基于“脑-肠轴”学说探讨加味痛泻要方干预腹泻型肠易激综合征的疗效

Evaluation of clinical effects of Jiawei Tongxie Yaofang decoction in treatment of irritable bowel syndrome based on brain-intestinal axis theory

目的基于"脑-肠轴"学说探讨加味痛泻要方干预腹泻型肠易激综合征(diarrhea irritable bowel syndrome,IBS-D)老年患者的临床研究.方法将80例IBS-D老年患者随机分为对照组和观察组各40例.对照组给予口服双歧杆菌三联活菌肠溶胶囊,2粒/次,3次/d.观察组在对照组治疗基础上给予加味痛泻要方治疗,煎取汁液250 m L,早晚分服,1剂/d.观察临床疗效、症状积分和脑肠肽水平变化.结果治疗后观察组有效率为95.0%,对照组为80.0%,差异有统计学意义(P<0.05);2组治疗后腹痛、腹胀、大便次数、黏液便、大便性状等症状积分均低于治疗前,差异有统计学意义(P<0.05);且观察组治疗后明显低于对照组(P<0.01);治疗后5羟色胺3受体、促肾上腺皮质激素、降钙素基因相关肽水平2组组内比较,差异有统计学意义(P<0.05),且观察组明显低于对照组(P<0.05).结论在"脑-肠轴"学说理论指导下,加味痛泻要方合双歧杆菌三联活菌肠溶胶囊能提高I B S-D的临床疗效,改善临床症状和降低脑肠肽水平.

AIM To evaluate the clinical effects of Jiawei Tongxie Yaofang decoction in the treatment of irritable bowel syndrome（IBS） based on the brainintestinal axis theory.METHODS Eighty elderly patients with severe IBS treated at the First People＇s Hospital of Xiaoshan District Hangzhou City were randomly and equally divided into a control group and an observation group. Both groups were given oral Bifidobacterium triple viable enteric capsules and the observation group was additionally given Jiawei Tongxie Yaofang decoction. The effective rate symptom scores and ghrelin levels were compared between the two groups. RESULTS The total effective rate in the observation group was 95.0% which was higher than that of the control group（80.0%）. After treatment the scores of abdominal pain abdominal distension defecation frequency mucus in stool and stool character were significantly lower than those before treatment in bothgroups（P〈0.05）. The symptom scores in the observation group were significantly lower than those of the control group（P〈0.05）. The levels of 5-hydroxytryptamine 3 receptor adrenocorticotropic hormone and calcitonin gene related peptide differed significantly between before and after treatment in both groups（P〈0.05） and were significantly lower in the observation group than in the control group（P〈0.05）.CONCLUSION Based on the brain-axis theory Jiawei Tongxie Yaofang decoction can significantly improve the clinical symptoms and reduce the relapse rate in patients with IBS.