黄芪汤联合耳穴贴压治疗慢性便秘气虚证临床研究
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摘要
目的观察黄芪汤联合耳穴贴压治疗慢性便秘气虚证的临床疗效,以及对患者生活质量的影响。方法采用随机数字表法将72例患者分为治疗组和对照组各36例。治疗组予黄芪汤,每日1剂,每日2次,口服;并行耳穴贴压,每次单耳贴压,3 d换另一侧。对照组予乳果糖口服溶液,每次30 mL,每日1次,口服。2组均连续治疗4周,停药4周进行随访。观察2组治疗前后主要症状评分及生活质量评分,评价2组临床疗效,比较复发情况。结果与本组治疗前比较,2组治疗后粪便性状,排便费力,排便时间,下坠、不尽、胀感,排便频率,腹胀评分明显降低(P<0.05);生活质量评分明显降低(P<0.05)。2组治疗后比较,治疗组各项症状评分及生活质量评分明显低于对照组(P<0.05)。治疗组总有效率为94.4%(34/36),对照组为61.1%(22/36),治疗组明显优于对照组(P<0.01)。治疗组复发率为14.7%(5/34),对照组为45.5%(10/22),2组比较差异有统计学意义(P<0.05)。结论黄芪汤联合耳穴贴压可改善慢性便秘气虚证患者主要症状,提高其生活质量,临床疗效满意,并可降低复发率。
Objective To observe the clinical efficacy of Huangqi Decoction combined with auricular acupoint sticking for the treatment of qi-deficiency type of chronic constipation and its effect on life quality of patients.Methods Totally 72 patients were divided into treatment group and control group through random number table method, with 36 cases in each group. The treatment group took Huangqi Decoction, one dosage per day, twice a day, orally, and also received auricular acupoint sticking, with each time the single ear pressed, 3 d for the other side. The control group took Lactulose, 30 mL per time, once a day, orally. The treatment for both groups lasted for four weeks. The follow-up was conducted with medicine stopped for four weeks. The main symptom scores and life quality scores of the two groups before and after treatment were observed. The clinical efficacy of the two groups was evaluated and the recurrence was compared. Results Compared with before treatment, the fecal traits, defecation difficulty, defecation time, falling, incomplete, bulging, defecation frequency, and abdominal distension scores of the two groups were significantly lower(P<0.05). The life quality scores were significantly lower(P<0.05). After treatment, the symptom scores and life quality scores of the treatment group were significantly lower than those of the control group(P<0.05). The total effective rate was 94.4%(34/36) in the treatment group and 61.1%(22/36) in the control group. The treatment group was significantly better than the control group(P<0.05). The recurrence rate was 14.7%(5/34) in the treatment group and 45.5%(10/22) in the control group, with statistical significance(P<0.05). Conclusion Huangqi Decoction combined with auricular acupoint sticking can improve the main symptoms and life quality of patients, with satisfied clinical efficacy, and can reduce recurrence rate.
Objective To observe the clinical efficacy of Huangqi Decoction combined with auricular acupoint sticking for the treatment of qi-deficiency type of chronic constipation and its effect on life quality of patients.Methods Totally 72 patients were divided into treatment group and control group through random number table method, with 36 cases in each group. The treatment group took Huangqi Decoction, one dosage per day, twice a day, orally, and also received auricular acupoint sticking, with each time the single ear pressed, 3 d for the other side. The control group took Lactulose, 30 mL per time, once a day, orally. The treatment for both groups lasted for four weeks. The follow-up was conducted with medicine stopped for four weeks. The main symptom scores and life quality scores of the two groups before and after treatment were observed. The clinical efficacy of the two groups was evaluated and the recurrence was compared. Results Compared with before treatment, the fecal traits, defecation difficulty, defecation time, falling, incomplete, bulging, defecation frequency, and abdominal distension scores of the two groups were significantly lower(P<0.05). The life quality scores were significantly lower(P<0.05). After treatment, the symptom scores and life quality scores of the treatment group were significantly lower than those of the control group(P<0.05). The total effective rate was 94.4%(34/36) in the treatment group and 61.1%(22/36) in the control group. The treatment group was significantly better than the control group(P<0.05). The recurrence rate was 14.7%(5/34) in the treatment group and 45.5%(10/22) in the control group, with statistical significance(P<0.05). Conclusion Huangqi Decoction combined with auricular acupoint sticking can improve the main symptoms and life quality of patients, with satisfied clinical efficacy, and can reduce recurrence rate.
引文
[1]中华中医药学会脾胃病分会.便秘中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(15):1345-1350.
[2]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南(2013,武汉)[J].胃肠病学,2013,18(10):605-612.
[3]廖奕,刘诗.慢性功能性便秘病理生理机制研究[J].临床消化病杂志,2013,25(4):225-229.
[4]李春波,何燕玲.健康状况调查问卷SF-36的介绍[J].国外医学:精神病学分册,2002,29(2):116-119.
[5]时丽媛.SF-36量表用于益坤内异丸治疗肾虚血瘀型子宫腺肌病痛经的研究[D].北京:北京中医药大学,2013.
[6]中华人民共和国卫生部.中药新药临床研究指导原则:第一辑[M].北京,1993:131.
