四神汤加味治疗腹泻型肠易激综合征脾虚湿盛证疗效及对患者肠道菌群和炎症因子的影响

Efficacy of Sishen Tang Plus in treating diarrhea-type irritable bowel syndrome with spleen deficiency and dampness and its effect on patients'intestinal flora and inflammatory factors

目的:探讨四神汤加味对腹泻型肠易激综合征(IBS-D)脾虚湿盛证的疗效及对患者肠道菌群和血清肿瘤坏死因子-α(TNF-α)与白细胞介素-6(IL-6)水平的影响。方法:纳入2021年9月—2023年3月在广州市黄埔区鱼珠街社区卫生服务中心就诊的IBS-D患者80例,根据随机数字表法分成对照组和观察组,每组40例。对照组采用马来酸曲美布汀胶囊口服治疗,观察组在对照组治疗方案基础上加用四神汤加味,两组均治疗观察4周。比较两组治疗前和治疗4周后临床症状评分、疗效、肠道菌群、血清TNF-α与IL-6水平。结果:治疗前,两组患者IBS症状严重程度量表(IBS-SSS)评分比较,差异无统计学意义(P>0.05);治疗后,两组患者IBS-SSS评分均低于治疗前,观察组患者IBS-SSS评分低于对照组患者,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者双歧杆菌、乳酸杆菌、肠杆菌菌落数比较,差异无统计学意义(P>0.05);治疗后,两组患者双歧杆菌、乳酸杆菌菌落数多于治疗前,肠杆菌菌落数少于治疗前,观察组患者双歧杆菌、乳酸杆菌菌落数多于对照组患者,肠杆菌菌落数少于对照组患者,差异有统计学意义(P<0.05)。治疗前,两组患者血清TNF-α及IL-6水平比较,差异无统计学意义(P>0.05);治疗后,两组患者血清TNF-α及IL-6水平均低于治疗前,观察组患者血清TNF-α及IL-6水平均低于对照组患者,差异有统计学意义(P<0.05)。结论:四神汤加味治疗IBS-D脾虚湿盛证效果明显,能改善患者肠道菌群,降低其血清TNF-α与IL-6水平。

Objective To investigate the curative effect of modified Sishen Decoction on the course of treatment of patients with diarrhea-predominant irritable bowel syndrome(IBS-D)with spleen deficiency and dampness syndrome and its effect on intestinal flora and serum levels of tumor necrosis factor-α(TNF-α)-αand interleukin-6(Il-6).Methods A total of 80 patients with diarrhea-predominant irritable bowel syndrome(IBS-D)who were treated in our hospital from September 2021 to March 2023 were included.According to the random number table method,they were divided into control group and observation group,with 40 cases in each group.The control group was treated with trimebutine maleate capsules orally;The conventional western medicine in the treatment observation group was the same as that in the control group,and on the basis of the treatment plan of the control group,Sishen Decoction was taken orally.Both groups were treated for 4 weeks.The clinical symptom scores,efficacy,intestinal flora,serum TNF-αand Il-6 levels were compared between the two groups before and after 4 weeks of treatment.Results Before treatment,there was no significant difference in the Irritable Bowel Syndrome Severity Scoring System(IBS-SSS)score between the two groups(P>0.05).After treatment,the IBS-SSS scores of the two groups were lower than those before treatment,and the IBS-SSS score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the number of bifidobacteria,lactobacilli and enterobacteria between the two groups(P>0.05).After treatment,the number of bifidobacteria and lactobacilli colonies in the two groups was more than that before treatment,and the number of enterobacteria colonies was less than that before treatment.The number of bifidobacteria and lactobacilli colonies in the observation group was more than that in the control group,and the number of enterobacteria colonies was less than that in the control group.Before treatment,there was no significant difference in serum TNF-αand Il-6 levels between the two groups(P>0.05).After treatment,the levels of serum TNF-αand Il-6 in the two groups were lower than those before treatment,and the levels of serum TNF-αand Il-6 in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusions The effect of modified Sishen decoction on IBS-D patients with spleen deficiency and dampness syndrome is obvious,which can improve the intestinal flora of patients and reduce the levels of TNF-αand Il-6 in serum.