| Objective:To observe the charactrestic of traditional Chinese medicine(TCM) syndromes in 116 patients with functional gastrointestinal disorders(FGIDs) and malaise, analy the curative effect of treatment group compared with control group, explore the core features of FGIDs patients with tiao-shen therapy in multiaspect (such as TCM syndromes, symptoms, tongue image, pulse, compatibility of TCM tranquilizer).Methods:Acording to the order of see-doctor time,116casesof FGIDs with malaise, who met the inclusive criteria, were dived into a treatment group and a control group. Two groups were diagnose and treated by YAO Nai-li or ZHANGRun-shun chief physician in Guang’anmen Hospital, ChinaAcademy of Chinese Medical Sciences. Acording to dialectical treatment of TCM, all patients in two groups were treated for 4 weeks and required for return visit every two weeks.78 cases of patients in treatment group were used tranquilizer of TCM, but 38 cases of patients in control group were not used tranquilizer of TCM. Every patient was required to fill in the case report form. All diagnosis and treatment information was collected and input the structured clinical diagnosis and treatment information collecting system, then the multidimensional relational database was built with correlation among symptoms, syndrome, disease, therapy, prescription of TCM, herbs, outcome. The TCM clinical experience was analyzed by the datamining platform. Summarize clinical indication, adaptation disease, the species and dosage of common sedative herbs, clinical effectiveness of the Tiao Shen therapeutic methods.Multifactor Dimensionality Reduction (MDR) was used to summary effective compatibility. This study was analyzed with SPSS 20.0 software package. Normal distribution data were using t test. Independent samples t test was used between groups. Before and after treatment in a group were compared with Paired samples t test.p＜0.05 reveals that the outcome has statistically difference.Results:116 cases of FGIDs patients with malaise were included in this study, two patients withdrew in control group and two patients withdrew in treatment group. Total loss rate was 3.33%. ①In general symptoms integral, the main digestive tract symptoms integral, mental symptoms integral, affecting the work integral and the quality of life integral, symptoms integral after treatment decreased compared with before treatment in two groups, there is a significant statistical difference(P＜0.01) between before and after treatment with Paired samples t test.In general symptoms integral, mental symptoms integral, affecting the work integral and the quality of life integral, the decreased degree of symptoms integral in treatment group was obviously higher than that in control group, but there is no significant statistical difference(P>0.05). While the decreased degree of main digestive tract symptoms integral in control group was obviously higher than that in treatment group, but there is no significant statistical difference(P＞0.05S).② general symptoms, mental symptoms and affecting the work, total effective rate of treatment group were higher than that of control group,there is no significant statistical difference(P>0.05) with x2 test. In the main digestive tract symptoms and the quality of life, total effective rate of control group were higher than that of treatment group.there is no significant statistical difference(P>0.05) with x2 test. ③In sleep, dreaminess, palpitation, dysphoria, anxiety and depression, the total effective rate of treatment group were higher than those of control group, there is significant statistical difference in sleep (P=0.002) and dysphoria (P=0.044). ④ The top 13 of tranquilizer of TCM in 44 effective cases of treatment group are Dan-shen, Sheng long-gu, Sheng mu-li, He huan-hua, Zhen zhu-mu, Suan zao-ren, He huan-pi, Shou wu-teng, Yu-jin, Shi chang-pu, Duan mu-li, Bai-he, Bai zi-ren. The effective rate of tranquilizer of TCM are as follows:Zhen zhu-mu(67.86%), Bai zi-ren (61.54%), Bai-he (60%),Dan-shen (60%),He huan-pi (54.17%),He huan-hua (53.13%),Sheng long-gu (50.82%),Sheng mu-li (50%),Shi chang-pu (50%),Shou wu-teng (50%),Yu-jin (44.44%),Suan zao-ren (43.24%),Duan mu-li (40.91%).