健脾合剂联合复合乳酸菌对肝郁脾虚证IBS-D患者IBS-SSS、HAMA评分的影响

Effects of Jianpi Mixture Combined with Lactic Acid Bacteria Complex on IBS-SSS and HAMA Scores in Patients with IBS-D with Syndrome of Stagnation of Liver Qi and Spleen Deficiency

目的:探讨健脾合剂联合复合乳酸菌在肝郁脾虚证腹泻型肠易激综合征(IBS-D)患者中的治疗价值。方法:选取九江市第一人民医院2020年7月—2022年7月收治的88例肝郁脾虚证IBS-D患者为研究对象,按随机数字表法分为对照组与观察组,各44例。对照组予以复合乳酸菌肠溶胶囊口服治疗,观察组在对照组基础上联合健脾合剂口服治疗。观察对比两组中医症候疗效、中医症状积分、肠道功能、内脏敏感性、病情严重程度、心理状态、生存质量及安全性。结果:观察组总有效率高于对照组(P<0.05);治疗后,观察组各中医症状积分及总积分均低于对照组(P<0.05);治疗后,观察组二胺氧化酶(DAO)、内毒素(ET)、肠型脂肪酸结合蛋白(I-FABP)水平均低于对照组(P<0.05);治疗后,观察组初始感觉阈值、初始排便冲动阈值、最大耐受容量均高于对照组(P<0.05);治疗后,观察组内脏敏感指数(VSI)、IBS症状严重程度量表(IBS-SSS)评分均低于对照组(P<0.05);治疗后,观察组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05);治疗后,观察组IBS生存质量量表(IBS-QOL)各维度评分均低于对照组(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:健脾合剂联合复合乳酸菌治疗肝郁脾虚证IBS-D患者的效果显著,可有效改善患者中医症状,降低病情严重程度,提高肠屏障功能,降低内脏敏感性,改善心理状态,提高生活质量。

Objective:To explore the therapeutic value of Jianpi Mixture combined with Lactic Acid Bacteria Complex on patients with diarrhea-predominant irritable bowel syndrome(IBS-D)with syndrome of stagnation of liver Qi and spleen deficiency.Method:A total of 88 patients with IBS-D with syndrome of stagnation of liver Qi and spleen deficiency admitted to Jiujiang NO.1 People's Hospital from July 2020 to July 2022 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 44 cases in each group.The control group was given oral treatment with Lactic Acid Bacteria Complex Enteric Capsules,and the observation group was combined with Jianpi Mixture oral treatment on the basis of the control group.The TCM syndrome efficacy,TCM symptoms score,intestinal function,visceral sensitivity,disease severity,mental status,quality of life and safety of the two groups were observed and compared.Result:The total effective rate of observation group was higher than that of control group(P<0.05).After treatment,the integrals of each TCM symptoms and total integrals in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of diamine oxidase(DAO),endotoxin(ET)and intestinal fatty acid-binding protein(I-FABP)in observation group were lower than those in control group(P<0.05).After treatment,the initial sensory threshold,the initial defecation impulse threshold and the maximum tolerance capacity in the observation group were higher than those in the control group(P<0.05).After treatment,the scores of visceral sensitivity index(VSI)and IBS symptom severity scale(IBS-SSS)in observation group were lower than those in control group(P<0.05).After treatment,the scores of Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)in the observation group were lower than those in the control group(P<0.05).After treatment,the each dimension score of IBS quality of life scale(IBS-QOL)in observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Jianpi Mixture combined with Lactic Acid Bacteria Complex in the treatment of patients with IBS-D with syndrome of stagnation of liver Qi and spleen deficiency can effectively improve the TCM symptoms,reduce the disease severity,improve the intestinal barrier function,reduce visceral sensitivity,improve the mental status and improve the quality of life.