莫沙比利联合聚卡波非钙治疗便秘型肠易激综合征的疗效观察和对细胞因子的影响

Clinical efficacy of mosapride combined with polycarbophil calcium in the treatment of constipation-type irritable bowel syndrome and its effect on cytokines

目的探讨莫沙比利联合聚卡波非钙治疗便秘型肠易激综合征的疗效观察和对细胞因子的影响。方法选取2018年1月至2019年1月上海健康医学院附属周浦医院收治的120例便秘型肠易激综合征病人,按照随机数字表法分为观察组和对照组(60例/组),其中对照组给予枸橼酸莫沙必利分散片,5毫克/次,3次/天,餐前服;观察组在对照组基础上给予聚卡波非钙,500毫克/片,3次/天,2片/次,三餐后用水200 mL送服。两组均治疗4周,观察两组排便情况,比较两组通便时间,对两组临床疗效及治疗期间不良反应进行评价,并检测两组病人治疗前后细胞因子变化。结果治疗后两组排便困难程度评分和排便时间均显著降低(P<0.05),但观察组降低更为明显(t=10.887,5.041,P<0.05)。治疗4周后观察组的总有效率为98.33%显著性高于对照组的80.00%(P<0.05)。治疗后两组5-羟色胺、胃动素、血管活性肠肽(VIP)及降钙素基因相关肽(CCRP)、神经肽Y均显著改善(P<0.05),但观察组改善更为明显(t=19.754、8.782、3.382、7.362、11.657,P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论莫沙比利联合聚卡波非钙治疗便秘型肠易激综合征临床疗效好,可显著改善病人排便困难等症状,并可上调胃动素水平,下调5-羟色胺、VIP、CCRP、神经肽Y水平。

Objective To investigate the efficacy of mosapride combined with polycarbophil calcium in the treatment of constipationinduced irritable bowel syndrome and its effect on cytokines.Methods A total of 120 patients with constipation-type irritable bowel syndrome in Zhoupu Hospital Affiliated to Shanghai Medical College of Health from January 2018 to January 2019 were chosen and randomly divided into the observation group and the control group(60 cases in each group).The control group were given mosapride ci⁃trate dispersible tablets,5 mg/time,3 times/day,before meals.The observation group had polycarbophil calcium on the basis of the con⁃trol group,500 mg/tablet,3 times/day,2 tablets/time,200 ml water after three meals.Both groups were treated for 4 weeks.Before and after treatment in the two groups,indexes including the laxative time,the clinical efficacy and the incidence of adverse reactions were compared.Besides,the cell factors were detected.Results After treatment,the scores of defecation difficulty and defecation time were significantly lower compared with those before treatment(P<0.05),but the decrease was more significant in the observation group(t=10.887,5.041,P<0.05).After 4 weeks of treatment,the total effective rate in the observation group was 98.33%,which was signifi⁃cantly higher than that in the control group 80.00%(P<0.05).After treatment,the levels of serotonin(5-HT),motilin(MOT),vasoactive intestinal peptide(VIP),calcitonin gene-related peptide(CCRP)and neuropeptide Y were all significantly improved(P<0.05),but the improvements in the observation group were more obvious(t=19.754,8.782,3.382,7.362,11.657,P<0.05).There were no significant differences between the two groups in terms of adverse reactions(P>0.05).Conclusions Mosapride combined with polycarbophil cal⁃cium in the treatment of constipation-type irritable bowel syndrome has better clinical effects,which can significantly improve the symptoms of patients with difficulty in defecation.Its mechanism relates to up-regulating the level of motilin and down-regulating the levels of 5-HT,VIP,CCRP and neuropeptide Y.