附子理中汤合四神丸对腹泻型肠易激综合征疗效观察

Observation of Fuzi Lizhong Decoction(附子理中汤)and Sishen Pill(四神丸)On Diarrhea Irritable Bowel Syndrome

目的观察附子理中汤合四神丸在腹泻型肠易激综合征(IBS-D)患者中的疗效。方法依据随机数字表法将医院2020年6月—2022年10月接收的80例IBS-D患者分为对照组和观察组各40例。两组均给予常规治疗,对照组给予服用盐酸洛哌丁胺胶囊和马来酸曲美布汀治疗,在对照组基础上,观察组服用附子理中汤合四神丸治疗。治疗1个月后,比较两组临床疗效、中医证候积分、蛋白酶激动受体(蛋白酶激活受体2[PAR2]、蛋白酶激活受体4[PAR4])及炎症因子(C反应蛋白[CRP]、白细胞介素-6[IL-6])水平;治疗结束后随访3个月,评估随访期间两组病情复发情况。结果治疗后,观察组治疗总有效率95.00%高于对照组80.00%(P<0.05)。治疗后,两组腹部冷痛、形寒肢冷、腰膝酸软、不思饮食积分均较治疗前降低,且观察组积分较对照组低(P<0.05)。治疗后,两组PAR2、PAR4水平均较治疗前降低,且观察组水平较对照组低(P<0.05)。治疗后,两组血清CRP、IL-6水平均较治疗前降低,且观察组水平较对照组低(P<0.05)。观察组复发率2.50%低于对照组20.00%(P<0.05)。结论附子理中汤联合四神丸对腹泻型肠易激综合征患者可提高疗效,进一步降低中医证候积分,还可改善蛋白酶激动受体水平,减轻炎症反应,利于降低复发风险。

Objective To observe the effects of Fuzi Lizhong Decoction(附子理中汤)and Sishen Pill(四神丸)in patients with diarrhoeal irritable bowel syndrome(IBS-D).Methods According to the method of random number table,80 patients with IBS-D received in our hospital from June 2020 to October 2022 were divided into control group(40 cases)and observation group(40 cases).Both groups were given routine treatment.The control group was given loperamide hydrochloride capsule and trimebutine maleate.On the basis of the control group,the observation group was given Fuzi Lizhong Decoction and Sishen Pill.After one month of treatment,the clinical efficacy,TCM syndrome score,the levels of proteinase-activated receptor[proteinase-activated receptor 2(PAR2),proteinase-activated receptor 4(PAR4)]and inflammatory factors[C-reactive protein(CRP),interleukin(IL)-6]were compared between the two groups.After treatment,the patients were followed up for 3 months to evaluate the relapse of the two groups during the follow-up period.Results After one treatment,the total effective rate in the observation group was 95.00% higher than that in the control group 80.00%(P<0.05).After one treatment,the scores of abdominal cold pain,cold limbs,waist and knee soreness and insensibility of diet in the two groups were lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).After one treatment,the levels of PAR2 and PAR4 in the two groups were lower than those before treatment,and the level in the observation group was lower than that in the control group(P<0.05).After one treatment,the levels of serum CRP and IL-6 in the two groups were lower than those before treatment,and the level in the observation group was lower than that in the control group(P<0.05).The recurrence rate in the observation group was 2.50% lower than that in the control group 20.00%(P<0.05).Conclusion Fuzi Lizhong Decoction combined with Sishen Pill can improve the curative effect of patients with diarrhoeal irritable bowel syndrome,further reduce the integral of traditional chinese medicine syndromes,improve the level of proteinase-activated receptor,reduce inflammatory reaction,and reduce the risk of recurrence.