云母石合用痛泻要方治疗腹泻型肠易激综合征

王媛媛，李镇*，郑亮

(江苏省第二中医院脾胃病科，南京 210017)

摘要：目的观察云母石连用痛泻要方加味治疗腹泻型肠易激综合征肝郁脾虚证的临床疗效。方法选取诊断病例60例，分为对照组和治疗组，每组30例。治疗组：云母石连用痛泻要方加味(云母石10 g，炒白芍12 g，陈皮10 g，炒白术12 g，防风12 g。辨证加减:肝郁者加醋柴胡6 g，绿萼梅10 g等；脾虚者加炒党参15 g，茯苓12 g，山药15 g等；湿热者加葛根10 g，黄连5 g，黄芩10 g，地锦草15 g，辣蓼15 g等；伴脾肾阳虚者加吴茱萸5 g，肉豆蔻10 g，五味子10 g等)。对照组：口服匹维溴胺50 mg，2次/d，双歧杆菌三联活菌0.42 g,3次/d。4周为1个疗程。对2组临床症状积分、中医证候疗效及HAMD抑郁量表、HAMA焦虑量表进行评估。结果治疗组总有效率83.3%，大于对照组的56.7%(P<0.05)，治疗组抑郁量表及焦虑量表评分治疗后小于治疗前(P<0.05)，并优于对照组(P<0.05)。结论云母石连用痛泻要方加味治疗腹泻型肠易激综合征肝郁脾虚证在改善胃肠道症状及解除精神抑郁或焦虑状态方面具有优势。

关键词：云母石;痛泻要方;肠易激综合征;腹泻;健脾胜湿;疏肝解郁

DOI:10.13463/j.cnki.jlzyy.2015.01.013

中图分类号：R574文献标志码： A

文章编号：1003-5699(2015)01-0043-04

基金项目：江苏省中医药管理局

作者简介：王媛媛(1977-)，女，硕士研究生，副主任医师,主要从事中医脾胃病的临床及科研工作。

收稿日期:(责任编辑：张晔2014-08-29)

*通信作者：李镇，电子信箱-dashi0114@163.com

Mica atba combined with Tongxieyaofang for diarrhea-predominant irritable bowel syndrome

WANG Yuanyuan,LI Zhen*,ZHENG Liang

(Department of Spleen and Stomach,The Second TCM Hospital of Jiangsu Province,Nanjing 210017,China)

Abstract：ObjectiveTo observe the clinical effect of mica atba combined with flavored Tongxieyaofang on liver and spleen deficiency syndrome of diarrhea-predominant irritable bowel syndrome.MethodsIBS-D 60 patients were randomly divided

into control group and treatment group (30 cases in each group).Treatment group:mica atba combined with flavored Tongxieyaofang (mica atba 10 g,stir-baked RADIX PAEONIAE ALBA 12 g,dried tangerine peel 10 g,roasted Rhizoma Atractylodis Macrocephalae 12 g,radix sileris 12 g.Dialectical addition and subtraction:radix bupleuri 6 g and FLOS MUME 10 g for the stagnation of liver Qi;Fried Radix Codonopsis 15 g,Poria cocos 12 g and Rhizoma Dioscoreae 15 g for the deficiency of spleen;Pueraria 10 g,Coptis chinensis 5 g,Radix Scutellariae 10 g,Creeping Euphorbia 15 g,Polygonum hydropiper 15 g for damp heat;evodia rutaecarpa 5 g,Nutmeg 10 g,Schisandra 10 g for Yang deficiency of spleen and kidney.) Control group:oral Pinaverium bromide 50 mg Bid and triple live Bifidobacterium Yin 0.42 g Tid (4 weeks for a course of treatment).The clinical symptom score,TCM symptoms HAMA and HAMD depression scale efficacy anxiety Scale were assessed.ResultsThe total efficiency of the treatment group was 83.3%,which was higher than that of the control group (56.7%) (P<0.05).The anxiety depression scale scores of the treatment group after treatment was less than that of pre-treatment (P<0.05) and better than that of the control group (P<0.05).ConclusionsThe combined use of traditional Chinese medicine has advantages in improving gastrointestinal symptoms and relieving depression or anxiety aspect.

Keywords:mica atba;Tongxieyaofang;irritable bowel syndrome;diarrhea;tonifying spleen;dispersing stagnated liver Qi for relieving Qi stagnation

随着生活节奏的加快，功能性胃肠病(FGIDs)的发病率不断提高。肠易激综合征(Irritable bowe syndrome,IBS)是其中最常见的功能性肠病之一，是一组持续存在或间歇发作的以腹痛、腹胀、排便习惯异常、大便性状异常为临床表现的症候群。该病缺乏可解释症状的形态学改变和生化异常[1]。现代医学认为，本病为精神因素、遗传因素、感染因素、饮食因素、神经和内分泌等多因素作用的结果[2]，是一种生物心理学疾病[3]。……