益气固肠方治疗腹泻型肠易激综合征的疗效观察及对结肠组织5-羟色胺和肥大细胞脱颗粒情况的影响

Effect of Yiqi Guchang recipe on diarrhea-predominant irritable bowel syndrome and it effects on serum 5-HT and mast cell degranulation in colon

目的观察益气固肠方治疗腹泻型肠易激综合征(IBS)的临床疗效及对结肠组织5-羟色胺和肥大细胞脱颗粒情况的影响。方法将118例腹泻型IBS患者随机分为2组。治疗组59例予益气固肠方治疗;对照组59例予匹维溴铵片治疗。2组均治疗4周,比较2组治疗前后中医证候积分、肠易激综合征患者生活质量问卷(IBS-QOL)评分、结肠组织5-羟色胺(5-HT)、肥大细胞数量及肥大细胞脱颗粒情况,并统计疗效。结果治疗组总有效率96.61%,对照组总有效率81.36%,治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候积分均明显降低(P<0.05),且治疗组治疗后中医证候积分低于对照组(P<0.05)。2组治疗后IBS-QOL评分均升高(P<0.05),且治疗组治疗后IBS-QOL评分高于对照组(P<0.05)。2组治疗后结肠组织5-HT水平均明显降低(P<0.05),且治疗组治疗后5-HT水平低于对照组(P<0.05)。2组治疗后结肠组织肥大细胞数量、肥大细胞脱颗粒比例均明显降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论益气固肠方治疗腹泻型IBS疗效肯定,安全性好,其机制可能与降低结肠组织中5-HT的表达,减少肥大细胞脱颗粒有关。

Objective To observe the curative effects of Yiqi Guchang recipe on diarrhea-predominant irritable bowel syndrome( IBS) and it effects on serum 5-HT and mast cell degranulation in colon. Methods 118 patients with diarrhea-predominant IBS were randomly divided into two groups. 59 cases in treatment group were treated by Yiqi Guchang recipe. 59 cases in control group were treated by Dicetel tablets. The curative effect was evaluated after 4 weeks treatment,and the scores of TCM syndrome and the Irritable Bowel Syndrome Quality of Life( IBS-QOL) questionnaire,colonic 5-HT,mast cell number and mast cell degranulation before and after treatment were compared between the two groups. The curative effects were evaluated in two groups. Results The total effective rate in treatment group( 96. 61%) was superior to control group( 81. 36%,P < 0. 05). The TCM syndrome score after treatment were significantly reduced in both groups( P < 0. 05),and which in treatment group was lower than that in control group( P < 0. 05). The IBS-QOL score after treatment increased in both groups( P < 0. 05),and which in treatment group was higher than that in control group( P < 0. 05). The colonic 5-HT after treatment were significantly reduced in both groups( P < 0. 05),and which in treatment group was lower than that in control group( P < 0. 05).The number of mast cells and the proportion of mast cells degranulation after treatment were significantly reduced in both groups( P < 0. 05),and which in treatment group was lower than that in control group( P < 0. 05). There was no significant difference on the incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Yiqi Guchang recipe has exact and safe effects on the treatment of diarrhea-predominant IBS,and its mechanism may be related to decreasing the expression of 5-HT in colon tissue and reducing mast cell degranulation.