中药联合艾灸治疗腹泻型肠易激综合征的临床研究
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摘要
【目的】观察中药联合艾灸治疗腹泻型肠易激综合征(IBS-D)患者的临床疗效及对患者生活质量的影响。【方法】将74例IBS-D患者随机分为治疗组和对照组,每组各37例。治疗组给予自拟中药(以四神丸合参苓白术散为基础方)联合艾灸(取穴神阙、中脘、足三里、天枢、脾俞、肾俞)治疗,对照组给予口服匹维溴铵片,疗程4周。观察2组治疗前后中医证候和生活质量(QOL)的变化情况,评价2组的临床疗效及安全性。【结果】(1)2组各有2例患者无法坚持服药而退出研究,即最终2组各有35例患者完成试验。(2)治疗4周后,治疗组的总有效率为91.43%,对照组为85.71%,2组疗效比较,差异无统计学意义(P> 0.05)。(3)治疗后,治疗组的大便泄泻、腹痛腹胀、脘腹痞满、倦怠乏力、神疲懒言、畏寒肢冷、腰膝酸软、食欲不振8个证候评分均较治疗前明显降低(P <0.01);而对照组仅大便泄泻、腹痛腹胀、脘腹痞满、倦怠乏力4个证候评分较治疗前降低(P <0.05或P <0.01);治疗组在改善各项中医证候评分方面优于对照组(P <0.05或P <0.01)。(4)治疗后,2组IBSQOL 8个项目评分均有不同程度改善(P <0.05或P <0.01),且治疗组在改善情绪状况、精神状态、睡眠状况和饮食影响方面优于对照组(P <0.05或P <0.01)。(5)治疗组和对照组的不良反应发生率分别为5.71%和11.42%。【结论】中药与艾灸联合治疗IBS-D疗效确切,能明显改善患者的临床症状,提高患者的生活质量,且无明显的不良反应。
Objective To evaluate the clinical efficacy of Chinese medicine combined with moxibustion for the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)and to observe its effect on the quality of life.Methods Seventy-four cases of IBS-D patients were randomly divided into treatment group and control group,37 cases in each group. The treatment group was treated with self-prescribed Chinese medicine recipe(modification of Sishen Wan and Shenling Baizhu San)combined with moxibustion on acupionts of Shenque(CV8),Zhongwan(CV12),Zusanli(ST36),Tianshu(ST25),Pishu(BL20)and Shenshu(BL23),while the control group wastreated with oral use of Pinaverium Bromide Tablets,the treatment lasting for 4 weeks. The changes of traditionalChinese medicine(TCM)syndromes and quality of life(QOL)of the two groups were observed before and after treatment,and the clinical effects and safety after treatment were also evaluated. Results(1)Two cases of patientsin each group dropped out for suspension of medication,and eventually 35 cases in each group completed the trial.(2)After treatment for 4 weeks,the total effective rate was 91.43% in the treatment group,and was 85.71% in thecontrol group,the difference being insignificant(P > 0.05).(3)After treatment,the scores of 8 syndromes ofdiarrhea, abdominal pain and distention, abdominal fullness, lassitude and weakness, mental fatigue withreluctance to talk,aversion to cold and cold limb,sore and limp loins and knees,and loss of appetite in thetreatment group in comparison with those before treatment(P < 0.01),while in the control group only the scores of4 syndromes of diarrhea,abdominal pain and distention,abdominal fullness,and lassitude and weakness in weredecreased comparison with those before treatment(P < 0.05 or P < 0.01),and the improvement of syndrome scoresin the treatment group was superior to that in the control group(P < 0.05 or P < 0.01).(4)After treatment,thescores of 8 items of IBS-QOL in the two groups were improved to various degrees(P < 0.05 or P < 0.01),and theimprovement of emotion,mental status,sleep quality and diet in the treatment group was superior to that in thecontrol group(P < 0.05 or P < 0.01).(5)The incidence of adverse reaction in the treatment group and the controlgroup was 5.71% and 11.42%,respectively. Conclusion The combination of Chinese medicine with moxibustion is effective and safe for the treatment of IBS-D by improving the clinical symptoms and enhancing the quality of life.
Objective To evaluate the clinical efficacy of Chinese medicine combined with moxibustion for the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)and to observe its effect on the quality of life.Methods Seventy-four cases of IBS-D patients were randomly divided into treatment group and control group,37 cases in each group. The treatment group was treated with self-prescribed Chinese medicine recipe(modification of Sishen Wan and Shenling Baizhu San)combined with moxibustion on acupionts of Shenque(CV8),Zhongwan(CV12),Zusanli(ST36),Tianshu(ST25),Pishu(BL20)and Shenshu(BL23),while the control group wastreated with oral use of Pinaverium Bromide Tablets,the treatment lasting for 4 weeks. The changes of traditionalChinese medicine(TCM)syndromes and quality of life(QOL)of the two groups were observed before and after treatment,and the clinical effects and safety after treatment were also evaluated. Results(1)Two cases of patientsin each group dropped out for suspension of medication,and eventually 35 cases in each group completed the trial.(2)After treatment for 4 weeks,the total effective rate was 91.43% in the treatment group,and was 85.71% in thecontrol group,the difference being insignificant(P > 0.05).(3)After treatment,the scores of 8 syndromes ofdiarrhea, abdominal pain and distention, abdominal fullness, lassitude and weakness, mental fatigue withreluctance to talk,aversion to cold and cold limb,sore and limp loins and knees,and loss of appetite in thetreatment group in comparison with those before treatment(P < 0.01),while in the control group only the scores of4 syndromes of diarrhea,abdominal pain and distention,abdominal fullness,and lassitude and weakness in weredecreased comparison with those before treatment(P < 0.05 or P < 0.01),and the improvement of syndrome scoresin the treatment group was superior to that in the control group(P < 0.05 or P < 0.01).(4)After treatment,thescores of 8 items of IBS-QOL in the two groups were improved to various degrees(P < 0.05 or P < 0.01),and theimprovement of emotion,mental status,sleep quality and diet in the treatment group was superior to that in thecontrol group(P < 0.05 or P < 0.01).(5)The incidence of adverse reaction in the treatment group and the controlgroup was 5.71% and 11.42%,respectively. Conclusion The combination of Chinese medicine with moxibustion is effective and safe for the treatment of IBS-D by improving the clinical symptoms and enhancing the quality of life.