[7]彭军良.陆金根教授重用生黄芪治疗肛肠疾病的临床经验[J].中国中医急症,2015,24(1):89-91.
[8]沈映君,陈长勋.中药药理学[M].上海:上海科学技术出版社,2012:130-140.
[9]李绍芝,谭晓红.黄芪对在体小肠和离体小肠黏膜耗氧量的影响[J].湖南中医学院学报,1996,16(2):44-48.
[10]曹莉,杨世雷.黄芪双向性功用探讨[J].中医研究,2018,31(1):11-13.
[11]李茹柳,迟莉,郭文峰,等.白术黄芪汤单药提取部位组方对不同病变阶段大鼠溃疡性结肠炎的影响[J].中国中药杂志,2008,33(2):209-212.
[12]佘颜,邓艳玲,赵先平,等.生白术治疗便秘探析[J].湖南中医杂志,2016,32(1):133-135.
[13]郁伟伦,王帅帅,任霞.白术对小鼠肠道菌群调节作用的实验研究[J].山东中医杂志,2011,30(6):417-419.
[14]刘丽莎,王锐,旭日花,等.白术多糖对益生菌的促生长作用及结构分析[J].食品科学,2010,31(19):124-128.
[15]李冀,刘蔚雯,肖洪彬,等.枳术汤治疗功能性消化不良的配伍研究[J].中华中医药学刊,2007,25(2):199-201.
[16]刘蔚雯.枳实、白术促胃肠动力作用的配伍及枳术饮作用机理的研究[D].哈尔滨:黑龙江中医药大学,2007.
[17]麻晓慧,缪红,程建军,等.枳术丸煎剂与枳术汤对大鼠P物质的影响[J].时珍国医国药,2007,18(7):1605.
[18]郑方.归芪通便汤及耳穴治疗儿功能性便秘的临床研究[D].咸阳:陕西中医学院,2008.
[19]焦美丽,赵红军.耳穴疗法在临床应用体会[J].陕西中医,2012,33(9):1272,封3.
[20]陆姝帆.体针配合耳穴贴压治疗中风后虚证便秘的临床疗效观察[D].沈阳:辽宁中医药大学,2010.
[21]吴圆荣,赵若华,俞婷婷,等.耳穴按压治疗慢性功能性便秘随机对照试验的Meta分析[J].解放军护理杂志,2016,33(9):1-6.
[2]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南(2013,武汉)[J].胃肠病学,2013,18(10):605-612.
[3]廖奕,刘诗.慢性功能性便秘病理生理机制研究[J].临床消化病杂志,2013,25(4):225-229.
[4]李春波,何燕玲.健康状况调查问卷SF-36的介绍[J].国外医学:精神病学分册,2002,29(2):116-119.
[5]时丽媛.SF-36量表用于益坤内异丸治疗肾虚血瘀型子宫腺肌病痛经的研究[D].北京:北京中医药大学,2013.
[6]中华人民共和国卫生部.中药新药临床研究指导原则:第一辑[M].北京,1993:131.
[7]彭军良.陆金根教授重用生黄芪治疗肛肠疾病的临床经验[J].中国中医急症,2015,24(1):89-91.
[8]沈映君,陈长勋.中药药理学[M].上海:上海科学技术出版社,2012:130-140.
[9]李绍芝,谭晓红.黄芪对在体小肠和离体小肠黏膜耗氧量的影响[J].湖南中医学院学报,1996,16(2):44-48.
[10]曹莉,杨世雷.黄芪双向性功用探讨[J].中医研究,2018,31(1):11-13.
[11]李茹柳,迟莉,郭文峰,等.白术黄芪汤单药提取部位组方对不同病变阶段大鼠溃疡性结肠炎的影响[J].中国中药杂志,2008,33(2):209-212.
[12]佘颜,邓艳玲,赵先平,等.生白术治疗便秘探析[J].湖南中医杂志,2016,32(1):133-135.
[13]郁伟伦,王帅帅,任霞.白术对小鼠肠道菌群调节作用的实验研究[J].山东中医杂志,2011,30(6):417-419.
[14]刘丽莎,王锐,旭日花,等.白术多糖对益生菌的促生长作用及结构分析[J].食品科学,2010,31(19):124-128.
[15]李冀,刘蔚雯,肖洪彬,等.枳术汤治疗功能性消化不良的配伍研究[J].中华中医药学刊,2007,25(2):199-201.
[16]刘蔚雯.枳实、白术促胃肠动力作用的配伍及枳术饮作用机理的研究[D].哈尔滨:黑龙江中医药大学,2007.
[17]麻晓慧,缪红,程建军,等.枳术丸煎剂与枳术汤对大鼠P物质的影响[J].时珍国医国药,2007,18(7):1605.
[18]郑方.归芪通便汤及耳穴治疗儿功能性便秘的临床研究[D].咸阳:陕西中医学院,2008.
[19]焦美丽,赵红军.耳穴疗法在临床应用体会[J].陕西中医,2012,33(9):1272,封3.
[20]陆姝帆.体针配合耳穴贴压治疗中风后虚证便秘的临床疗效观察[D].沈阳:辽宁中医药大学,2010.
[21]吴圆荣,赵若华,俞婷婷,等.耳穴按压治疗慢性功能性便秘随机对照试验的Meta分析[J].解放军护理杂志,2016,33(9):1-6.