中西医结合治疗腹泻型肠易激综合征的临床研究

目的 观察中西医结合治疗腹泻型肠易激综合征（IBS-D）的疗效.方法 将76例IBS-D患者按随机数字表法分为对照组和治疗组,每组38例.对照组给予匹维溴胺片50 mg,口服,3次·d^-1;治疗组在对照组治疗的基础上加用自主中药汤剂,早晚2次服用.2组均4周为1个疗程.采用IBS症状积分表（BSS）评分系统进行评分,观察2组患者的疗效及治疗前后IBS-D病情变化积分的情况.停药3个月后对痊愈和显效患者进行随访,观察其复发的情况.结果 治疗组总有效率为86.8％,对照组总有效率为65.8％,2组比较差异有统计学意义（P＜0.05）.2组治疗前腹痛、腹胀、腹泻、黏液便等症状积分比较差异均无统计学意义（均P＞0.05）,治疗1个月后治疗组的单项积分均明显低于对照组（均P＜0.05）.停止服药后3个月随访,治疗组18.2％的患者IBS-D复发或加重,对照组46.1％的患者IBS-D复发或加重,2组比较差异有统计学意义（P＜0.05）.结论 中西医结合治疗IBS-D能有效地提高患者近期疗效及改善主要单项症状,远期疗效也较稳定,复发率低,较单用西药治疗更有优势.

Combined Traditional Chinese and Western Medicine for Diarrhea-Predominant Irritable Bowel Syndrome

Objective To observe the efficacy of combined traditional chinese and western medicine in the treatment of diarrhea-predominant irritable bowel syndrome（IBS-D）.Methods Seventysix patients were randomly treated with 50 mg pinaverium bromide tablets 3 times per day （control group,n=38） or in combination with traditional chinese medicine decoction twice per day （treatment group,n=38） for 4 weeks. The BSS scoring system was used to evaluate the curative efficacy before and after treatment. The follow-up was performed 3 months after treatment to observe the recurrence in patients achieving recovery or improvement. Results The total effective rate in treatment group was significantly higher than that in control group （86.8% vs 65.8%,P〈0.05）. There were no significant differences in the integrals of abdominal pain, abdominal distension, diarrhea and mucus stools between the two groups before treatment （P〉0.05）,At 1 month after treatment, the integral of each item was obviously lower than that in control group（P〈0,05）. At 3 months after treatment,the rate of IBS-D recurrence or aggravation in treatment group was significantly lower than that in control group （18.2% vs 46.1%,P〈0.05）. Conclusion Compared with western medicine alone, combined traditional chinese medicine and western medicine treatment can effectively improve shorterm effects and major individual symptoms with stable long-term effects and low recurrence rate in patients with IBSD.