附子理中汤治疗腹泻型肠易激综合征脾肾阳虚证临床研究

目的：评价附子理中汤治疗脾肾阳虚证腹泻型肠易激综合征(diarrhea irritable bowel syndrome, IBS-D)的疗效。方法将符合入选标准98例脾肾阳虚型IBS-D患者按随机数字表法分为2组各49例。均给予纠正电解质、水紊乱等常规治疗，对照组在此基础上服用柳氮磺胺吡啶片，中医组在此基础上加用附子理中汤。观察2组治疗前后症状积分、健康调查量表积分、证候积分、结肠内镜积分变化，比较2组不良反应发生率，评价临床疗效。结果治疗后，中医组症状总积分(1.80±0.19)分比(4.90±2.24)分，t＝9.653]、健康调查量表总积分(14.01±7.11)分比(31.44±12.91)分，t＝8.278]、证候总积分(2.33±0.10)分比(4.86±0.93)分，t＝18.934]、结肠内镜积分(0.89±0.03)分比(1.60±1.14)分， t＝4.358]均明显低于对照组(P＜0.01)。中医组总有效率93.88%(46/49)比75.51%(37/49)，χ2＝6.376]明显高于对照组(P＝0.012)。中医组未见不良反应，对照组为12.24%(6/49)，2组比较差异有统计学意义(χ2＝6.391，P＝0.012)。结论附子理中汤可有效改善脾肾阳虚型IBS-D的临床症状，提高临床疗效。

Clinical study ofFuzi-Lizhongdecoction for diarrhea irritable bowel syndrome with Chinese pattern of spleen kidney yang deficiency

ObjectiveTo assess the effect of Fuzi-Lizhongdecoction for the diarrhea irritable bowel syndrome (IBS-D) with the Chinese pattern of spleen kidney yang deficiency.MethodsA total of 98 patients diagnosed IBS-D with spleen kidney yang deficiency Chinese patternwere included from April,2014 toMarch, 2015 in our hospital,and were randomly divided into the control group and Traditional Chinese Medicine (TCM) group at ratio of 1:1, 9 paitents in each group, two groups were administrated with the convetional treatment such as correct water, electrolyte disorders. Besides, the control group was added withsulfasalazine treatment, and TCM group withFuzi-Lizhongdecoction. Outcomes includedchanges of symptoms scores, questionnaire scores, TCM syndrome scores, endoscopic scoresand adverse events.Results After treatment, the TCM group showed significantly lower scores of symptoms (1.80 ± 0.19vs. 490 ± 2.24,t=9.653), questionnaire (14.01 ± 7.11vs.31.44 ± 12.91,t=8.278), TCM syndrome (2.33 ± 0.10 vs.4.86 ± 0.93,t=18.934), endoscopic assessment (0.89 ± 0.03 vs.1.60 ± 1.14, t=4.358) than those of the control group (P<0.01). The TCM group showed significantly higher effective rate (93.88%vs.75.51%) than the control groupa (χ2=6.376,P=0.012). The adverse events of TCM group and control group were 0% (0/49) and 12.24% (6/49), and the difference was statistically significant (χ2=6.391,P=0.012).Conclusion Fuzi-Lizhong decoction is safe and effective therapy for IBS-D with Chinese pattern of Yang deficiency of spleen and kidney.