曲美布汀联合双歧杆菌三联活菌胶囊对功能性消化不良重叠IBS-D患者肠道的影响

Influence of Trimebutine combined with Bifid Triple Viable Capsules on intestinal microecology of patients with functional dyspepsia and diarrhea-predominant pattern irritable bowel syndrome

目的探讨曲美布汀联合双歧杆菌三联活菌胶囊对功能性消化不良(FD)重叠腹泻型肠易激综合征(IBS-D)患者肠道微生态的影响。方法选取90例FD重叠IBS-D患者,随机分为观察组和对照组各45例。两组患者均予以曲美布汀片100mg/次,3次/d,口服;观察组在对照组基础上加用双歧杆菌三联活菌胶囊630mg/次,2次/d,餐后约30min温水服用,两组患者均连用8周。观察两组患者治疗前后肠道菌群的变化,并比较其临床效果及不良反应。结果治疗8周后,观察组患者粪便中双歧杆菌和乳杆菌数量增加,而肠杆菌、肠球菌和酵母菌数量下降(P<0.05)。对照组患者粪便中这5种菌的数量治疗前后无明显变化(P>0.05)。治疗8周后,观察组患者总有效率高于对照组(χ~2=4.05,P<0.05)。观察组和对照组患者治疗中分别出现不良反应6例(13.33%)和8例(17.78%),症状均较轻微,两组比较差异无统计学意义(χ~2=0.34,P>0.05)。结论曲美布汀联合双歧杆菌三联活菌胶囊治疗FD重叠IBS-D患者疗效较肯定,安全性较高,其作用机制可能是通过调节肠道菌群,重建肠道微生态平衡,从而改善其消化不良及腹泻症状。

Objective To discuss the influence of Trimebutine combined with Bifid Triple Viable Capsules on intestinal microecology of patients with functional dyspepsia（FD）and diarrhea-predominant pattern irritable bowel syndrome（IBS-D）.Methods 90 patients with FD and IBS-D were randomly divided into observation group（n=45）or control group（n=45）.Both groups were given Trimebutine tablets 100 mg tid,while the observation group was additionally given Bifid Triple Viable Capsules 630 mg bid,for 8 weeks.The changes of intestinal flora in both groups were observed,and the clinical efficacy and adverse reactions were compared between groups.Results After treatment,the quantities of Bifidobacteriaand Lactobacilli obviously increased,while the quantities of Enterobacters,Enterococci and Saccharomycetes were decreased in observation group（P〈0.05）.No obvious changes in the quantities of the 5 bacteria were observed in control group（P〈0.05）.The total clinical efficiency rate in observation group was higher than that in control group（χ^2=4.05,P〈0.05）.6 vs 8 cases of adverse reactions with mild symptoms were appeared in observation group（13.33%）vs control group（17.78%）,with no obvious differences（χ^2=0.34,P〈0.05）.Conclusion Trimebutine combined with Bifid Triple Viable Capsules has reliable curative effect on patients with FD and IBS-D,with favorable safety.The mechanism of action may be that the microecological balance was rebuilt through adjusting the disorder of intestinal flora,resulting in the improvement of the symptoms of the diseases.