| 摘要: |
| 目的：观察柴芍枳术汤治疗便秘型肠易激综合征肝郁脾虚证的临床疗效。方法：选取便秘型肠易激综合征肝郁脾虚证患者80 例，将其随机分为治疗组和对照组，每组各40 例。对照组采用马来酸曲美布汀片和乳果糖口服溶液治疗，治疗组在对照组基础上予以柴芍枳术汤加减治疗，疗程均为4周。比较2组临床疗效及治疗前后IBS生活质量评价表（quality of life IBS，IBS-QOL)评分、促肾上腺皮质激素释放激素（corticotropin-releasing hormone，CRH）、促肾上腺皮质激素（adrenoticotropic hormone，ACTH）及皮质醇（corticosterone，CORT）水平，治疗6个月后对2组进行电话随访，观察复发情况。结果：治疗组失访3 例;对照组失访1 例，服用其他药物1 例;本研究最终纳入受试者75 例。总有效率治疗组为89.2%（33/37），对照组为73.7%（28/38），2组比较，差异有统计学意义（P＜0.05）。2组IBS-QOL评分及CRH、ACTH、CORT水平治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P＜0.05）。复发率治疗组为6.1%（2/33），对照组为21.4%（6/28），2组比较，差异有统计学意义（P＜0.05）。结论：柴芍枳术汤能缓解便秘型肠易激综合征肝郁脾虚证患者的便秘症状，改善生活质量，减少患者痛苦，有效降低CRH、ACTH、CORT水平，从而达到治疗效果，但其相关的机制研究，仍需进一步探索。 |
| 关键词: 便秘型肠易激综合征 肝郁脾虚证 中西医结合疗法 柴芍枳术汤 |
| DOI： |
|
|
| Clinical effect of Chaishao Zhizhu decoction in treatment of constipation-predominant irritable bowel syndrome with stagnation of liver Qi and spleen deficiency：An analysis of 37 cases |
| YANG Ting,PI Mao |
| (Xiangtan Hospital of Traditional Chinese Medicine，Xiangtan 411100，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Chaishao Zhizhu decoction in the treatment of constipation-predominant irritable bowel syndrome with stagnation of liver Qi and spleen deficiency.Methods：A total of 80 patients with constipation-predominant irritable bowel syndrome with stagnation of liver Qi and spleen deficiency were enrolled and randomly divided into treatment group and control group，with 40 patients in each group.The patients in the control group received trimebutine maleate tablets and lactulose oral solution，while those in the treatment group received Chaishao Zhizhu decoction in addition to the treatment in the control group，and the course of treatment was 4 weeks for both groups.The two groups were compared in terms of clinical outcome，Irritable Bowel Syndrome-Quality of Life (IBS-QOL) score，corticotropin-releasing hormone (CRH)，adrenocorticotropic hormone (ACTH)，and corticosterone (CORT) before and after treatment.Telephone follow-up was performed after 6 weeks of treatment to observe recurrence.Results：Three patients in the treatment group and 1 in the control group were lost to follow-up，and 1 patient in the control group took other medications;75 subjects were finally included in this study.There was a significant difference in overall response rate between the treatment group and the control group ［89.2% (33/37) vs 73.7% (28/38)，P＜0.05］.After treatment，both groups had significant changes in IBS-QOL score and the levels of CRH，ACTH，and CORT，and there were significant differences in these indicators between the two groups after treatment (P＜0.05).There was a significant difference in recurrence rate between the treatment group and the control group ［6.1% (2/33) vs 21.4% (6/28)，P＜0.05］.Conclusion：For patients with constipation-predominant irritable bowel syndrome with stagnation of liver Qi and spleen deficiency，Chaishao Zhizhu decoction can alleviate constipation symptoms，improve quality of life，reduce pain，and effectively lower the levels of CRH，ACTH，and CORT，thereby exerting a therapeutic effect on the disease.However，further studies are needed to explore related mechanisms. |
| Key words: constipation-predominant irritable bowel syndrome stagnation of liver Qi and spleen deficiency integrated traditional Chinese and Western medicine therapy Chaishao Zhizhu decoction |
