小柴胡汤加减治疗慢传输型便秘临床疗效评价
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摘要
目的:观察小柴胡汤加减治疗慢传输型便秘的临床疗效。方法:采用随机对照方法,将120例STC患者分为治疗组(小柴胡汤加减)与对照组(琥珀酸普芦卡必利片)各60例。观察比较两组患者便秘症状评分、结肠传输试验标记物排出数量,以及焦虑、抑郁自评量表评分评价临床疗效,并在疗程结束3个月后对患者进行随访。结果:(1)在改善便秘方面,治疗组有效率为79.3%,对照组有效率为72.4%,两组在改善便秘症状方面无明显差异;治疗组与对照组3个月后复发率有统计学差异。(2)在改善焦虑抑郁方面,治疗组优于对照组,有统计学差异。结论:小柴胡汤加减治疗慢传输型便秘可有效改善便秘症状,与琥珀酸普芦卡必利效果相当,临床疗效肯定,远期疗效较西药好。此外,小柴胡汤加减同时能有效改善患者焦虑抑郁心理状态,缓解焦虑、抑郁的情绪优于琥珀酸普芦卡必利,提高生活质量,体现中医优势。
Objective:To observe clinical effect of Modified Xiaochaihu Decoction in treating slow transit constipation(STC). Methods:Randomized,controlled method was applied in this experiment. According to random number table method,120 patients were divided into treatment group(Modified Xiaochaihu Decoction)and control group(Prucalopride Succinate Tablets),each group of 60 cases. Both groups of patients were evaluated in the score of constipation symptom,the output quantity of markers in CTT,the score of self-rating anxiety scale and self-rating depression scale before and after treatment along with clinical efficacy. The patients were followed up after 3 months of treatment. Results:(1)In the relief of constipation symptom,the effective rate of the treatment group was 79.3%,and the control group was 72.4%. There were no obvious differences in improving constipation symptoms between both groups. The recurrence rate of treatment group was lower than the control group 3 months after treatment,which has statistical difference.(2)Compared with the control group,the treatment group was superior in relieving anxiety and depression symptom,which had statistical difference. Conclusion:Modified Xiaochaihu Decoction can treat STC by reducing the score of constipation and increasing the output quantity of markers in CTT which is equals to Prucalopride Succinate Tablets. The method has certain effect. The long-term curative effect of Modified Xiaochaihu Decoction is better. Besides it can also relieve the symptoms of anxiety and depression,and ease the anxiety and depression mood,which is better than Prucalopride Succinate Tablets,and improves the quality of life and shows the advantage of TCM.
Objective:To observe clinical effect of Modified Xiaochaihu Decoction in treating slow transit constipation(STC). Methods:Randomized,controlled method was applied in this experiment. According to random number table method,120 patients were divided into treatment group(Modified Xiaochaihu Decoction)and control group(Prucalopride Succinate Tablets),each group of 60 cases. Both groups of patients were evaluated in the score of constipation symptom,the output quantity of markers in CTT,the score of self-rating anxiety scale and self-rating depression scale before and after treatment along with clinical efficacy. The patients were followed up after 3 months of treatment. Results:(1)In the relief of constipation symptom,the effective rate of the treatment group was 79.3%,and the control group was 72.4%. There were no obvious differences in improving constipation symptoms between both groups. The recurrence rate of treatment group was lower than the control group 3 months after treatment,which has statistical difference.(2)Compared with the control group,the treatment group was superior in relieving anxiety and depression symptom,which had statistical difference. Conclusion:Modified Xiaochaihu Decoction can treat STC by reducing the score of constipation and increasing the output quantity of markers in CTT which is equals to Prucalopride Succinate Tablets. The method has certain effect. The long-term curative effect of Modified Xiaochaihu Decoction is better. Besides it can also relieve the symptoms of anxiety and depression,and ease the anxiety and depression mood,which is better than Prucalopride Succinate Tablets,and improves the quality of life and shows the advantage of TCM.
引文
[1]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[J].胃肠病学,2013,18(10):605-612.
[2]傅传刚,高显华.便秘外科治疗的争议和共识[J].中国实用外科杂志,2012,32(1):60-62.
[3]杨洋,程遥,史海霞,等.功能性便秘合并焦虑抑郁状态中医诊疗思路[J].辽宁中医杂志,2017,44(3):492-493.
[4]王芳,姚树坤,马军宇,等.脾胃湿热型功能性便秘患者症状、精神心理状态及生活质量的分析[J].中日友好医院学报,2013,27(5):281-283,287.
[5]邵万金.便秘罗马Ⅲ标准(二)——功能性便秘[C]//中华中医药学会肛肠分会换届会议暨便秘专题研讨会论文专刊.北京:中华中医药学会,2007:2.
[6]中华医学会外科学分会肛肠外科学组.便秘诊治暂行标准[J].现代实用医学,2003(4):258-259.
[7]张声生,李乾构,时昭红.慢性便秘中医诊疗共识意见[J].北京中医药,2011,30(1):3-7.
[8]中华医学会外科学分会肛肠外科学组.便秘症状及疗效评估[J].中华胃肠外科杂志,2005(4):355.
[9]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:378-385.
[10]朱勇.丁义江教授学术思想与临证经验总结及温阳通便颗粒治疗脾肾阳虚型便秘的临床研究[D].南京:南京中医药大学,2015.
[11]董玉杰.小柴胡汤加减治疗肠道气滞型功能性便秘的临床观察[D].北京:北京中医药大学,2014.
[12]张敏.小柴胡汤加减治疗肠道气滞型功能性便秘的疗效[J].中国医药科学,2016,6(7):73-75,98.
