酪酸梭菌活菌胶囊联合乳果糖治疗便秘型肠易激综合征疗效及对患者血清胃肠激素水平的影响

Curative Effect and Influence on Serum Gastrointestinal Hormone Levels of Patients with Constipation-predominant Irritable Bowel Syndrome Treated by Clostridium Butyricum Capsules Combined with Lactulose

目的:观察酪酸梭菌活菌胶囊与乳果糖联合对便秘型肠易激综合征(IBS-C)血清胃肠激素水平的影响及疗效。方法:90例IBS-C患者随机分为联合组和对照组。对照组予乳果糖10 ml,po tid治疗;联合组在此基础上加用酪酸梭菌活菌胶囊0.6 g,bid,温开水送服。观察治疗前与治疗10周后两组患者血清血管活性肠肽(VIP)、一氧化氮(NO)水平和症状总评分变化,比较两组临床疗效及药品不良反应,并随访3个月及6个月观察复发情况。结果:治疗10周后,两组血清VIP和NO水平及症状总评分均明显下降(P<0.05和P<0.01),且联合组下降幅度较对照组更明显(P<0.05)。联合组临床总有效率较对照组更佳(P<0.05)。两组药品不良反应例数比较,差异无统计学意义(P>0.05)。随访3个月及6个月,联合组复发率均明显低于对照组(P<0.05)。讨论:酪酸梭菌活菌胶囊联合乳果糖用于IBS-C具有协同增效作用,安全性良好,并可降低其近期复发率,与其能降低血清VIP和NO水平,纠正血清胃肠激素水平异常有关。

Objective：To study curative effect and influence on serum gastrointestinal hormone levels of patients with constipation-predominant irritable bowel syndrome （IBS-C） treated by clostridium butyricum capsules combined with lactulose. Methods：90 cases with IBS-C were divided into combined group and control group at random. The patients in control group were given lactulose（ 10ml,po tid）, the patients in combined group were given additionally clostridium butyri- cum capsules （0.6g, bid, with warm boiled water） on the basis of the control group. The changes of serum vasoactive in- testinal peptide （VIP） and nitric oxide （NO）, clinical curative effect and adverse drug reaction （ADR） were compared af- ter 10 weeks＇ treatment, and the reoccurrences were observed according to 3 and 6 months＇ following-up. Results：After 10 weeks＇ treatment, the serum VIP and NO levels and the total score of symptoms in two groups were declined than before （P 〈 0.05 or P 〈 0.01 ）, and the declining rates in combined group were much higher than those in control group （P 〈 0.05 ）. The total clinical efficiency of patients in combined group was much higher than that in control group （ P 〈 0.05 ）. There were no statistical differences in ADR cases between two groups （P 〉 0.05）. According to the 3 and 6 months＇ fol- lowing-up after treatment, the reoccurrence rate in combined group was much lower than that in control group （ P 〈 0.05 ）. Conclusion ： Clostridium butyricum capsules combined with lactulose have synergistic effect on IBS-C with favorable security , and which can obviously decrease recent reoccurrence rate,whose mechanism of action may have close effect on reducing serum VIP and NO levels and adjusting the abnormal of serum gastrointestinal hormone level.