健脾祛湿方对腹泻型肠易激综合征患者肠道微生态系统的影响

Effect of Jianpi Qushi decoction on intestinal micro-ecological system in patients with diarrhea-predominant irritable bowel syndrome

目的:探讨健脾祛湿方对腹泻型肠易激综合征患者肠道菌群的影响。方法:选取2016年7月—2018年8月接受治疗的腹泻型肠易激综合征患者90例,依据电脑数字表法随机分为对照组与实验组2组,每组各45例,对照组予以西医常规治疗,实验组于此基础上施予健脾祛湿方治疗,对比2组肠道菌群、中医症状积分、直肠黏膜受体表达以及血清脑肠肽水平。结果:治疗后,实验组乳酸杆菌及双歧杆菌数均比对照组多,而酵母菌、肠杆菌及肠球菌数量则比对照组少,差异有统计学意义(P<0.05);实验组中医症状积分比对照组低,差异有统计学意义(P<0.05);实验组直肠黏膜组织中蛋白酶激活受体2(protease activated receptors 2,PAR2)表达是(0.60±0.09),蛋白酶激活受体4(PAR4)表达是(0.17±0.04),分别比对照组的(0.73±0.11)及(0.25±0.07)低,差异有统计学意义(P<0.05);与对照组比较,实验组神经降压素(NT)及血浆活性肠肽(VIP)水平更低,神经肽Y(NPY)水平更高(P<0.05)。结论:健脾祛湿方有助于改善腹泻型肠易激综合征患者的肠道菌群,降低中医症状积分,并且改善直肠黏膜受体表达以及血清脑肠肽水平。

Objective: Observation of Jianpi Qushi decoction on the patients with Diarrhea-predominant irritable bowel syndrome and its influence on the intestinal flora, TCM symptom score, rectal mucosal receptor expression and serum brain gut peptide. Methods: Ninety patients with diarrhea predominant irritable bowel syndrome in our hospital from July 2016 to August 2018 were selected and randomly divided into control group and experimental group according to computer number table method, with 45 cases in each group. The control group was given conventional western medicine treatment, while the experimental group was given Jianpi Qushi decoction Treatment on this basis The expression of receptor in rectal mucosa and serum brain gut peptide. Results: After treatment, the number of lactobacillius and bifidobacterium in the experimental group were more than those of the control group, while the number of saccharomyce, enterobacteriaceae and enterococcus were less than those of the control group, with statistically significant(P<0.05). The TCM symptom score of the experimental group was lower than that of the control group, with statistically significant(P<0.05). In the the experimental group, the expression of protease activated receptors 2 in rectal mucosa was(0.60±0.09), the expression of protease activated receptors 4 was(0.17±0.04), which were lower than those of the control group(0.73±0.11) and(0.25±0.07), respectively, with statistically significant(P<0.05). The levels of neurotensin(NT) and vasoactive intestinal peptide(VIP) were lower than those of the control group, while the level of neuropeptide Y(NPY) was higher than that of the control group, with statistically significant(P<0.05). Conclusion: Jianpi Qushi decoction on the patients with diarrhea-predominant irritable bowel syndrome can help to improve the intestinal flora, reduce the TCM symptom score, as well as improve the rectal mucosal receptor expression and serum brain gut peptide.