中医辨证分型治疗肠易激综合征的临床观察

目的：中医辨证分型治疗肠易激综合征，以西药得舒特为对照，从肠道症状和生活质量两方面观察其临床疗效。方法：符合罗马Ⅲ诊断标准的96例肠易激综合征患者，中药组76例，辨证分为4型：中药1组（肝郁脾虚型）20例，予疏肝健脾方治疗；中药2组（脾气虚弱型）18例，予益气健脾止泻方治疗；中药3组（脾肾阳虚型）19例，予温补脾肾，固涩止泻方治疗；中药4组（湿热阻滞型）19例，予清化湿热方治疗。对照组20例，予得舒特治疗。5组服药疗程为4周。采用症状等级评分表和SF-36生活质量评价作为判定依据，观察治疗前后各组患者肠道症状及生活质量的变化。结果：①中药组的治疗有效率优于对照组，差异有显著性（P〈0．05）。②治疗前后中药组患者肠道症状均有显著改善，对照组的腹胀症状无明显改善。中药组对腹痛、大便次数、大便急迫方面的改善作用明显优于对照组。③中药组治疗前后患者躯体疼痛（BP）、总体健康（GH）、活力（VT）、社会功能（SF）、精神健康（MH）维度的积分均有明显提高，具有统计学意义（P〈0．05），对照组患者仅活力维度的生活质量得到显著改善，具有统计学差异（P〈0．05）。结论：中医辨证分型治疗肠易激综合征疗效确切，在肠道症状的改善和生活质量的提高两方面都显著优于西药得舒特。

Clinical Observation on Traditional Chinese Medicine Syndrome Differentiation and Treatment for Irritable Bowel Syndrome

Objective：To observe the clinical efficacy of traditional Chinese medicine syndrome differentiation for treating irritable bowel syndrome（IBS） ,taking Western medicine as the control. Methods：IBS was diagnosed based on Rome Ⅲ standard. Ninty - six IBS patients were randomly divided into five groups. All the patients took oral administration. 20 patients were in the first group（ liver depression and spleen deficiency type）were treated with Shugan Jianpi Formula. 18 patients in the second group（ spleen- Qi deficiency type）were treated with Yiqi Jianpi Zhixie Formula. 19 patients in the third group （spleen and kidney Yang deficiency type） were treated with methods of warming kidney and spleen and relieving diarrhea. 9 patients in the fourth group （ heat and damp blocking type） were treated with methods of clearing and resolving heat and damp. 20 patients in the fifth group were as the control group and were only given pinaverium bromide. The treating procedure was 4 weeks in all five groups. Symptom grading chart and SF - 36 living quality were used as the judgemental basis. Improvement of bowel＇s syndrome and living quality in three groups were observed pre - and post - treating. Results：（1）Treating effects were obviously much better in the Chinese medicine group than that in the control group, and there was a significant difference （P 〈 0.05）, （2） Bowel＇s symptoms were improved in the Chinese medicine groups while it was not obvious in control group. Chinese traditional medicine also reduced the stomachache degree, defecate times and shit urgent symptom in treating groups, while these above symptoms did not obviously change in control group. （3）Bodily pain（ BP）, general health（ GH）, vitality（VT）, social functioning （SF） and mental health （MH） dimension of integral were significantly improved in treating groups. Compared with treating groups, only VT was improved significantly in control group, there was statistical difference （ P 〈 0.05 ）. Conclusion ： There are definite effects in treating IBS with traditional Chinese medicine syndrome differentiation than single Western medicine, and there is obvious improvement in aspects associated with bowel＇s symptom and living quality. It is worthy of further promotion.