复方嗜酸乳杆菌联合阿米替林治疗难治性腹泻型肠易激综合征对血清炎性因子影响及临床效果

Effects of Compound Lactobacillus Acidophilus Combined with Amitriptyline on Serum Inflammatory Factors in Patients with Refractory Diarrhea-predominant Irritable Bowel Syndrome and Its Clinical Effect

目的探讨复方嗜酸乳杆菌联合阿米替林治疗难治性腹泻型肠易激综合征(IBS-D)对血清炎性因子影响及临床效果。方法选取难治性IBS-D 92例作为研究对象,根据治疗方法不同将其分为观察组48例和对照组44例,观察组在常规治疗基础上予复方嗜酸乳杆菌联合阿米替林进行治疗,对照组在常规治疗基础上予复方嗜酸乳杆菌进行治疗,两组均治疗4周。观察比较两组治疗前后血干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平和临床症状评分,治疗后临床效果,以及治疗过程中不良反应发生情况。结果治疗前,两组血IFN-γ、TNF-α、IL-10水平及各临床症状评分、总评分比较差异无统计学意义(P>0.05)。治疗后,两组血IFN-γ、TNF-α水平及各临床症状评分、总评分均较治疗前降低,而血IL-10水平均较治疗前升高,差异有统计学意义(P<0.05)。治疗后,观察组血IFN-γ、TNF-α水平及各临床症状评分、总评分均低于对照组,血IL-10水平高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗过程中,观察组总不良反应发生率高于对照组,但差异无统计学意义(P>0.05)。结论复方嗜酸乳杆菌联合阿米替林治疗难治性IBS-D临床效果显著,且具有一定安全性,分析其原因可能与降低炎性因子水平和减轻应激反应有关。

ObjectiveTo investigate the effect of compound lactobacillus acidophilus combined with amitriptyline on serum inflammatory factors in patients with refractory diarrhea-predominant irritable bowel syndrome (IBS-D) and its clinical effect. MethodsA total of 92 patients with refractory IBS-D were selected as research subjects. The patients were divided into observation group (n=48) and control group (n=44) according to different treatment methods. The observation group was treated with compound lactobacillus acidophilus combined with amitriptyline on the basis of conventional treatment. The control group was treated with compound lactobacillus acidophilus on the basis of conventional treatment. Both groups were treated for 4 weeks. The levels of serum interferon-γ(IFN-γ), tumor necrosis factor-α(TNF-α), interleukin-10 (IL-10) and clinical symptom scores before and after treatment, clinical effects after treatment and adverse reactions during treatment were observed and compared between the two groups. ResultsBefore treatment, there was no significant difference in serum IFN-γ, TNF-α, IL-10 levels, clinical symptom scores and total scores between the two groups ( P >0.05). After treatment, the levels of serum IFN-γ, TNF-α, clinical symptom scores and total scores of the two groups were lower than those before treatment, while the levels of serum IL-10 were higher than those before treatment, suggesting significant differences ( P < 0.05). After treatment, the levels of serum IFN-γ, TNF-α, clinical symptom scores and total scores were lower in observation group than in control group, whereas the levels of serum IL-10 were higher than those in control group, suggesting significant differences ( P <0.05). After treatment, the total effective rate of the observation group was significantly higher than that of the control group, and there was significant difference ( P <0.05). In the course of treatment, the total incidence of adverse reactions was higher in the observation group than in the control group, but there was no significant difference ( P >0.05). ConclusionCompound lactobacillus acidophilus combined with amitriptyline is effective and safe in the treatment of refractory IBS-D, which may be related to the reduction of inflammatory factors and stress response.