黄礼 韦祎 刘英莲

摘要 目的：探討麻子仁增液汤对便秘型肠易激综合征患者（IBS-C）的临床效果。方法：选取2017年2月至2019年2月海口市第三人民医院收治的IBS-C患者100例作为研究对象，按随机数字表法分为对照组（n=49）和观察组（n=51）。对照组采用乳果糖治疗，观察组采用麻子仁增液汤+乳果糖治疗，比较2组临床疗效、中医症候积分、机体肠道菌群微生态变化、生命质量及不良反应。结果：观察组临床总有效率为94.12%，高于对照组的79.59%（P<0.05）;治疗后观察组中医证候大便干结、腹胀腹痛、潮热颧红、口干少津及小便短赤、身热积分低于对照组（P<0.05）;治疗后观察组乳酸杆菌、双歧杆菌、肠道菌群定植抗力B/E值高于对照组，而拟杆菌、肠杆菌低于对照组（P<0.05）;治疗后观察组健康忧虑、焦虑不安、躯体意念、社会功能、人际关系、挑食、行为障碍、性行为评分均高于对照组（P<0.05）;2组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：麻子仁增液汤对IBS-C患者的治疗效果较好，可调节机体肠道菌群变化，改善微生态环境，提高生命质量。

关键词 麻子仁增液汤;肠易激综合征;便秘型;肠道;菌群;微生态;生命质量;研究

Clinical Study on the Self-Made Maziren Zengye Decoction on Patients with Constipation

Predominant Irritable Bowel Syndrome

HUANG Li1，WEI Yi2，LIU Yinglian2

（1 Department of Chinese Medicine，Third People′s Hospital of Haikou City，Haikou 571100，China;

2 College of Chinese Medicine，Hainan Medical College，Hainan Province，Haikou 571199，China）

Abstract Objective：To explore the clinical effect of self-made Maziren Zengye Decoction on patients with constipation predominant irritable bowel syndrome （IBS-C）.Methods：A total of 100 IBS-C patients admitted to the Third People′s Hospital of Haikou City from February 2017 to February 2019 were selected as the research objects and were randomly divided into a control group （n=49，lactulose treatment） and an observation group （n=51，self-made Maziren Zengye decoction+lactulose treatment）.The clinical efficacy，TCM symptom score，microecological changes of intestinal microflora，quality of life and adverse reactions between the 2 groups were compared.Results：The total clinical effective rate in the observation group was 94.12%，which was higher than 79.59% in the control group （P<0.05）.After treatment，the scores of dry stool，abdominal distension，abdominal pain，hot flashes，red cheeks，dry mouth，little body fluid，short and red urine and body heat in the observation group were lower than those in the control group （P<0.05）.After treatment，Lactobacillusm，Bifidobacterium and colonization resistance of intestinal flora B/E value in the observation group were higher than those in the control group，while Bacteroides and Enterobacter in the observation group were lower than those in the control group （P<0.05）.After treatment，the scores of health anxiety，anxiety，somatic ideation，social function，interpersonal relationship，pickiness，behavioral disorder and sexual behavior in the observation group were higher than those in the control group （P<0.05）.There was no difference in the incidence of adverse reactions between the 2 groups （P>0.05）.Conclusion：The self-made Maziren Zengye Decoction has a good therapeutic effect on IBS-C patients.It can adjust the changes of intestinal microflora，improve the micro-ecological environment，and improve the quality of life.

Keywords Self-made Maziren Zengye Decoction; Irritable bowel syndrome; Constipation type; Intestinal; Microflora; Microecology; Quality of life; Study

中图分类号：R256.3;R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.02.018

便秘型肠易激综合征（Constipation Predominant Irritable Bowel Syndrome，IBS-C）是临床常见的慢性功能性肠道疾病，以腹痛或伴随排便习惯改变为主要特征，临床常表现为腹胀、腹痛、大便干结硬块、排便频率减少等症状[1]。目前该病的发病机制尚不明确，可能与内脏感觉异常、脑-肠轴互动异常、肠道动力异常、肠道炎性反应及肠道菌群失调等因素有关[2]，临床上常采用胃肠促动力药、肠解痉药、调节内脏敏感性等药物治疗，但效果不甚明显。中医认为，其归属于“痞满”“气秘”“便秘”等范畴，其病变部位在肠道，与脾、肺、肝、胃、肾脏器密切相关，当脾胃受损，运化无力，肠腑气滞不通，糟粕内停不下;当嗜食生冷之物，内滞阴寒，肠道凝滞，肠腑传导失常，糟粕停于内，以致病发;同时热、实、冷、虚4个方面相互转化或相互兼夹，疾病缠绵反复，日久气血津液不足，以致肠中津液不足，肠道失去润养，大肠传导不利，故病发[3-4]。……