加味交泰丸治疗腹泻型肠易激综合征临床研究

Clinical Study on the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome with Supplemented Jiaotai Pills

目的:观察加味交泰丸治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)的临床疗效。方法:将60例IBS-D患者按照随机数字表法分为对照组和观察组,每组各30例。对照组给予地衣芽孢杆菌活菌胶囊口服,观察组给予加味交泰丸治疗。比较两组患者治疗前后临床症状积分、IBS症状严重程度量表(IBS-symptom severity scale,IBS-SSS)积分、情绪障碍[汉密尔顿焦虑量表(hamilton depression scale,HAMD)、汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)]积分及肠道菌群变化情况。结果:观察组治疗后各项主症积分低于本组治疗前,对照组仅腹痛、大便次数积分低于本组治疗前,差异具有统计学意义(P<0.05),但两组患者治疗后各项主症积分比较,差异无统计学意义(P>0.05)。观察组治疗后失眠、情志抑郁或烦躁、心悸等次症积分低于本组治疗前,对照组治疗后肠鸣、腹胀等次症积分低于本组治疗前,治疗后观察组情志抑郁或烦躁、心悸等次症积分低于对照组,差异具有统计学意义(P<0.05)。两组治疗后IBS-SSS、HAMD、HAMA评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组治疗后酵母菌、肠球菌、大肠杆菌数量低于本组治疗前,乳酸杆菌、双歧杆菌数量高于本组治疗前,观察组治疗后对酵母菌、肠球菌数量低于对照组,对照组大肠杆菌少于观察组,乳酸杆菌、双歧杆菌数量高于观察组,差异具有统计学意义(P<0.05)。结论:加味交泰丸治疗IBS-D,可改善患者的临床症状,缓解抑郁、焦虑状态,且对酵母菌、肠球菌有抑菌作用。

Objective:To observe the clinical efficacy of Supplemented Jiaotai Pills(加味交泰丸,SJTP)on diarrhea-predominant rritable bowel syndrome(IBS-D).Methods:A total of 60 IBS-D patients were randomly divided into the control group and the observation group according to random number table method,with 30 cases in each group.The control group was given Bacilus Licheniformis Capsules orally,while the observation group was given SJTP.Then the changes of the clinical symptom scores,IBS symptom severity scale(IBS-SSS)scores,emotional disorders[including Hamilton anxiety scale(HAMD)scores,Hamilton anxiety scale(HAMA)scores],and intestinal flora between two groups of patient before and after treatment were compared.Results:After treatment,the main symptom scores of the observation group were lower than those of the same group before treatment,while the control group only had lower scores for abdominal pain and bowel movements than those of the same group before treatment,and all the differences were statistically significant(P<0.05),but there was no statistically significant difference in each of the main symptom scores between the two groups(P>0.05);The scores of insomnia,emotional depression or irritability,palpitations and other secondary symptoms in the observation group were lower than those of the same group before treatment,while the scores of borborygmus,abdominal distension and other secondary symptoms in the control group were lower than those of the same group before treatment;The scores of emotional depression or irritability,palpitations and other secondary symptoms in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05);The IBS-SSS,HAMD,and HAMA scores of the two groups were lower than those of the same group before treatment,and the observation group's were lower than those of the control group,and all the dfferences were statistically significant(P<0.05);The number of yeast,enterococcus and escherichia coli in the two groups was lower than that before treatment,while the number of lactobacillus and bifidobacteria was higher than that before treatment;the number of yeast and enterococcus in the observation group was lower than that in the control group,while the number of escherichia coli in the control group was lower than that in the observation group,and the number of lactobacillus and bifidobacteria was higher than that in the observation group,and all the differences were statistically significant(P<0.05).Conclusion:SJTP can improve the clinical symptoms of patients with IBS-D,relieve depression and anxiety,and has bacteriostatic effect on yeast and enterococcus.