调脾固肠汤治疗非感染性腹泻（脾胃虚弱证）的临床研究

发布时间：2018-11-21 09:48

【摘要】：目的:本课题通过对非感染性腹泻(脾胃虚弱证)的临床研究,探究调脾固肠汤对非感染性腹泻(脾胃虚弱证)的临床疗效以及安全性。进一步验证中医辨证论治理论对非感染性腹泻的治疗作用。方法:本课题采用临床开放试验研究,选择符合中医诊断为泄泻(脾胃虚弱证),且符合西医诊断为非感染性腹泻的患者。参照纳入标准,入选80例非感染性腹泻患者,随机分成治疗组40例以及对照组40例。治疗组口服调脾固肠汤,(太子参30g、茯苓30g、粉葛30g、怀山药30g、炒薏苡仁30g、莲子15g、防风15g、炒白术15g、半枝莲15g、仙鹤草10g、车前草10g--均选用云南省中医医院中药房煎药机统一煎药),150ml/次,3次/日,每日1剂;对照组予以口服参苓白术颗粒治疗,1日3次,每次1袋(6g),口服。两组患者都以治疗2周(开始与结束作为治疗介点)作为观察治疗疗程。均以服用药2周后,再分别观察、记录:(1)分别记录两组患者的疗效指标(治疗前、后)。(2)两组患者治疗前后的安全性指标。结果:本课题选取研究病例为80例,当中包含治疗组40例(实际39例);及对照组40例(实际39例)。最终治疗组因未按规定时间就诊的,脱落1例;对照组中经审核,不符合治疗方案的,剔除1例。结果显示:治疗组和对照组的总有效率分别为92.3%,71.8%,经比较差异有显著性(P0.05)统计学意义;两组患者在治疗期间(一个疗程2周)内,血尿便常规、肝功、肾功及心电图观察,均未发现异常改变,提示治疗安全性可靠。结论:调脾固肠汤在改善非感染性腹泻(脾胃虚弱证)的临床证候方面确有疗效,参苓白术颗粒有效;治疗组中药调脾固肠汤在改善大便次数、粪便性质、肠鸣证候方面优于对照组。而在改善食少纳呆、脘腹闷痛、神疲倦怠试验组与对照组无差异性,且未发现明显的副作用,可以将其作为治疗非感染性腹泻(脾胃虚弱证)的用药选择及参考。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Tiaopi Guchang decoction in treating non-infectious diarrhea (deficiency of spleen and stomach). Further verify the therapeutic effect of TCM syndrome differentiation theory on non-infectious diarrhea. Methods: open clinical trial was used to select the patients with diarrhea (spleen and stomach weakness syndrome) and non infectious diarrhea diagnosed by western medicine. According to the inclusion criteria, 80 patients with non-infectious diarrhea were randomly divided into treatment group (n = 40) and control group (n = 40). In the treatment group, 30 g of Radix Pseudostellariae, 30g of Poria cocos, 30g of Pink Pueraria, 30g of yam, 30g of Coix seed, 15g of Fangfeng, 15g of Atractylodes macrocephala, 15g of Scutellaria davidii, 10g of Herba Cassia were taken orally in the treatment group. Plantain 10g-all selected traditional Chinese Medicine Hospital of Yunnan Province decoction machine unified decoction), 150ml/ times, 3 times a day, 1 dose per day; The control group was treated with Shenling Atractylodes granules, 3 times a day, 1 bag (6 g), orally. Both groups were treated for 2 weeks. After taking the drug for 2 weeks, we observed and recorded: (1) the efficacy index (before and after). (2) of the two groups of patients were recorded before and after treatment. Results: there were 80 cases in this study, including 40 cases in the treatment group (39 cases) and 40 cases in the control group (39 cases). In the final treatment group, 1 case dropped out because of not seeing a doctor in accordance with the prescribed time, and 1 case was excluded in the control group after examination, which did not conform to the treatment plan. The results showed that the total effective rates of the treatment group and the control group were 92.3% and 71.8, respectively. The difference was statistically significant (P0.05). There were no abnormal changes in hematuria routine, liver function, renal function and electrocardiogram during the treatment period (a course of 2 weeks) in both groups, indicating that the treatment was safe and reliable. Conclusion: Tiaopi Guchang decoction is effective in improving the clinical symptoms of non-infectious diarrhea (spleen and stomach deficiency syndrome), and Shenling Baizhu granule is effective. The treatment group was superior to the control group in improving defecation times, fecal properties and bowel syndrome. However, there was no difference between the experimental group and the control group in improving food intake, stomachache, and fatigue, and no obvious side effects were found, which could be used as a drug choice and reference for the treatment of non-infectious diarrhea (spleen and stomach weakness syndrome).
【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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