| 高文艳,王长洪,林一帆,陆宇平,巩阳,季芳,刘杨,王立新.健脾调肝温肾方治疗腹泻型肠易激综合征的临床研究[J].,2010,30(1):13-17 |
| 健脾调肝温肾方治疗腹泻型肠易激综合征的临床研究 |
| Effect of Jianpi Tiaogan Wenshen Recipe in Treating Diarrhea-predominant Irritable Bowel Syndrome |
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| DOI： |
| 中文关键词: 腹泻型肠易激综合征 健脾调肝温肾方 疗效 直肠敏感性 |
| 英文关键词:diarrhea-predominant irritable bowel syndrome Jianpi Tiaogan Wenshen Recipe curative efficacy sensitivity of rectum |
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| 中文摘要: |
| 目的观察肝脾肾同调法治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)疗效并探讨其机制。方法选择80例IBS-D患者进行前瞻性随机、西药治疗平行对照的临床试验。治疗组和对照组各40例,治疗组口服健脾调肝温肾方,对照组口服匹维溴铵片。疗程为4周。于治疗前后观察并记录腹痛或腹部不适、腹胀、大便次数、大便性状及排便急迫感情况并检测直肠敏感性。停药4周后对治愈和显效患者进行随访。结果治疗组脱落3例,对照组脱落4例。腹痛或腹部不适、腹胀、大便次数、大便性状及排便急迫感记分两组治疗前比较,差异均无统计学意义(P>0.05);两组各症状终点记分与基线比较差异均有统计学意义(P<0.05)。黏液便的改善治疗后两组间记分差异有统计学意义,治疗组优于对照组(P<0.01)。综合疗效:符合方案集(PPS):治疗组痊愈率为24.3%(9/37),总有效率为81.1%(30/37);对照组分别为19.4%(7/36),80.6%(29/36);金分析集(FAS):治疗组的痊愈率为22.5%(9/40),总有效率为80.0%(32/40);对照组分别为17.5%(7/40),77.5%(31/40),两组比较,差异无统计学意义(P>0.05)。随访结果:对两组痊愈和显效的病例随访,治疗组和对照组分别有4例和12例复发或加重,两组比较,差异有统计学意义(P<0.01)。直肠敏感性:治疗后两组直肠感知阈值、排便阈值和疼痛阈值均有改善,与本组治疗前比较,差异有统计学意义(P<0.05),两组间比较,差异无统计学意义(P>0.05)。结论健脾调肝温肾方治疗IBS-D有效,且改善黏液便方面优于匹维溴铵,远期疗效也优于匹维溴铵。其治疗机制可能是通过调整肠道敏感性而发挥作用。 |
| 英文摘要: |
| Objective To verify the efficacy of Jianpi Tiaogan Wenshen Recipe(JTWR) in treating diarrhea -predominant irritable bowel syndrome(IBS-D) and to analyze its therapeutic mechanism through observing the effect of JTWR on clinical symptoms and rectal sensibility in patients.Methods With a prospective,randomized controlled trial adopted,80 patients with IBS-D were assigned randomly equally and to two groups.The treatment group was treated with JTWR,and the control group was treated with pinaverium bromide tablet (PVB),all for four weeks.Patients’ symptoms,such as abdominal discomfort,pain,and distension;frequency of defecation;appearance of stool;and occurrence of tenesmus were recorded before and after treatment by scoring,and the rectal sensitivity was detected as well.Patients with therapeutic effect of cured and markly effective were followed up four weeks after withdrawal of medication.Results Three cases in the treatment group and four cases in the control group were dropped.Except the appearing of mucus stool,no statistically significant difference was shown between the two group in all other symptoms,either at before or after treatment;but the end point scores of individual symptoms between pre-and post-treatment were different statistically in both groups (P<0.05).Per-protocol population set(PPS) analysis on comprehensive effect showed that the total effective rate and the cure rate in the treatment group was 81.1%(30/37) and 24.3%(9/37),and those in the control group,80.6%(29/36) and 19.4%(7/36) respectively;while the full analysis set(FAS) showed a result of 80.0%(32/40) and 22.5%(9/40) vs 77.5%(31/40) and 17.5%(7/40) respectively,all with insignificant difference between groups(P>0.05).Follow-up study showed that relapse or aggravation of disease occurred in four cases in the treatment group and 12 in the control group respectively,showing significant difference between groups(P<0.01).Rectal sensitivity examination showed that the rectal thresholds of sensation,defecation, and maximum tolerable volume were improved in both groups after treatment(P<0.05),but showed no significant difference between groups(P>0.05).Conclusions JTWR is effective in treating IBS-D,with the effect better than PVB in improving mucus stool,also in the remote effect.Its therapeutic mechanism is possibly by way of adjusting the sensitivity of rectum. |
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