医工作室门诊就诊的患者中,选取符合要求的48例患者,采用随机分组法随机分为两组,治疗组和对照组各24例。治疗组给予经验效方生白术润肠汤(方药组成：生白术100g、黄芪30g、党参30g、生地20g、升麻6g、陈皮10g),对照组给予乳果糖口服液治疗,5日为1疗程,治疗4疗程,随访4周,观察两组治疗前后便秘症状、中医症候积分、复发率等指标改变情况,比较两种方案对肺脾气虚型功能性便秘的治疗效果。结果：1、临床总体疗效评价：两组用药均能改善功能性便秘临床症状,治疗组临床疗效的有效率高于对照组,差异有统计学意义。2、持续稳定性疗效：疗程结束后随访4周,治疗组复发率低于对照组,二者之间有统计学差异,表明治疗组中药汤剂持续稳定性好。3、单项症状疗效：便秘症状改善方面,两组患者大便性状、排便频率、排便时间等观察指标症状总积分较治疗前均有所下降,差异有统计学意义(P0.05)。其中中药治疗组在改善排便频率、排便时间、排便不尽感及阻塞感、腹胀腹痛等观察指标方面优于西药对照组(P0.05),差异有统计学意义。在改善大便性状、排便困难指数方面与对照组相当,差异无统计学意义(P0.05)。中药治疗组对气短、自汗、便后乏力、神疲懒言等中医症候观察指标改善优于西药对照组,差异具有统计学意义(P0.01)。结论：生白术润肠汤治疗功能性便秘,中医辨证属肺脾气虚证的患者有明显的疗效,不仅可以明显改善患者气短、自汗、神疲乏力等中医症状,且对大便性状、排便频率、排便时间、腹胀腹痛等便秘症状有不同程度的改善。从而提高了患者生活质量,缓解了患者焦虑情绪。生白术润肠汤为功能性便秘的治疗提供了新的思路及方剂,是一种有效率高、稳定性好,适合临床广泛使用的汤剂,值得进一步深入研究和探讨。
[Abstract]:Objective: to observe the clinical efficacy and safety of Shengzhu Runchang decoction in the treatment of functional constipation with deficiency of lung and spleen qi. Methods: from May 2014 to October 2015, 48 patients who met the requirements were randomly divided into two groups. There were 24 cases in the treatment group and 24 cases in the control group. The treatment group was given the experiential effect of Fang Sheng Baizhu Runchang decoction (prescription composition: 100 g of Atractylodes macrocephala, 30 g of Astragalus membranaceus, 30g of Codonopsis, 20g of Shengdi, 6g of Shengma, 10g of Chen Pei). The control group was treated with lactulose oral liquid, 5 days as a course of treatment, 4 courses of treatment, followed up for 4 weeks. To observe the changes of constipation symptom, TCM symptom score and recurrence rate before and after treatment, and to compare the therapeutic effect of the two schemes on functional constipation with deficiency of lung and spleen qi. Results: 1. Overall clinical efficacy evaluation: both groups were able to improve the clinical symptoms of functional constipation, the effective rate of clinical efficacy in the treatment group was higher than that in the control group, the difference was statistically significant. The effect of sustained stability was: follow up for 4 weeks after the end of the course of treatment. The recurrence rate of the treatment group was lower than that of the control group, and there was statistical difference between the two groups, which indicated that the treatment group had good stability of traditional Chinese medicine decoction, the curative effect of single symptom: the improvement of constipation symptom, the defecation character and defecation frequency of the two groups, The total score of observation indexes such as defecation time was lower than that before treatment, and the difference was statistically significant (P0.05). The Chinese medicine treatment group in improving defecation frequency defecation time defecation and obstruction feeling abdominal distention abdominal pain and other observation indicators than the western medicine control group (P0.05) the difference was statistically significant. In improving defecation traits, defecation difficulty index was similar to the control group, the difference was not statistically significant (P0.05). The improvement of TCM symptom observation index in TCM treatment group was better than that in western medicine control group (P0.01). Conclusion: the treatment of functional constipation with Shengbaizhu Runchang decoction has obvious curative effect on the patients with syndrome differentiation of deficiency of lung and spleen qi. It can not only obviously improve the symptoms of short breath, self-sweating, fatigue and so on, but also can improve the defecation character and defecation frequency. Defecation time, abdominal distention and abdominal pain and other constipation symptoms have different degrees of improvement. Thus, the quality of life of the patients was improved, and the anxiety of the patients was alleviated. Shengbaizhu Runchang decoction provides a new way of thinking and prescription for the treatment of functional constipation. It is a kind of decoction with high effective rate, good stability and suitable for wide clinical use. It is worthy of further study and discussion.
【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】：2016
【分类号】：R256.35

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