中药易激灵配合西药治疗腹泻型肠易激综合征的临床研究

The Clinical Trial on Irritable Bowel Syndrome (Diarrhea Predominant) with Therapy of Integrated Chinese Traditional and Western Medicine

目的:探讨中药易激灵配合西药治疗肠易激综合征(IBS)的作用机制。方法:用电子气压泵消化道张力检测系统、毛细管液压灌注压力检测系统及硝酸还原酶法观察治疗组(中药易激灵+谷维素、心痛定组)70例和对照组(谷维素、心痛定组)50例IBS患者疗前疗后肠动力、肠内脏感觉、肠黏膜内一氧化氮(NO)含量的变化。结果:治疗组总有效率90%,对照组总有效率42%,治疗组明显优于对照组(P<0.05)。经易激灵加西药治疗后,治疗组中直肠排便阈值指数明显增高,乙状结肠运动指数、直肠运动指数明显下降,治疗前后比较差异有显著性意义(P<0.05);直肠感觉阈值、疼痛阈值有一定改善,但差异无显著性意义(P>0.05);治疗后肠黏膜NO含量明显增高,治疗前后比较差异有显著性意义(P<0.05)。对照组单纯西药疗前疗后肠道测压指标无显著性差异(P>0.05),NO含量也未见有明显变化(P>O.05)。结论:中西医结合治疗腹泻型IBS的作用机制很可能是有效地增加肠黏膜NO含量,改善乙状结肠和直肠运动功能,使粪便向结肠远端转运时间延长,从而达到治疗目的。

Objective: To investigate the possible role of treatment to the patients with diarrhea predominant IBS with therapy of integrated Chinese traditional and western medicine. Methods: Treatment group (70 cases treated by TCM YiJiLing and western medicine) and contrast group (50 cases treated by western medicine) before and after treatment are studied. To observe the change of the intestinal motility, visceral perception and the content of NO in colonic mucosa by means of electric barostat and perfusion catheter manometer. Results: The total effective ratio (90%) of treatment group is significantly higher than that (42%) of contrast group (P<0.05). (Treatment group) After being treatment, thresholds of defecation in patients with IBS were significantly higher than before (P<0.05); the motility indexes of sigmoid and rectum were significiently lower than before (P<0.05); the content of NO in colonic mucosa was significantly higher than before (P<0.05). But these didn't showed after treatment in contrast group. Conclusions: The method of integrated Chinese traditional and western medicine (TCM YiJiLing+western medicine) could possibly increase the content of NO in colonic mucosa efficiently and improve the motility function of sigmoid and rectum.