健脾止泄方联合凝结芽孢杆菌活菌片对腹泻型IBS患者血清NPY水平、IBS症状严重程度积分及直肠最大耐受阈值的影响

Effects of Jianpi Zhixie Prescription combined with Bacillus coagulans live bacterial tablets on serum NPY level,symptom severity score of IBS and rectal maximum tolerance threshold in patients with diarrhea-predominant irritable bowel syndrome

[目的]观察健脾止泄方联合凝结芽孢杆菌活菌片对腹泻型肠易激综合征(IBS)患者血清神经肽Y(NPY)水平、IBS症状严重程度积分及直肠最大耐受阈值的影响。[方法]依据自愿接受治疗方案的不同将2017年12月~2018年12月在我院就诊的94例腹泻型IBS患者分为2组,对照组48例接受凝结芽孢杆菌活菌片治疗,研究组46例在对照组基础上联合使用健脾止泄方。进行疗效评价,测定血清5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)、P物质(SP)、NPY水平,统计IBS症状严重程度积分,并对直肠最大耐受阈值、双歧杆菌/肠杆菌值进行比较。[结果]研究组总有效率明显高于对照组(P<0.05);治疗后2组血清5-HT、CGRP、SP、NPY水平与治疗前相比均明显降低(P<0.05),且治疗后研究组血清5-HT、CGRP、SP、NPY水平均明显低于对照组(P<0.05);治疗后2组IBS症状严重程度积分与治疗前相比均明显下降(P<0.05),且治疗后研究组IBS症状严重程度积分明显低于对照组(P<0.05);治疗后2组直肠最大耐受阈值、双歧杆菌/肠杆菌值与治疗前相比均明显增大(P<0.05),且治疗后研究组直肠最大耐受阈值、双歧杆菌/肠杆菌值明显大于对照组(P<0.05)。[结论]腹泻型IBS临床治疗应用健脾止泄方与凝结芽孢杆菌活菌片联合治疗方案,有利于增进疗效,合理调节血清5-HT、CGRP、SP、NPY水平,IBS症状严重程度积分下降明显,且直肠最大耐受阈值、双歧杆菌/肠杆菌值改善明显。

[Objective]To observe the effects of Jianpi Zhixie Prescription combined with Bacillus coagulans live bacterial tablets on serum neuropeptide Y(NPY)level,symptom severity score of irritable bowel syndrome(IBS)and rectal maximum tolerance threshold in patients with diarrhea-predominant irritable bowel syndrome.[Methods]94 patients with diarrhea-predominant irritable bowel syndrome treated in our hospital from December 2017 to December 2018 were divided into two groups according to different voluntary treatment schemes.48 patients in the control group were treated with Bacillus coagulans live bacterial tablets,and 46 patients in the study group were treated with Jianpi Zhixie Prescription on the basis of the control group.The therapeutic effect was evaluated,the levels of serum 5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP),substance P(SP)and NPY were measured,IBS symptom severity scores were counted,and the maximum tolerance threshold of rectum and bifidobacterium/enterobacter values were compared.[Results]The total effective rate of the study group was significantly higher than that of the control group(P<0.05).After treatment,the levels of serum 5-HT,CGRP,SP and NPY in the two groups were significantly lower than those before treatment(P<0.05),and levels of serum 5-HT,CGRP,SP and NPY in the study group were significantly lower than those in the control group(P<0.05).After treatment,the IBS symptom severity score of the two groups was significantly lower than that of the control group(P<0.05),and the IBS symptom severity score of the study group was significantly lower than that of the control group(P<0.05).After treatment,the maximum tolerance threshold of rectum and bifidobacterium/enterobacter value of the two groups were significantly higher than those before treatment(P<0.05),and the maximum tolerance threshold of rectum and bifidobacterium/enterobacter value of the study group were significantly higher than those of the control group(P<0.05).[Conclusion]The combination of Jianpi Zhixie Prescription and Bacillus coagulans live bacterial tablets has benifit to improve the therapeutic effect in the treatment of diarrhea-predominant irritable bowel syndrome,reasonably regulates the levels of serum 5-HT,CGRP,SP and NPY,significantly decreases the severity score of IBS symptoms and significantly improves the maximum tolerance threshold of rectum and the bifidobacterium/enterobacter value improve significantly.