目的 观察逍遥煎剂联合穴位贴敷治疗腹泻型肠易激综合征（diarrhea predominant irritable bowel syndrome IBS-D)肝郁脾虚证的临床疗效。方法 将130例IBS-D肝郁脾虚证患者随机分为2组，每组65例。对照组患者接受酪酸梭菌二联活菌、匹维溴铵治疗；观察组患者在对照组疗法基础上，口服逍遥煎剂以及接受穴位贴敷治疗。两组均以4周为1个疗程。比较治疗前后以及停药4周后两组患者Bristol大便性状评分、中医症状评分、肠易激综合征生活质量(irritable bowel syndrome-quality of life, IBS-QOL)评分、肠易激综合征严重程度评分系统（irritable bowel syndrome-severity scoring system，IBS-SSS）评分。结果 与治疗前比较，治疗4周后和停药4周后，两组患者Bristol评分，IBS-SSS评分及腹痛、腹泻、便溏评分，症状总评分均显著降低（P＜0.05），IBS-QOL的焦虑不安、日常生活、躯体意识、健康担忧、食物回避、社会功能、性生活、人际关系评分均显著升高（P＜0.05）。与对照组比较，观察组治疗4周后和停药4周后IBS-SSS评分，腹痛、便溏评分和症状总评分明显降低（P＜0.05），IBS-QOL的焦虑不安、日常生活、躯体意识、健康担忧、食物回避、社会功能、人际关系评分均显著升高（P＜0.05）。结论 逍遥煎剂口服联合穴位贴敷可减轻IBS-D的严重程度，改善患者生活质量，具有较好的近期疗效和远期疗效。
Objective To investigate the clinical effect of Xiaoyao Decoction combined with acupoint application in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) with liver stagnation and spleen deficiency. Methods A total of 130 patients with IBS-D with liver stagnation and spleen deficiency were randomly divided into control group and observation group, with 65 patients in each group. The patients in the control group were given Combined Clostridium Butyricum and Bifidobacterium and pinaverium bromide, and those in the observation group were given oral Xiaoyao Decoction and acupoint application in addition to the treatment in the control group. Each course of treatment was 4 weeks. The two groups were compared in terms of Bristol stool score, traditional Chinese medicine (TCM) score, irritable bowel syndrome-quality of life (IBS-QOL) score, and irritable bowel syndrome-severity scoring system (IBS-SSS) score before treatment, after treatment, and after 4 weeks of drug withdrawal. Results Both groups had significant reductions in Bristol score, IBS-SSS score and scores of abdominal pain, diarrhea, and loose stool, and total symptom score after 4 weeks of treatment and after 4 weeks of drug withdrawal (P<0.05), as well as significant increases in the scores of anxiety, daily life, body consciousness, health concern, food avoidance, social function, sexual life, and interpersonal relationship of IBS-QOL(P<0.05). Compared with the control group after 4 weeks of treatment and after 4 weeks of drug withdrawal, the observation group had a significant reduction in IBS-SSS score，scores of abdominal pain, loose stool, and total symptom score (P<0.05) and significant increases in the scores of anxiety, daily life, body consciousness, health concern, food avoidance, social function, and interpersonal relationship of IBS-QOL(P<0.05). Conclusion Oral Xiaoyao Decoction combined with acupoint application can alleviate the severity of IBS-D and improve patients quality of life and thus has good short- and long-term effects.
张树卿,查安生,邹晓华,欧阳劲光,王 睿,夏酉年,曹 静,汪 悦,纪慧萍.逍遥煎剂联合穴位贴敷治疗腹泻型肠易激综合征肝郁脾虚证临床观察[J].安徽中医药大学学报,2020,39(1):16-20复制