辨证治疗腹泻型肠易激综合征60例临床观察

目的 观察中医辨证分型治疗腹泻型肠易激综合征的临床疗效。方法将60例符合罗马Ⅲ诊断标准的腹泻型肠易激综合征患者辨证分为3型，肝郁脾虚型（24例）予痛泻要方协定方治疗，脾气虚弱型（20例）予参苓白术散协定方治疗，脾。肾阳虚型（16例）予四神丸合理中汤协定方治疗。3组疗程均为8周。采用目前国际公认的肠道症状尺度表和生活质量量表，观察治疗前后各组患者肠道症状及生活质量的变化情况。结果肝郁脾虚组有效率为83．3％，脾气虚弱组为85．0％，脾肾阳虚组为75．0％，组间疗效差异无统计学意义（P〉0．05）。3组肠道症状、生活质量和排便情况在治疗后均显著改善（P〈0．05）。结论中医辨证分型治疗腹泻型肠易激综合征疗效确切。

Clinical Observation of Syndrome Differentiation and Treatment for 60 Cases of Diarrhea-Predominant Irritable Bowel Syndrome

Objective To observe the clinical efficacy of syndrome differentiation and treatment for diarrhea-predominant irritable bowel syndrome. Methods Sixty cases were differentiated into three syndromes： liver-depression and spleen-deficiency syndrome with 24 cases treated with ＂Tongxie Yaofang Decoction＂, spleen-qi deficiency syndrome with 20 cases treated with ＂Shenling Baizhu Powder＂ and spleen-kidney yang-deficiency syndrome with 16 cases treated with ＂Sishen Pill＂ and ＂Lizhong Decoction＂, all with a course of 8 weeks. Gastrointestinal scale and life quality scale were used to assess the gastrointestinal symptoms and quality of life. Results The effective rate was 83.3% in the liver-depression and spleen-deficiency syndrome, 85.0% in the spleen-qi deficiency syndrome and 75.0% in the spleen-kidney yang-deficiency syndrome, with no difference among the three rates（P 〉0.05 ） ; the gastrointestinal symptoms, quality of life and defecation were all improved in the three syndromes（P 〈0.05）. Conclusion Syndrome differentiation and treatment has positive effects on diarrhear-predominant irritable bowel syndrome.