[13]苏光悦,王芳,张菁菁,等.小柴胡汤抗抑郁作用[C]//中国药理学会第十一次全国学术会议专刊.北京:中国药理学会,2011:1.
[14]陈亚双,孙世伟.柴胡的化学成分及药理作用研究进展[J].黑龙江医药,2014,27(3):630-633.
[15]舒文将,姚昕利,陈宗游,等.中药柴胡的药理研究与临床应用[J].广西科学院学报,2017,33(4):268-273.
[16]郑勇凤,王佳婧,傅超美,等.黄芩的化学成分与药理作用研究进展[J].中成药,2016,38(1):141-147.
[17]薛瑞.半夏药理作用的研究进展[C]//中国药理学会制药工业专业委员会第十三届学术会议暨2008生物医药学术论坛论文汇编.北京:中国药理学会,2008:4.
[18]李鹏英,俞年军,李勇,等.半夏在神经系统疾病中应用的研究进展[J].中国现代中药,2016,18(3):390-395.
[19]章斌,金剑,金芝贵,等.枳壳的药理作用与临床应用进展[J].医药导报,2013,32(11):1462-1464.
[20]罗艳春,韩晶莉,罗艳秋,等.黄芪、白术、枳壳对大鼠肠道微生态失调的调整作用[J].中国老年学杂志,2009,29(12):1485-1487.
[21]张林,王洪.厚朴的现代药理研究进展[J].内蒙古中医药,2010,29(8):105-107.
[22]张晗.天王补心汤加减治疗心阴不足型广泛性焦虑的临床疗效观察[D].北京:北京中医药大学,2014.
[23]徐晓婷,邓志鹏,仲浩,等.香附化学成分及药理作用研究进展[J].齐鲁药事,2012,31(8):473-475.
[24]Sunil AG,Kesavayanan KS,Kalaivani P,et al.Total oligomeric flavonoids of Cyperus rotundus ameliorates neurological deficits,excitotoxicity and behavioral alterations induced by cerebral ischemic-reperfusion injury in rats[J].Brain Res Bull,2011,84(6):394-405.
[2]傅传刚,高显华.便秘外科治疗的争议和共识[J].中国实用外科杂志,2012,32(1):60-62.
[3]杨洋,程遥,史海霞,等.功能性便秘合并焦虑抑郁状态中医诊疗思路[J].辽宁中医杂志,2017,44(3):492-493.
[4]王芳,姚树坤,马军宇,等.脾胃湿热型功能性便秘患者症状、精神心理状态及生活质量的分析[J].中日友好医院学报,2013,27(5):281-283,287.
[5]邵万金.便秘罗马Ⅲ标准(二)——功能性便秘[C]//中华中医药学会肛肠分会换届会议暨便秘专题研讨会论文专刊.北京:中华中医药学会,2007:2.
[6]中华医学会外科学分会肛肠外科学组.便秘诊治暂行标准[J].现代实用医学,2003(4):258-259.
[7]张声生,李乾构,时昭红.慢性便秘中医诊疗共识意见[J].北京中医药,2011,30(1):3-7.
[8]中华医学会外科学分会肛肠外科学组.便秘症状及疗效评估[J].中华胃肠外科杂志,2005(4):355.
[9]中华人民共和国卫生部.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:378-385.
[10]朱勇.丁义江教授学术思想与临证经验总结及温阳通便颗粒治疗脾肾阳虚型便秘的临床研究[D].南京:南京中医药大学,2015.
[11]董玉杰.小柴胡汤加减治疗肠道气滞型功能性便秘的临床观察[D].北京:北京中医药大学,2014.
[12]张敏.小柴胡汤加减治疗肠道气滞型功能性便秘的疗效[J].中国医药科学,2016,6(7):73-75,98.
[13]苏光悦,王芳,张菁菁,等.小柴胡汤抗抑郁作用[C]//中国药理学会第十一次全国学术会议专刊.北京:中国药理学会,2011:1.
[14]陈亚双,孙世伟.柴胡的化学成分及药理作用研究进展[J].黑龙江医药,2014,27(3):630-633.
[15]舒文将,姚昕利,陈宗游,等.中药柴胡的药理研究与临床应用[J].广西科学院学报,2017,33(4):268-273.
[16]郑勇凤,王佳婧,傅超美,等.黄芩的化学成分与药理作用研究进展[J].中成药,2016,38(1):141-147.
[17]薛瑞.半夏药理作用的研究进展[C]//中国药理学会制药工业专业委员会第十三届学术会议暨2008生物医药学术论坛论文汇编.北京:中国药理学会,2008:4.
[18]李鹏英,俞年军,李勇,等.半夏在神经系统疾病中应用的研究进展[J].中国现代中药,2016,18(3):390-395.
[19]章斌,金剑,金芝贵,等.枳壳的药理作用与临床应用进展[J].医药导报,2013,32(11):1462-1464.
[20]罗艳春,韩晶莉,罗艳秋,等.黄芪、白术、枳壳对大鼠肠道微生态失调的调整作用[J].中国老年学杂志,2009,29(12):1485-1487.
[21]张林,王洪.厚朴的现代药理研究进展[J].内蒙古中医药,2010,29(8):105-107.
[22]张晗.天王补心汤加减治疗心阴不足型广泛性焦虑的临床疗效观察[D].北京:北京中医药大学,2014.
[23]徐晓婷,邓志鹏,仲浩,等.香附化学成分及药理作用研究进展[J].齐鲁药事,2012,31(8):473-475.
[24]Sunil AG,Kesavayanan KS,Kalaivani P,et al.Total oligomeric flavonoids of Cyperus rotundus ameliorates neurological deficits,excitotoxicity and behavioral alterations induced by cerebral ischemic-reperfusion injury in rats[J].Brain Res Bull,2011,84(6):394-405.