固本益肠汤四联续贯疗法治疗脾虚泄泻疗效观察

[目的]观察固本益肠汤联合甲硝唑、肠道益生菌及食物日志指导的饮食调整四联续贯疗法治疗脾虚泄泻的疗效。[方法]108例脾虚泄泻患者随机分为3组，四联治疗（A）组36例，给予固本益肠汤100ml／次，3次／d，联合甲硝唑200mg，2次／d，整肠生0．5g，3次／d及食物日志指导的饮食调整四联续贯治疗；对照1（B1）组36例，给予甲硝唑、整肠生；对照2（B2）组36例，仅给予甲硝唑，治疗剂量及方法均同A组；以上药物除甲硝唑服用1周外，其他服用至第4周，整肠生在甲硝唑停药后开始服用。所有病例均经结肠镜检查排除器质性疾病。[结果]A组治愈率（77．8％）明显优于B1、B2组（41．7％、13．9％）（P〈0．01），而B1组显效率（74．3％）较132组（30．6％）为优（P〈0．01）。停药后A组6周与12周复发率（8．3％、11．1％）均较B1、B2组（25．8％、42．9％，36．0％、52．0％）低（P〈0．01），B1、B2组12周复发率明显高于6周（P〈0．05）。[结论]固本益肠汤四联续贯疗法治疗脾虚泄泻，可提高治愈率及显效率，降低复发率，较单纯甲硝唑及甲硝唑与肠道益生菌联合治疗为优，临床观察无明显不良反应，是一种较有效的治疗方法。

Clinical value of Guben Yichang decoction based quadruple therapy in patient with diarrhea due to splenic asthenia

[Objective]To observe the curative effect of Guben Yichang decoction based quadruple therapy in patient with diarrhea due to splenic asthenia. [Methods]One hundred and eight cases of patients with diarrhea due to splenic asthenia were randomly divided into three groups, group A （n=36） received Guben Yichang decoction based quadruple therapy （Guben Yichang decoction 100ml,bid＋Metronidazole 200mg bid＋ Entrocoordinatibiogen 2 tablets bid＋food-remedy ）; group B1 （n=36） received double therapy （Metronidazole 200mg bid＋ Entrocoordinatibiogen 2 tablets bid） ; group B2 received Metronidazole 200mg bid only. Metronidazole was given for one week, the others were four weeks; Entrocoordinatibiogen was given after Metronidazole. The diagnosis was determined by electronic colonoscopy. [Results] The curative rate in A （77. 8%） was better than that in B1/2（41. 7%, 13. 9%）（P〈0. 01）. The excellence rate in B1（74. 3%） was better than that in B2（30.6%） （P〈0. 01）. The recrudescence rate after stopping therapy 6w and 12w in A （8. 3%, 11.1%）were lower than that in B1/2 （25.8 %, 42. 9 % ; 36. 0%, 52.0%） （P〈0.01）. The recrudescence rate of 12w in B1/2 were higher than that of 6w（P〈0. 01）. [Conclusion]Guben Yichang decoction Based quadruple therapy in patient with diarrhea due to splenic asthenia could raise the curative rate and excellence rate, cut down recrudescence rate, which is better than that of antibiotic with probiotics or antibiotic only.