加味葛根芩连汤治疗脾胃湿热型腹泻型肠易激综合征疗效观察

Efficacy observation of modified Gegen Qinlian decoction on IBS-D with damp-heat syndrome of spleen-stomach

目的:观察加味葛根芩连汤治疗脾胃湿热型腹泻型肠易激综合征的临床疗效。方法:选取脾胃湿热腹泻型肠易激综合征患者96例,随机分为两组各48例。对照组予双歧杆菌乳杆菌三联活菌片治疗,治疗组在对照组基础上联合加味葛根芩连汤治疗。治疗两周后评价两组临床疗效,观察两组症状积分、炎症介质白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平以及脑肠肽5-羟色胺(5-HT)水平,半年后评价复发情况。结果:治疗组总有效率95.83%高于对照组总有效率79.17%,治疗组疗效优于对照组(P﹤0.05);两组治疗后症状积分、炎症指标、5-HT水平均较治疗前显著下降,且治疗组优于对照组(P<0.05);随访半年,治疗组复发率低于对照组(P<0.05)。结论:在西药治疗基础上予加味葛根芩连汤治疗IBS-D效果更佳,其机制可能与其抑制肠道炎症反应,降低脑肠肽水平相关,并且可以缓解患者胃肠症状,降低复发率。

Objective:To observe the clinical effect of modified Gegen Qinlian decoction on IBS-D with dampheat syndrome of spleen-stomach.Methods:96 cases of patients with diarrhea-predominant irritable bowel syndrome of spleen-stomach damp-heat type were selected as researched objects,and randomly divided into two groups,48 cases in each group.The control group was treated with bifidobacterium lactobacillus triple active bacteria tablets,while the treatment group was treated plus with modified Gegen Qinlian decoction on the basis of control group.After two weeks of treatment,the clinical effect was evaluated in two groups;and the symptom score and the levels of inflammatory mediators interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and brain-gut peptide 5-hydroxytryptamine(5-HT)were observed in two group.The recurrence was evaluated after half a year.Results:The total effective rate of treatment group was 95.83%,which was higher than 79.17%of control group,and the curative effect of treatment group was better than that of control group(P﹤0.05).After treatment,in both groups,the symptom score,inflammatory indexes and 5-HT level were significantly decreased compared with before treatment,and the treatment group was better than control group(P﹤0.05).Within half a year of follow-up,the recurrence rate of treatment group was lower than that of control group(P﹤0.05).Conclusion:On the basis of treatmen with western medicine,the treatment plus with modified Gegen Qinlian decoction has better effect on IBS-D.Its mechanism may be related to the inhibition of intestinal inflammatory reaction and the reduction of brain gut peptide level,which can alleviate the gastrointestinal symptoms of patients and reduce the recurrence rate.