加味痛泻要方对肠易激综合征机制的探讨

Study on the Mechanism of Modified Tongxie Decoction in the Treatment of Irritable Bowel Syndrome

目的观察加味痛泻要方联合匹维溴铵治疗肝郁脾虚证腹泻型肠易激综合征的有效性。方法将符合纳入标准的100例患者按随机数字表法分为对照组和治疗组各50例,对照组给予西药匹维溴铵,治疗组在此基础上联合加味痛泻要方治疗,两组疗程均为4周。观察各组临床总有效率、临床症状积分评分(腹痛、腹泻、腹胀、排便次数、黏液便)、血浆脑肠肽水平。结果治疗组临床总疗效率(94%)明显高于对照组(72%)(P<0.05),治疗组临床各症状积分显著优于对照组(P<0.05);两组脑肠肽水平均明显下降(P<0.05),以治疗组下降更为显著(P<0.05)。结论加味痛泻要方联合匹维溴铵对肝郁脾虚证腹泻型肠易激综合征疗效显著,其机制可能是通过调节脑肠肽物质5-HT3R、CGRP水平来起到治疗肝郁脾虚证腹泻型肠易激综合征的作用。

Objective To observe the efficacy of modified Tongxie decoction combined with pinaverium bromide in the treatment of liver-spleen deficiency diarrhea irritable bowel syndrome. Method 100 cases of patients met the inclusion criteria were randomly divided into control group and treatment group（ with 50 cases in each group）. The control group was treated with pinaverium bromide. The treatment group was treated with modified Tongxie decoction on the basis of the control group. Two groups were treated for 4 weeks. The clinical total effective rate,clinical symptom score（ abdominal pain,diarrhea,abdominal distension,defecation frequency,mucus stool）,plasma brain gut peptide level were observed. Result The clinical total effective rate of the treatment group（ 94%） was significantly higher than that of the control group（ 72%）（ P 0. 05）,the clinical symptom score of the treatment group was significantly better than that of the control group（ P 0. 05）,the brain gut peptides of the two groups were significantly decreased（ P 0. 05）,while the treatment group decreased significantly（ P 0. 05）. Conclusion Modified Tongxie decoction combined with pinaverium bromide on the treatment of liver-spleen deficiency irritable bowel syndrome has significantly therapeutic effect,which may be the mechanism to achieve the treatment of liver stagnation and spleen deficiency diarrhea irritable bowel syndrome by regulating the activity of brain gut peptide substances 5-HT3R and CGRP level.