【作者】 陈啟铭；

【导师】 袁青；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2011， 硕士

【摘要】 目的观察肠三针为主穴对肠易激综合征辨证治疗的疗效及分析其影响因素方法将59例确诊为肠易激综合征患者(按照纳入标准和排除标准)随机分为治疗组(29例)和对照组(30例),治疗组进行针灸辨证治疗(主穴：百会穴肠三针(天枢关元上巨虚)配穴：脾胃虚弱者加足三里,针刺,补法,脾肾阳虚者灸肾俞.命门,肝气乘脾者加太冲泻法足三里补法,湿热中阻者加阴陵泉,泻法),对照组进行常规西药治疗(思密达,每次一袋,一天2次,匹维溴铵,每次50mg,一天3次口服,止泻不止加洛哌丁胺,每次4mg,),共3个疗程,每个疗程5天,两组患者进行年龄.病程.性别的可比性比较,观察是否具有可比性,治疗结束后观察总体疗效和各种症状(腹痛腹胀,大便性状,大便次数)的改善情况并进行组内和组间的对比,再分析其影响疗效的因素(年龄,病程,辨证分型)结果1.两组病人在总体疗效和大便次数分数的改善在统计学上无明显差异的(p>0.05),治疗组和对照组疗效相当,但从总有效率可以看出治疗组(86.2%)要比对照组(73.4%)改善明显。2.同组病人在治疗前后大便性状和腹痛腹胀改善的比较中可以看出有显著性差异,治疗后两组的对比(P<0.05)说明两组治疗均能改善大便性状和腹痛腹胀,但针灸比常规西药治疗更有效。3.不同辨证分型IBS的疗效不一样,脾胃虚弱型效果最好,肝气乘脾和湿热中阻的效果次之,脾肾虚弱型疗效较前三组弱,提示这个方法最适合脾胃虚弱型。4.各年龄段之间疗效对比无显著差异(P>0.05),提示年龄与疗效无关。5.从病程和疗效中的关系分析可以看出,病程越长,治疗效果越差,反之相对较好.结论该方法能明显改善肠易激综合症的总体症状,对比常规西药组,腹痛腹胀和大便性状的改善更明显,脾胃虚弱型的患者疗效更显著,患者病程越长,治疗效果越差,反之相对较好,疗效与年龄无关。更多还原

【Abstract】 ObjectiveTo observe the clinical effect of Chang-Three-Needle Technique(Tianshu, Guanyuan, Shangjuxu) on Irritable Bowel Syndrome(IBS) of Diarrhea type, and analyse the relationship between effect and influencing factor, such as age, course and differentiation type of chinese medicine.MethodsRandomized 59 IBS patients into Chang-Three-Needle group and control group. 29 patients of Chang-Three-Needle group received acupuncture with Baihui and Chang-Three-Needle. According to the differentiation standards of Chinese Medicine:reinforced Zusanli on Spleen-Stomach Asthenia patients; applied moxa on Shenshu, Mingmen on Yang-deficiency of Spleen-Kidney patients; reduced Taichong and reinforced Zusanli on Liver Qi suppressed Spleen patients; reduced Yinlingquan on Damp-heat patients, while the control group received oral drugs(Smecta lbag each time, Bid, PO, Pinaverium Bromide 50mg eachtime,Tid,PO.if diarrhea can not stop, add Loperamide 4mg,) depended on their symptoms. The sduty lasted for 3 courses, with 5 days as one course and 2 days break between each course. Grading each patients according symptoms.Results1. The total effecative and Defecate number showed no significant difference between two groups (P>0.05).2. In comparing description of defecate and abdominal feelings, both groups were improved. Chang-Three-Needle group was superior and showed a significant difference to control group.3. Effecatives differed from differentiation syndroms. Spleen-Stomach Asthenia patients achieved the best effecative, Liver Qi suppressed Spleen patients and Damp-heat patients follwed behind. While the effecative of Yang-deficiency of Spleen-Kidney patients were the lowest.4. No significant difference were shown between effecatives and age. Course and effecative were reciprocal to each other.5. The relationship between course of disease and curative effect show that curative effect will be better if course of disease shorterConcIusionChang-Three-Needle Technique can improve the total symptomsof IBS pat ients, is more excellent than oral drugs in improving description of de fecate and abdominal feelings, especial in Spleen-Stomach Asthenia pati ents. Course can interfered the effecative, but age cannot.更多还原