藿蔻理气除湿汤治疗腹泻型肠易激综合征疗效观察及对肠屏障功能、胃肠道激素水平的影响

Observation on Curative Effect of Huokou Liqi Chushi Decoction for Diarrhea-Predomi⁃nant Irritable Bowel Syndrome and Its Effect on Intestinal Barrier Function and Gastro⁃intestinal Hormone Levels

目的:观察自拟藿蔻理气除湿汤治疗腹泻型肠易激综合征(IBS-D)的临床疗效及对肠屏障功能、胃肠道激素水平的影响。方法:选取89例IBS-D患者,随机分为对照组44例和观察组45例。对照组给予匹维溴铵片治疗,观察组给予藿蔻理气除湿汤治疗。治疗4周后,比较2组临床疗效,以及治疗前后中医证候评分,血清D-乳酸、二胺氧化酶(DAO)、胃泌素(GAS)、降钙素基因相关肽(CGRP)及肠易激综合征相关生存质量量表(IBS-QOL)评分变化。结果:观察组总有效率为93.18%,对照组为77.78%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组腹痛即泻、腹部冷痛、腰膝酸软、不思饮食、形寒肢冷等证候评分及总分均较治疗前降低(P<0.05),且观察组上述各项评分及总分均低于对照组(P<0.05)。治疗后,2组血清D-乳酸、DAO水平均较治疗前降低(P<0.05),且观察组D-乳酸、DAO水平均低于对照组(P<0.05)。治疗后,2组GAS水平较治疗前下降(P<0.05),CGRP水平较治疗前升高(P<0.05);且观察组GAS水平低于对照组(P<0.05),CGRP水平高于对照组(P<0.05)。治疗后,2组IBS-QOL评分均较治疗前升高(P<0.05),且观察组IBS-QOL评分高于对照组(P<0.05)。治疗期间,2组均未出现明显的血、尿常规及肝肾功能异常。结论:藿蔻理气除湿汤治疗IBS-D患者疗效确切,能有效调节胃肠道激素水平,改善肠道屏障功能及临床症状,提高其生活质量水平。

Objective:To observe the clinical effect of self-made Huokou Liqi Chushi Decoction for diarrhea-predominant irritable bowel syndrome(IBS-D)and its effect on intestinal barrier function and gastrointestinal hormone levels.Methods:A total of 89 cases of IBS-D patients were randomly divided into the control group and the observation group,with 44 and 45 cases in each group respectively.The control group was given the oral administration of Pinaverium Bromide Tablets,and the observation group was treated with Huokou Liqi Chushi Decoction.After 4 weeks of treatment,the changes in traditional Chinese medicine syndrome scores,levels of D-lactic acid,diamine oxidase(DAO),gastrin(GAS)and calcitonin gene-related peptide(CGRP)in serum,and scores of irritable bowel syndrome-related Quality of Life Scale(IBS-QOL)before and after treatment as well as the clinical effects were compared between the two groups.Results:The total effective rate was 93.18%in the observation group and 77.78%in the control group,the difference being significant(P<0.05).After treatment,the scores of syndromes like sudden diarrhea after abdominal pain,abdominal cold-pain,soreness and weakness of waist and knees,poor appetite and cold body and limbs as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of D-lactic acid and DAO in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of D-lactic acid and DAO in the observation group were lower than those in the control group(P<0.05).After treatment,GAS levels in the two groups were decreased when compared with those before treatment(P<0.05),and CGRP levels were increased when compared with those before treatment(P<0.05);GAS level in the observation group was lower than that in the control group(P<0.05),and CGRP level was higher than that in the control group(P<0.05).After treatment,IBS-QOL scores in the two groups were increased when compared with those before treatment(P<0.05),and the IBS-QOL score in the observation group was higher than that in the control group(P<0.05).During the treatment,there were no obvious abnormalities in blood and urine routine as well as liver and kidney function between the two groups.Conclusion:Huokou Liqi Chushi Decoction for IBS-D patients has a definite curative effect,and can effectively regulate gastrointestinal hormone levels,improve intestinal barrier function,improve clinical symptoms and enhance the quality of life of patients.