气滞胃痛颗粒联合复方阿嗪米特治疗肠易激综合征的临床研究

Clinical study of Qizhi Weitong Granules combined with Compound Azintamide Enteric-coated Tablets in treatment of irritable bowel syndrome

目的探讨气滞胃痛颗粒联合复方阿嗪米特肠溶片治疗肠易激综合征的临床疗效。方法选取海洋石油总医院2016年11月—2017年11月收治的肠易激综合征患者94例为研究对象,随机将入组者分为对照组和治疗组,每组各47例。对照组口服复方阿嗪米特肠溶片,2片/次,3次/d;治疗组在对照组治疗的基础上口服气滞胃痛颗粒,1袋/次,3次/d。两组患者均连续治疗4周。观察两组临床疗效,比较治疗前后两组患者临床症状积分、肠易激综合征生活质量指数评分量表(IBS-QOL)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分和血清学指标。结果治疗后,对照组和治疗组的临床总有效率分别为80.85%、95.74%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者腹痛积分、腹胀积分、腹泻积分和便秘积分均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组症状积分比对照组降低更显著,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者HAMD量表评分、HAMA量表评分均显著降低,IBS-QOL评分显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组量表评分明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清血管活性肽(VIP)、5-羟色胺(5-HT)、生长抑素(SS)水平均显著降低,神经肽Y(NPY)水平均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组血清学指标水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论气滞胃痛颗粒联合复方阿嗪米特肠溶片治疗肠易激综合征具有较好的临床疗效,可改善临床症状,提高患者生活质量,促进机体胃肠激素和神经肽水平改善,具有一定的临床推广应用价值。

Objective To investigate the clinical effects of Qizhi Weitong Granules combined with Compound Azintamide Entericcoated Tablets in treatment of irritable bowel syndrome（IBS）. Methods Patients（94 cases） with IBS in Marine Oil General Hospital from November 2016 to November 2017 were randomly divided into control（47 cases） and treatment（47 cases）. Patients in the control group were po administered with Compound Azintamide Enteric-coated Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Qizhi Weitong Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the symptom scores, IBS-QOL scores, HAMD scores, HAMA scores, and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.85% and 95.74%, respectively, and there were differences between two groups（P〈 0.05）. After treatment, the symptom scores of abdominal pain, abdominal distention, diarrhea, and constipation were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. And the symptom scores in the treatment group were lower than those in the control group, with significant difference between two groups（P〈 0.05）. After treatment, HAMD and HAMA scores in two groups were significantly decreased, but IBS-QOL scores was significantly increased, and there were differences in the same group（P〈 0.05）. And these scores in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. After treatment, the VIP, 5-HT, and SS levels in two groups were significantly decreased, but NPY levels were significantly increased, and there were differences in the same group（P〈 0.05）. And the serological indexes levels in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. Conclusion Qizhi Weitong Granules combined with Compound Azintamide Enteric-coated Tablets has clinical curative effect in treatment of IBS, can effectively improve their clinical symptoms, improve the quality of life, improve the levels of gastrointestinal hormone and neuropeptide, which has a certain clinical application value.