奥替溴铵联合益生菌治疗腹泻型肠易激综合征疗效

Effect of otilonium bromide combined with probiotics for diarrhea-predominant irritable bowel syndrome

目的观察奥替溴铵联合益生菌治疗腹泻型肠易激综合征(IBS-D)小肠细菌过度生长(SIBO)的疗效,观察SIBO转阴后口-盲肠传递时间(OCTT)的变化。方法将60例SIBO阳性的IBS-D患者随机分为奥替溴铵口服组(对照组)、奥替溴铵联合双岐杆菌三联活菌胶囊口服组(试验组),疗程4周;治疗前后测定主要症状积分、SIBO、OCTT,观察SIBO阴转率、OCTT变化、主要症状改善情况。结果治疗后,试验组较对照组SIBO阴转率高73.7%(22/30)vs 46.7%(14/30)(P<0.05)。治疗前,两组主要症状积分及OCTT比较差异无统计学意义(P>0.05);治疗后,试验组较对照组主要症状积分、OCTT均下降(P<0.05),但试验组较对照组下降更明显(P<0.05或<0.01)。结论奥替溴铵联合双岐杆菌三联活菌胶囊可以使SIBO阴转,缩短OCTT,并能明显改善患者主要症状。

Objective To evaluate the effect of otilonium bromide combined with probiotics on the patients of diarrhea-predominant irritable bowel syndrome（IBS-D） with small intestinal bacterial overgrowth（SIBO）.Changes of orocecal transit time（OCTT） after SIBO negative conversion were observed.Methods Sixty patients diagnosed IBS-D with SIBO-positive were randomly divided into otilonium bromide group （n =30） and otilonium bromide and probiotics group（n =30）,the treatment course was four weeks,the scores of main symptom,SIBO and OCTT were measured before and after the treatment.The negative rate of SIBO,changes of OCTT and the effect on main symptoms were observed.Results The negative rate of SIBO in the experimental group was higher than that in control group after the treatment,73,7％（22/30） vs 46.7％ （14/30） （P ＜0.05）.The scores of main symptom,SIBO and OCTT between two groups showed no significant difference（P ＞0.05）.The scores of main symptom were improved and OCTT was shortened in two groups after the treatment（P ＜0.05 or ＜0.01）,but the scores of main symptom in the experimental group were decreased more than those of control group,OCTT was shorter than that of control group （P ＜0.05）.Conclusion The treatment of otilonium bromide and probiotics can make SIBO negative,shorten OCTT,and the method may well improve the main symptoms in IBS-D.