术汤加减治疗便秘型肠易激综合征临床观察.docVIP

术汤加减治疗便秘型肠易激综合征临床观察【摘要】 目的 探讨《金匮》枳术汤加减治疗便秘型肠易激综合征(constipation-dominant irritable bowel syndrome，IBS-C)的临床疗效。方法 IBS-C患者48例，随机分为治疗组和对照组，治疗组予枳术汤加减水煎取汁400 ml，服2次；对照组予替加色罗6 mg，2次/d，疗程均为12周。治疗前后分别评价患者的大便性状、肠道症状严重程度及临床疗效。结果 治疗12周后，治疗组与对照组患者的Bristol评分均较治疗前明显提高(治疗前后变化差值：治疗组 1．32±0．59，P＜0．05；对照组 1．34±0．61，P＜0．05)，腹部症状评分较治疗前有明显下降(治疗前后变化差值：治疗组 9．3±1．42，P＜0．05；对照组 9．6±1．61，P＜0．05；组间比较P＞0．05)，两组的治疗效果比较无明显差异(P＞0．05)。结论 枳术汤治疗IBS-C患者具有与替加色罗治疗相同的疗效，但枳术汤价廉易于推广。? 【关键词】 枳术汤；替加色罗；便秘型肠易激综合征?? Clinical observation Zhishu decoction on constipation-dominant irritable bowel syndrome GAO Ying, Department of Chinese Medicine,Second Hospital of Shandong Medical University，Shandong 250001，China? 【Abstract】 Objective To evaluate the clinical efficacy on constipation-dominant irrtable bowel syndrome(IBS-C)treated with Zhishu decoction．Methods 41 patients diagnosed as IBS-C according to the Rome Ⅲ criteria were randomly divided into two groups and followed up for twelve weeks．Treatment group was given：zhishu decoction 400 ml twice daily and control group was given ：tegaserod，6 mg twice daily．Main outcomes assessment included the Bristol stool form scale，the symptomatic scores and clinical efficacy at baseline and at the end of twelve weeks． Results After twelve weeks，the bristol stool form scale，the symptomatic scores and the clinical efficacy at baseline have significant improvement in both groups compared with baseline．There was no significant difference of efficiency between treatment and control group． Conclusions Clinical efficacy on IBS-C treated with Zhishu decoction in improving patients’ stool description and clinical symptom is as available as that of tegaserod treatment; but zhishu decoction is cheaper than that of tegaserod．? 【Key words】 Zhishu decoction； Tegaserod；IBS-C ? 肠易激综合征(irritable bowel syndrome，IBS)是一种非器质性胃肠道功能紊乱性疾病，由于遗传和心理因素的作用，导致胃肠道功能的易感性，出现胃肠道运动异常、内脏高敏感性和黏膜免疫的变化，患者表现为持续或间歇发作的腹痛或腹部不适，伴排便频率改变及粪便性状异常等[1]。肠易激综合征是一种发病率较高的功能性胃肠病，全球人群中有10％ ～20％ 的成人和青少年符合IBS的症状