引文
[1]梁海清,王世和.痛泻宁颗粒联合培菲康治疗感染后肠易激综合征的临床研究[J].重庆医学,2013,42(32):3898.
[2]张友胜,张晓东.中药配合针灸治疗肠易激综合征临床疗效研究[J].成都中医药大学学报,2016,39(1):80.
[3]陈世耀,庄莉红.肠易激综合征的流行病学[J].现代消化及介入诊疗,2007,12(2):91.
[4]陈灏珠,林果为.实用内科学[M]. 13版.北京:人民卫生出版社,2009:2045-2047.
[5] Longhstrech G F,Thompson W G,Chey W D,et al. Functional bowel disorders[M]. 3rd. McLean,VA:Degnon,2006:487.
[6]中华医学会消化病分会胃肠动力学组.肠易激综合征诊断和治疗的共识意见[J].中华消化杂志,2008,28(1):38.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:139.
[8] Hahn B A,Kirchdoerfer L J,Fullerton S,et al.Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome[J]. Aliment Pharmacol Ther,1997,11(3):547.
[9]舒健.肠复安治疗腹泻型肠易激综合征肝郁脾虚证的临床研究[D].南京:南京中医药大学,2014.
[10]薛红,张北华,王凤云,等.中药复方改善腹泻型肠易激综合征内脏高敏感作用机制探讨[J].世界中医药,2015,10(7):973.
[11]张欣.益君康联合艾灸治疗腹泻型肠易激综合征的临床观察[D].济南:山东中医药大学,2016.
[12]陈宏,康密.艾灸配合中成药治疗腹泻型肠易激综合征38例[J].陕西中医学院学报,2014,37(6):44.
[13]谢文堂,李茂清,周三林,等.参苓白术散与艾灸对肠易激综合征患者血清脑肠肽的影响[J].中国中医药信息杂志,2015,22(3):36.
[14]肖宇硕,卢金清,孟佳敏.艾灸治疗腹泻研究进展[J].中华中医药杂志(原中国医药学报),2017,32(11):5027.
[15]吴红梅,唐旭东,刘绍能,等.抑肝扶脾法改善腹泻型肠易激综合征患者生活质量的临床研究[J].中华中医药杂志(原中国医药学报),2016,31(8):3371.
[2]张友胜,张晓东.中药配合针灸治疗肠易激综合征临床疗效研究[J].成都中医药大学学报,2016,39(1):80.
[3]陈世耀,庄莉红.肠易激综合征的流行病学[J].现代消化及介入诊疗,2007,12(2):91.
[4]陈灏珠,林果为.实用内科学[M]. 13版.北京:人民卫生出版社,2009:2045-2047.
[5] Longhstrech G F,Thompson W G,Chey W D,et al. Functional bowel disorders[M]. 3rd. McLean,VA:Degnon,2006:487.
[6]中华医学会消化病分会胃肠动力学组.肠易激综合征诊断和治疗的共识意见[J].中华消化杂志,2008,28(1):38.
[7]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:139.
[8] Hahn B A,Kirchdoerfer L J,Fullerton S,et al.Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome[J]. Aliment Pharmacol Ther,1997,11(3):547.
[9]舒健.肠复安治疗腹泻型肠易激综合征肝郁脾虚证的临床研究[D].南京:南京中医药大学,2014.
[10]薛红,张北华,王凤云,等.中药复方改善腹泻型肠易激综合征内脏高敏感作用机制探讨[J].世界中医药,2015,10(7):973.
[11]张欣.益君康联合艾灸治疗腹泻型肠易激综合征的临床观察[D].济南:山东中医药大学,2016.
[12]陈宏,康密.艾灸配合中成药治疗腹泻型肠易激综合征38例[J].陕西中医学院学报,2014,37(6):44.
[13]谢文堂,李茂清,周三林,等.参苓白术散与艾灸对肠易激综合征患者血清脑肠肽的影响[J].中国中医药信息杂志,2015,22(3):36.
[14]肖宇硕,卢金清,孟佳敏.艾灸治疗腹泻研究进展[J].中华中医药杂志(原中国医药学报),2017,32(11):5027.
[15]吴红梅,唐旭东,刘绍能,等.抑肝扶脾法改善腹泻型肠易激综合征患者生活质量的临床研究[J].中华中医药杂志(原中国医药学报),2016,31(8):3371.