固肠胶囊联合双歧杆菌四联活菌片治疗IBS-D疗效及对患者肠道菌群、肠黏膜屏障功能的影响

Clinical Efficacy of Guchang Capsule Combined with Bifidobacterium Tetrabacterial Tablets in the Treatment of IBS-D and its Effect on Intestinal Flora and Intestinal Mucosal Barrier Function

目的:探究固肠胶囊联合双歧杆菌四联活菌片治疗腹泻型肠易激综合征(IBS-D)的临床疗效及对患者肠道菌群、肠黏膜屏障功能的影响。方法:IBS-D患者86例随机分为对照组(n=39)和观察组(n=47)。对照组给予双歧杆菌四联活菌片口服治疗,观察组在对照组治疗基础上给予固肠胶囊口服治疗,疗程均为1个月。评价两组患者症状改善及临床疗效,评估排便症状及大便性质改善有效率;检测两组患者治疗前后肠道肠杆菌、肠球菌、双歧杆菌、乳杆菌及酵母样真菌菌落数量及血清中肠黏膜屏障功能相关因子D-乳酸(D-LA)、肿瘤坏死因子-α(TNF-α)及乳脂球表皮生长因子-8(MFG-E8)含量。结果:观察组IBS症状尺度表总体疗效、大便性质改善的效果与对照组有差别(P<0.05)。治疗后,观察组患者腹痛程度、腹痛天数、腹胀程度、排便满意度、生活干扰度、IBS-BSS、每日排便次数、10 d中排便急迫天数均较治疗前降低(P<0.05),且优于对照组(P<0.05);与治疗前比较,观察组患者肠道肠杆菌、酵母样真菌菌落数量降低,肠球菌、双歧杆菌、乳杆菌菌落数量增加,血清D-LA、TNF-α含量下降,MFG-E8含量升高(P<0.05);且上述指标均有与对照组治疗后。结论:固肠胶囊联合双歧杆菌四联活菌片治疗IBS-D有较好的临床疗效,其作用机制与改善肠道菌群、增强肠黏膜屏障功能有关。

Objective:To explore the clinical efficacy of Guchang capsule combined with Bifidobacterium tetrabacterial tablets in the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D)and its effect on intestinal flora and intestinal mucosal barrier function.Methods:86 patients with IBS-D diagnosed in our hospital were randomly divided into control group(n=39)and observation group(n=47).The control group was treated by oral administration of Bifidobacterium tetrabacterial tablets,while the observation group was treated with Guchang capsule on the basis of the treatment of the control group.The course of treatment was one month.The symptoms and clinical efficacy of the two groups were evaluated,and the improvement efficiency of defecation symptoms and the nature of stool was evaluated.The colony numbers of enterobacter,enterococcus,bifidobacterium,Lactobacillus and yeast-like fungi in the intestinal tract and the levels of D-lactic acid(D-LA),tumor necrosis factor-α(TNF-α)and milk fat globule epidermal growth factor-8(MFG-E8)in serum were measured before and after treatment in the two groups.Results:The clinical effective rate and the improvement of stool quality in the observation group were significantly higher than those of the control group(P<0.05).After treatment,the degree of abdominal pain,days of abdominal pain,degree of abdominal distension,defecation satisfaction,life disturbance,IBS-BSS,daily defecation times and urgent defecation days in 10 days in the observation group were all lower than those before treatment(P<0.05),which were better than those in the control group(P<0.05).Compared with before treatment,the number of enterobacteria and yeast-like fungi colonies were decreased,the number of enterococcus,Bifidobacterium and Lactobacillus colonies were increased,the serum D-LA,TNF-αwas decreased,and MFG-E8 was increased in the observation group(P<0.05),and the above indexes were better than those in the control group after treatment,which were also superior to the control group(P<0.05).Conclusion:Guchang capsule combined with Bifidobacterium tetrabacterial tablets has good clinical efficacy in the treatment of diarrhea-predominant irritable bowel syndrome.Its mechanism is related to improving intestinal flora and enhancing intestinal mucosal barrier function.