摘要
目的：通过对“补肾温阳，活血通络”作用的自拟中药内服方治疗骶神经障碍综合征（SNDS）的临床研究，探索中医药治疗SNDS的病机、治法及疗效。方法：中医药治疗总例数58例，治疗组和对照组各29例，前者予以中药口服自拟中药基本方（济川煎和独活寄生汤为基本方加减而成）随证加减，后者予以长强穴及局部阿是穴电针治疗，疗程2周，治疗前后观察患者肛门直肠痛、排便障碍、肛门失禁、腹胀腹痛及腰痛的症状积分情况，观察治疗前后患者中医症状积分情况。结果：（1）疗效指标：中医药治疗研究两组患者的常见症状依次为：肛门直肠痛（82．8％），排便障碍（75．9％），腰痛（62．1％），腹胀痛（50％），肛门失禁（15．5％）。各组以上症状治疗后较治疗前均有改善，研究组的排便障碍疗效更优，与对照组比较有显著差异（P〈0．05）。（2）中医证候：两组患者治疗后中医证候总疗效较治疗前均有改善，治疗组疗效更优，与对照组比较有显著差异（P〈0．05）。结论：（1）SNDS根据其症状特点，归属于中医便秘、痹证、痛证的范畴，肾阳虚、寒湿痹阻、血脉瘀滞是本病的主要病机。补肾温阳、散寒除湿、活血通络是本病的主要治法，采用以济川煎和独活寄生汤为基本方加减而成的基本方治疗以及采用针灸疗法SNDS均具有较好的临床疗效，总体疗效相当。（2）采用辨证用药治疗本病较针灸治疗对SNDS的排便障碍、肛门直肠痛症状的改善疗效更好。（3）采用中医药治疗的疗效和国内文献中报告的生物反馈疗法和神经阻滞疗法的疗法接近，并能改善排便障碍、腰痛及腹胀痛等并发症状。（4）SNDS的临床特点为：好发于女性，好发于30-60岁；SNDS的临床症状除肛门失禁外，相互并发率很高。
Objective ： Through the role of ＂warming and recuperating the kidney yang, activating blood and dredging collaterals＂ treating of sacral nerve dysfunctional syndrome （ SNDS ） with clinical research, to explore the pathogenesis, therapeutic method and efficacy of traditional Chinese medicine treatment of SNDS. Methods ： The number of 58 cases of Chinese medicine treatment, each study and control group of 29 cases, the former group were given oral self-made chinese herbal preparation （ JiChuanJian and DuhuojishengTang made of the basic Prescription ） add subtract according to syndroms, the latter group were given electroacupuncture ＂Chang Qiang Point＂ and ＂A Shi point＂, course of 2weeks, the treatment Patients were observed before and after the symptom score of anorectal pain, dysporia （constipation）, anal incontinence, abdominal pain and distension, low back pain and the syndrome integral of chinese medicine. Results： （ 1 ）Endpoint The common symptom of Chinese medicine treatment patients were as follows： anorectal pain （ 82.8% ）, dysporia （ constipation75.9% ）, low back pain （ 62.1% ）, abdominal pain and distension （ 50% ）, anal incontinence （ 15.5% ）. Symptoms after treatment than before treatment had improved in each group, better efficacy of dysporia （ constipation ） in study group, compared with the control group were significantly different （ P〈0.05 ）. （ 2 ） TCM syndrome integral Two groups of patients overall efficacy of TCM syndrome integral after treatment than before treatment had improved, better study group, compared with the control group were significantly different （P〈0.05）. Conclusion ： （ 1 ） SNDS is a disease, according to characteristics of their symptoms, attributable to traditional Chinese medicine constipation, Bi Syndrome, pain syndrome category, Kidney Yang Deficiency, cold and wet Blockage, blood stasis is the main pathogenesis of this disease. Tonifying kidney yang, dispelling cold and dampness,promoting blood circulation and collaterals are the main therapies of this disease, the use of the JiChuanJian and DuhuojishengTang made of the basic Prescription of basic addition and subtraction and the use of acupuncture and moxibustion treatment of SNDS Has better clinical efficacy, the overall effect quite. （ 2 ） Use of Chinese medicine treatment of the disease better than the acupuncture therapy, defecation disorders, the symptoms of anorectal pain and better to improve the efficacy. （ 3 ）The efficacy of treatment with Chinese medicine and domestic literature reports of biofeedback therapy and nerve block therapy treatment approach, and can improve bowel disorders, low back pain and abdominal distension pain syndromes. （ 4 ） SNDS characterized by： more common in women, occurs in 30 to 60 age group. SNDS symptoms of incontinence in addition, the mutual complication rate is high.
出处
《辽宁中医药大学学报》
CAS
2012年第2期26-33,共8页
Journal of Liaoning University of Traditional Chinese Medicine
基金
江苏省中医药局立项课题资助项目(LZ09051)
关键词
骶神经障碍综合征
中医药
临床试验
sacral nerve dysfunctional syndrome
Chinese medicine
clinical trials
