【作者】 刘柱成；

【导师】 黄福斌；

【作者基本信息】 南京中医药大学 ， 中医学， 2010， 硕士

【摘要】 肠易激综合征(IBS)是临床常见病、多发病,本病起病隐匿,症状反复发作或慢性迁延,给患者带来了沉重的经济和心理负担。罗马Ⅲ诊断标准将IBS分为IBS腹泻型(IBS-D)、IBS便秘型(IBS-C)、IBS混合型(IBS-M)及IBS不定型(IBS-U)4型,临床以IBS-D占多数。笔者以中医理论为基础,结合导师及众多临床医家经验,认为肝郁脾虚,肝脾不调是IBS-D的重要病机,临床以肝郁脾虚证最为常见,从而确立疏肝健脾法为IBS-D的治疗大法。研究目的：观察疏肝健脾法治疗IBS-D肝郁脾虚证的临床疗效,研究结果可作为以后临床参考。研究方法：采用随机数字表分组法,将60例入选病人随机分为治疗组和对照组,分别用疏肝健脾法和口服洛哌丁胺治疗,疗程为4周,于治疗前后观察并记录2组主要症状、次要症状、不良反应等,对2组的数据进行统计学分析。研究结果：治疗组有效率96.67%,对照组有效率73.33%,治疗组有效率明显高于对照组(P<0.05)。治疗组和对照组均能明显改善IBS-D患者主要症状(P<0.01)。治疗组在改善患者腹痛上明显优于对照组(P<0.01),在改善大便次数、大便性状上2组无差异(P>0.05)。治疗组在改善患者次要症状上优于对照组。研究结论：中医疏肝健脾法治疗IBS-D肝郁脾虚证,安全有效,优势明显。更多还原

【Abstract】 Irritable Bowel Syndrome (IBS) is a clinical common and frequently-occurring disease, which is recurrent or chronic persistent, giving patients a heavy impact on the economic and psychological.By the Rome III diagnostic criteria, IBS is divided into four types:IBS diarrhea (IBS-D), IBS constipation(IBS-C), IBS mixed type (IBS-M), and IBS are not stereotypes (IBS-U) 4-type, with IBS-D is most common in clinical.The author based on the theory of TCM combined with many years of clinical practice of the instructor and clinical physicians suggested that liver depression and spleen deficiency is the most important pathogenesis of IBS-D. In clinical the syndrome of liver depression and spleen deficiency is most common,so as to set Shugan Jianpi Recipe (SJR) for the treatment of IBS-Din the main method. Objective:To verify the SJR in treating syndrome of liver depression and spleen deficiency of IBS-D. The results can be used as clinical reference later.Research Methods:A random number table grouping method,60 cases were randomly divided into treatment group and the control group, respectively treated with SJR and oral Loperamide for 4 weeks. Before and after the the treatment,observe and record the two groups’main symptoms, secondary symptoms, adverse reactions. The data is statistically analyzed to identify the advantage.Results:The treatment studies shown that the treatment group’s effective rate is 96.67%, when the comparison group’s is 73.33%,the treatment group was significantly higher (P<0.05).Both of the two groups,the main symptoms of patients after treatment have markedly improved. Treatment group had a better efficacy in improving abdominal pain than the control group (P<0.01), but no difference in improving stool frequency and character. In some secondary symptoms, the treatment group is better than the control group.Study Conclusion:SJR of TCM is safe and effective in treating syndrome of liver depression and spleen deficiency of IBS-D.更多还原