维生素D辅助治疗肠易激综合征的疗效及其作用机制研究

Efficacy and mechanism of Vitamin D as an adjuvant therapy for irritable bowel syndrome

目的观察维生素D辅助治疗肠易激综合征(IBS)的疗效并探讨其作用机制。方法选取2019年5月至2023年6月河南省周口市妇幼保健院(周口市儿童医院)收治的152例IBS患儿作为研究对象,根据随机数表法分为观察组和对照组各76例。对照组患儿予以常规治疗,观察组患儿在对照组基础上予以维生素D辅助治疗,均连续治疗4周。比较两组患儿的临床疗效,以及治疗前、治疗2周、4周后的肠道症状、肠道菌群、免疫炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、IL-8、IL-10]、肠道屏障功能指标[D-乳酸、二胺氧化酶(DAO)、肠型脂肪酸结合蛋白(IFABP)],同时比较两组患儿治疗期间的不良反应发生情况。结果观察组患儿的临床治疗总有效率为94.74%,明显高于对照组的82.89%,差异有统计学意义(P<0.05);治疗2周、4周后,观察组患儿的腹痛程度、腹痛时间、腹胀程度、排便满意度及生活干扰度评分明显低于对照组,差异均有统计学意义(P<0.05);治疗2周、4周后,观察组患儿的乳酸杆菌、双歧杆菌及肠球菌菌落数明显高于对照组,酵母样真菌菌落数明显低于对照组,差异均有统计学意义(P<0.05);治疗2周、4周后,观察组患儿的TNF-α、IL-6、IL-8、清D-乳酸、DAO、IFABP水平明显低于对照组,IL-10水平明显高于对照组,差异均有统计学意义(P<0.05);两组患儿治疗期间均未出现明显不良反应。结论维生素D辅助治疗IBS可有效改善患儿的肠道症状,调节肠道菌群、免疫炎性反应,修复肠道屏障功能,临床应用效果显著且安全性高。

Objective To investigate the efficacy of Vitamin D as an adjuvant therapy for irritable bowel syndrome(IBS)and to analyze its mechanism.Methods A total of 152 children with IBS admitted to Zhoukou Maternal and Child Health Hospital(Zhoukou Children's Hospital)from May 2019 to June 2023 were selected and randomly divided into an observation group and a control group,each with 76 cases.The children in the control group were given conventional treatment,while those in the observation group were given vitamin D as an adjuvant therapy on the basis of the treatment in the control group,both for 4 consecutive weeks.The clinical efficacy of the two groups of children was compared,as well as the intestinal symptoms,intestinal flora,immune inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8,IL-10],and intestinal barrier function indicators[D-lactate,diamine oxidase(DAO),intestinal fatty acid binding protein(IFABP)]before treatment,and at 2 weeks,4 weeks after treatment.The adverse reactions during treatment were also compared between the two groups.Results The total clinical efficacy rate in the observation group was 94.74%,which was significantly higher than 82.89%in the control group(P<0.05).At 2 weeks and 4 weeks after treatment,the scores of abdominal pain severity,abdominal pain duration,abdominal distension severity,satisfaction with defecation,and interference with daily life in the observation group were significantly lower than those in the control group(P<0.05);the colony counts of lactobacilli,bifidobacteria,and enterococci in the observation group were significantly higher than those in the control group,while the colony count of yeast-like fungi was significantly lower than that in the control group,with statistically significant differences(P<0.05);the levels of TNF-α,IL-6,IL-8,D-lactate,DAO,and IFABP in the observation group were significantly lower than those in the control group,while the level of IL-10 was significantly higher than that in the control group,with statistically significant differences(P<0.05).No significant adverse reactions occurred in both groups during treatment.Conclusion Vitamin D as an adjuvant therapy for IBS can effectively improve the intestinal symptoms of children,regulate intestinal flora,immune inflammatory response,and repair intestinal barrier function,with significant clinical application effect and high safety.