目的：观察柴胡桂枝干姜汤加减联合雷火灸治疗腹泻型肠易激综合征 （IBS-D） 少阳太阴寒热利证的临床效果。方 法：选取 IBS-D 少阳太阴寒热利证患者 60 例，随机分为治疗组和对照组各 30 例。治疗组给予柴胡桂枝干姜汤加减联合雷火灸治疗，对照组给予马来酸曲美布汀片联合双歧杆菌三联活菌胶囊治疗。比较 2 组大便性状、腹痛腹胀程度、排便频率评分，统计2 组胃肠道总体症状疗效，随访 2 个月，统计 2 组复发率。结果：治疗后，2 组大便性状、腹痛腹胀程度、排便频率评分均降低（P＜0.05）；治疗组大便性状、腹痛腹胀程度、排便频率评分均低于对照组（P＜0.05）。治疗组总有效率为 96.7%（29/30），对照组为 73.3% （22/30），治疗组总有效率高于对照组 （P＜0.05）。治疗组复发率为 0 （0/29），显著低于对照组的 13.64% （3/22），组间比较，差异有统计学意义（P＜0.05）。结论：柴胡桂枝干姜汤加减联合雷火灸治疗 IBS-D 少阳太阴寒热利证的临床效果较马来酸曲美布汀片联合双歧杆菌三联活菌胶囊更好，在改善患者症状及降低复发率方面有较大优势。
Abstract：Objective：To observe the clinical effect of modified Chaihu Guizhi Ganjiang tang combined with thunder-fire moxibustion on patients with irritable bowel syndrome with diarrhea(IBS-D) with Shaoyang Taiyin of cold，heat and diarrhea syndrome. Methods： A total of 60 patients with IBS- D with Shaoyang Taiyin of cold， heat and diarrhea syndrome were selected and randomly divided into the treatment group and the control group，30 cases in each group. The treatment group was treated with modified Chaihu Guizhi Ganjiang tang combined with thunder-fire moxibustion，and the control group was treated with trimebutin maleate tablets combined with bifidobacterium triple viable capsules. The scores of stool characteristics， degree of abdominal pain and distension， and defecation frequency were compared between the two groups. The overall gastrointestinal symptoms and effect in the two groups were counted. The recurrence rate in the two groups was counted after follow-up for two months. Results：After treatment，the scores of stool characteristics，degree of abdominal pain and distension， and defecation frequency were decreased(P＜0.05)； the above three scores in the treatment group were lower than those in the control group(P＜0.05). The total effective rate was 96.7% (29/30) in the treatment group and 73.3%(22/30) in the control group；the total effective rate in the treatment group was higher than that in the control group(P＜0.05). The recurrence rate in the treatment group was 0(0/29)，significantly lower than that of 13.64%(3/22) in the control group，the difference being significant(P＜0.05). Conclusion：The therapy of modified Chaihu Guizhi Ganjiang tang combined with thunder- fire moxibustion has better clinical effect than the treatment of trimebutin maleate tablets combined with bifidobacterium triple viable capsules in treating IBS- D patients with Shaoyang Taiyin of cold， heat and diarrhea syndrome，which has great advantages in improving patients' symptoms and reducing recurrence rate.