痛泻四神汤联合西药治疗腹泻型肠易激综合征疗效观察及对胃肠激素水平的影响

Curative Effect of Tongxie Sishen Tang Combined with Western Medicine on DiarrheaPredominant Irritable Bowel Syndrome and Its Effect on Levels of Gastrointestinal Hormones

目的:观察痛泻四神汤联合西药治疗腹泻型肠易激综合征(IBS-D)肝郁脾虚证的临床疗效及对降钙素基因相关肽(CGRP)和血管活性肠肽(VIP)水平的影响。方法:将136例患者随机分为对照组和观察组各68例。2组均服用马来酸曲美布汀分散片与复方嗜乳酸杆菌肠溶胶囊,观察组加予痛泻四神汤辨证内服。2组均连续治疗6周。治疗前后评定肝郁脾虚证评分、腹痛程度评分、IBS症状严重程度量表(IBS-SSS)积分,检测CGRP、VIP水平,比较2组的临床疗效。结果:治疗后,观察组临床疗效优于对照组(P<0.05)。2组肝郁脾虚证积分、腹痛程度评分及IBS-SSS积分均较治疗前下降(P<0.01),观察组3项分值均低于对照组(P<0.01)。2组血清CGRP、VIP水平均较治疗前下降(P<0.01),观察组血清CGRP、VIP水平均低于对照组(P<0.01)。结论:在曲美布汀和复方嗜乳酸杆菌治疗的基础上给予痛泻四神汤内服治疗IBS-D肝郁脾虚证患者,可进一步减轻IBS-D临床症状,并能抑制CGRP、VIP表达,调节胃肠激素水平,提高临床治疗效果。

Objective:To observe the clinical effect of Tongxie Sishen tang combined with western medicine for diarrheapredominant irritable bowel syndrome(IBS-D) with the liver depression and spleen deficiency syndrome, and its effect on levels of calcitonin gene related peptide(CGRP) and vasoactive intestinal peptide(VIP). Methods: A total of 136 cases of patients were randomly divided into the control group and the observation group,68 cases in each group. Both groups were given trimebutine maleate dispersible tablets and compound eosinophil-lactobacillus enteric-coated capsules;the observation group was additionally given oral administration of Tongxie Sishen tang based on syndrome differentiation. Both groups were continuously treated for six weeks. Before and after treatment,the scores of the liver depression and spleen deficiency syndrome,the degree of abdominal pain,and IBS Syndrome Severity Scale(IBS-SSS) were evaluated;the levels of CGRP and VIP were detected. The clinical effect was compared between the two groups. Results:After treatment,the clinical effect in the observation group was better than that in the control group(P<0.05). The scores of the liver depression and spleen deficiency syndrome, the degree of abdominal pain, and IBS-SSS in the two groups were decreased when compared with those before treatment(P<0.01),and the three scores above in the observation group were lower than those in the control group(P<0.01). The levels of CGRP and VIP in serum in the two groups were decreased when compared with those before treatment(P<0.01), and the two levels above in the observation group were lower than those in the control group(P<0.01). Conclusion: For IBS-D patients with the liver depression and spleen deficiency syndrome, the additional oral administration of Tongxie Sishen tang on a basis of trimebutine maleate and compound eosinophil-lactobacillus can further relieve clinical symptoms of IBS-D,inhibit the expression of CGRP and VIP,regulate the levels of gastrointestinal hormones,and improve clinical effect.