匹维溴铵、培菲康联合黛力新治疗腹泻型肠易激综合征的疗效观察

Efficacy of pinaverium bromide,bifid triple viable and deanxit in treating diarrhea-predominant irritable bowel syndrome

目的:观察匹维溴铵、培菲康联合黛力新治疗腹泻型肠易激综合征的临床疗效。方法:选择符合罗马Ⅲ诊断标准的D-IBS 68例,随机分为观察组和对照组各34例。观察组予以匹维溴铵、培菲康(双歧杆菌三联活菌胶囊)、黛力新(氟哌塞吨+美利曲辛)口服。对照组予以匹维溴铵和培菲康口服。分别在治疗第1周、2周、4周对比有效率,同时记录两组治疗后腹痛和腹泻的症状评分及症状总积分并进行对比。结果:观察组和对照组各34例患者完成了4周的治疗随访。两组治疗后症状均有所改善,但治疗1周末有效率差别尚未见有统计学意义;治疗2周末,观察组的有效率即明显高于对照组(79.4%,50%),差别有统计学意义(χ2=6.434,P<0.05);治疗4周末差别更为明显(91.2%,58.8%;χ2=9.490,P<0.01)。观察组在治疗后1周、2周、4周腹痛和腹泻症状评分和症状总积分均低于对照组,但治疗1周末,仅腹痛的症状评分下降较对照组有统计学意义(t=2.376,P<0.05);治疗2周末,症状总积分与对照组相比差别有统计学意义(t=2.607,P<0.05);治疗4周末,腹泻症状评分较对照组差别方有统计学意义(t=2.433,P<0.05),而腹痛的症状评分较对照组差别进一步明显(t=5.143,P<0.001)。结论:匹维溴铵、培菲康联合黛力新治疗腹泻型肠易激综合征疗效高于匹维溴铵、培菲康联合方案,尤其腹痛症状的改善表现得较早且明显,而腹泻的症状改善表现得较晚并不如前者突出。

Objective：To observe the clinical efficacies of combined pinaverium bromide with bifid triple viable capsule and deanxit in treating diarrhea-predominant irritable bowel syndrome （ D-IBS） .Methods：Sixty-eight patients with D-BIS based on Roman Ⅲ criteria were included and randomized into observational group and case-control group（n=34 for each group）.The observational group received oral pinaverium bromide,bifid triple viable capsule and deanxit（flupentixol＋melitracen）,and the controls were treated with oral pinaverium bromide and bifid triple viable capsule.The two groups were compared regarding the effective rate,relief of abdominal pain and diarrhea at 1,2 and 4 week of medication.Results：Patients in the two groups completed medication for 4 weeks,and their symptoms were relived a lot.However,the effective rate had no significance by the end of the first week.The observational group had higher effective rate than the controls after 2 weeks of medication（79.4% vs.50%;χ2 =6.434,P〈0.05）,and the efficacy was dominant for the observational group by the forth week（91.2% vs.58.8%;χ2 =9.490,P〈0.01）.The total score on symptom severity,including abdominal pain and diarrhea was lower in the observational group at week 1,2 and 4,yet the statistical difference was only associate with abdominal pain by the first week （t=2.376,P〈0.05）.After 2 and 4 weeks of medication,the two groups were significant regarding the total scores on symptom severity,diarrhea and ab-dominal pain（t=2.607,P〈0.05;t=2.433,P〈0.05;t=5.143,P〈0.001,respectively）.Conclusion：Combined pinaverium bromide with bifid triple viable capsule and deanxit can be more effective than pinaverium bromide plus bifid triple viable in treating D-IBS,and may lead to early effect on abdomi-nal pain,yet later effect on diarrhea.