痛泻四神汤联合马来酸曲美布汀与谷维素对腹泻型肠易激综合征患者血清IFN-γ、5-HT、NPY水平及T淋巴细胞亚群的影响

Influence of Tongxie Sishen decoction combined with trimebutine maleate and oryzanol on serum IFN-γ,5-HT,NPY levels and T lymphocyte subsets in patients with diarrhea predominant irritable bowel syndrome

[目的]分析痛泻四神汤联合马来酸曲美布汀与谷维素对腹泻型肠易激综合征(IBS-D)患者血清γ-干扰素(IFN-γ)、5羟色胺(5-HT)、神经肽Y(NPY)水平及T淋巴细胞亚群的影响。[方法]选取IBS-D患者98例作为研究对象,随机分为对照组和观察组各49例,对照组给予马来酸曲美布汀与谷维素治疗,观察组在此基础上加用痛泻四神汤,观察并记录2组患者治疗前后中医症状积分变化情况、临床疗效、IFN-γ、5-HT、NPY、T淋巴细胞亚群水平变化情况及不良反应发生率。[结果]治疗后观察组中医症状积分明显低于对照组(P<0.05);观察组临床疗效总有效率明显高于对照组(P<0.05);2组IFN-γ、5-HT、NPY均明显下降(P<0.05),且观察组各指标变化幅度明显高于对照组(P<0.05);治疗后2组T淋巴细胞亚群指标CD3^+、CD4^+水平及CD4^+/CD8^+均明显升高(P<0.05),CD8^+水平明显降低(P<0.05),且观察组各指标水平变化幅度均大于对照组(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。[结论]痛泻四神汤联合马来酸曲美布汀与谷维素治疗IBS-D能够有效降低血清IFN-γ、5-HT及NPY水平,改善T淋巴细胞CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+,且不良反应发生风险较低,疗效显著。

[Objective]To analyze the influence of Tongxie Sishen decoction combined with trimebutine maleate and oryzanol on serum interferon gamma（IFN-γ）,5 hydroxytryptamine（5-HT）,neuropeptide Y（NPY）levels and T lymphocyte subsets in the patients with diarrhea predominant irritable bowel syndrome（IBS-D）.[Methods]Ninety-eight patients with IBS-D were selected and randomly divided into the control group and the observation group,forty-nine cases in each group,the control group were treated with trimebutine maleate and oryzanol treatment,on the basisof this,the observation group were treated with Tongxie Sishen decoction,the changes of TCM symptom scores before and after the treatment,clinical efficacy,the changes of IFN-γ,5-HT,NPY,T lymphocyte subsets levels and the incidence rate of adverse reactions were observed and recorded in the two groups.[Results]After treatment,the TCM symptom score of the observation group was significantly lower than that of the control group（P〈0.05）;the total effective rate of the observation group was significantly higher than that of the control group（P〈0.05）;the levels of IFN-γ,5-HT and NPY in the two groups were significantly decreased（P〈0.05）,and the changes of the indexes in the observation group were significantly higher than those in the control group（P〈0.05）;after treatment,the CD3~＋,CD4~＋levels and CD4~＋/CD8~＋of T lymphocyte subsets in the two groups were significantly increased（P〈0.05）,the CD8~＋level decreased significantly（P〈0.05）,and the changes of the indexes in the observation group were greater than those in the control group（P〈0.05）;the incidence rate of adverse reactions in the observation group was significantly lower than that in the control group（P〈0.05）.[Conclusion]Tongxie Sishen decoction combined with trimebutine maleate and oryzanol in the treatment of IBS-D can effectively reduce the serum IFN-γ,5-HT and NPY levels,improve T lymphocyte CD3~＋,CD4~＋,CD8~＋levels and CD4~＋/CD8~＋,and the risk of adverse reaction is low,the curative effect is significant.