⑤ The doses of the top 4 TCM tranquilizer in 44 effective cases of treatment group areDan-shen (24.05±5.75)g, Sheng long-gu (25.80±5.34) g, Sheng mu-li (26.25±4.95)g, He huan-hua (13.75±2.21) g. ⑥The core TCM syndromes in 44 effective cases of treatment group separately are spleen-stomach deficiency, liver-stomach disharmony, stagnation of liver qi, endoretention of damp heat. Spleen-stomach deficiency:the main digestive symptoms are bloating, anorexia, sour regurgitation, stomachache. The symptoms about malaise are dysphoria, dreaminess, depression and anxiety. The tongueis dark, red, greasy fur. The pulse is deep and thread. The core prescription is made up of Huang-lian, Chao bai-zhu, Fu-lin, Fa ban-xia, Huang-qin, Chen-pi, Zhi-qiao, Gan-cao, He huan-hua, Sheng mu-li.liver-stomach disharmony:the main digestive symptoms are bloating, belching. The symptoms about malaise are dreaminess. The tongueis dark, red, greasy fur. The pulse is deep, wiry and thready. The core prescription is made up of Chai-hu, Gan-cao, Fa ban-xia, Zhi-qiao, Chen-pi, Dang-shen, Huang-lian, Chao zhi-shi, Bai-shao, Fu-lin, Zhen zhu-mu, Sheng long-gu, He huan-hua.stagnation of liver qi:the main digestive symptoms are anorexia, bloating, constipation, stomachache. The symptoms about malaise are dysphoria, anxiety, depression and dreaminess. The tongueis dark, red, moss yellow. The pulse is deep, wiry and thready. The core prescription is made up of Zhi-qiao, Chao zhi-shi, Gan-cao, Fu-lin, Dang-shen, Fa ban-xia, Dang-gui, Bai-shao, Sheng mu-li.endoretention of damp heat:the main digestive symptoms are bloating, stomachache. The symptoms about malaise are dreaminess, depression and dysphoria. The tongueis dark, red, greasy fur. The pulse is deep and thread. The core prescription is made up of Chao bai-zhu, Fu-lin, Huang-lian, Mu-xiang, Chen-pi, Dang-gui, Fa ban-xia, Dang-shen, Huang-qin, He huan-hua, Sheng long-gu, Sheng mu-li.The herbs compatibility with better efficacy are Dan-shen& He huan-hua, Dan-shen & Sheng long-gu, Dan-shen & He huan-hua & Fu-lin, Dan-shen & Chao zao-ren. The herbs compatibility with worse efficacy are Dan-shen & Duan mu-li & Fu-lin, Duan mu-li & Fu-lin, He huan-hua & Sheng long-gu & Duan mu-li & Fu-lin.Conclusion:①The core disease location of FGIDs with malaise are spleen, stomach, liver and heart, based on spleen-stomach deficiency. There are two ways in transformation of pathogenesis. The one is spleen-stomach deficiency→water retention due to hypofunction of the spleen→liver yin deficiency→heart yin deficiency; The other one is dampness-heat in spleen-stomach→stomach qi upward reversal →with the turbid pathogenic hysteresis→blood stasis.② According to dialectical treatment of TCM, which is used to treat patients of FGIDs with malaise, this therapy can boost overall health from four aspects (general symptoms, the main digestive tract symptoms, mental symptoms, affecting the work and the quality of life). ③ The efficacy of treatment group may be superior to that of control group in three aspects (general symptoms, mental symptoms, affecting the work and the quality of life), which lack evidence instatistics at present. The efficacy of control group may be superior to that of treatment group in the main digestive tract symptoms, where no significant statistical difference exsits. ④ The efficacy of treatment group may be superior to that of control group in three aspects (sleep, dreaminess, palpitation, dysphoria, anxiety and depression). ⑤ The efficacy advantage of Tiao-shen therapy may be reflected on liver-stomach disharmony, stagnation of liver qi, endoretention of damp heat and water retention due to hypofunction of the spleen. The efficacy advantage of Tiao-shen therapy may be not reflected on liver-spleen disharmony and spleen qi deficiency. ⑥ The correlation between drug compatibility and curative effect with MDR analysis, which can be taken as reference to clinical drug compatibility of hint. |
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