马来酸曲美布汀治疗肠易激综合征疗效及其对相关炎性介质的影响  

Effect of trimebutine maleate in treatment of irritable bowel syndrome and its effect on inflammatory mediators

作　　者：植家喜 施寒艳 徐晓蓉[2] 伍亚辉[1] 吴成明[1] 

机构地区：[1]同济大学医学院研究生院,上海200431 [2]上海市第十人民医院消化内科,200072

出　　处：《疑难病杂志》2017年第4期364-367,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察马来酸曲美布汀治疗肠易激综合征(IBS)的效果及其对相关炎性介质的影响。方法将2015年3月—2016年3月上海市第十人民医院消化内科诊治的IBS患者96例随机分为观察组和对照组各48例。2组患者治疗期间均给予充分休息、健康饮食、纠正水电解质紊乱、维持酸碱平衡等常规治疗。对照组另予复方地芬诺酯2.5 mg/次,3次/d及匹维溴铵50 mg/次,3次/d;观察组在对照组治疗基础上联合服用马来酸曲美布汀片50 mg/次,3次/d。2组患者均连续治疗4周。比较2组患者临床疗效、临床症状积分、TNF-α、IL-10、IL-18水平变化情况及不良反应发生情况。结果治疗后观察组总有效率为89.6%,显著高于对照组的70.8%(x^2=5.315,P-0.021);观察组大便性状、排便次数、腹痛症状积分、TNF-α、IL-18水平低于对照组,IL-10高于对照组(t=2.513、2.813、6.012、4.487、8.197、4.722,P<0.01);治疗期间2组患者均发生恶心、呕吐、头晕、头痛、口干、嗜睡、疲乏等不良症状,但差异均无统计学意义(P>0.05)。结论曲美布汀治疗IBS疗效确切,显著改善炎性反应,有效减轻临床症状,安全性好,值得临床推广应用。Objective To observe trimebutine maleate in treatment of irritable bowel syndrome （IBS） and its effect on inflammatory mediators. Methods Ninety-six patients with IBS were randomly divided into observation group and control group in Shanghai Tenth Peopleg Hospital from March 2015 to March 2016. 2 groups of patients during treatment were given adequate rest, a healthy diet, correct water and electrolyte disorders, maintaining acid-base balance and other conventional treatment. The control group were treated by compound diphenoxylate 2.5 mg, tid and pinaverium bromide 50 mg, rid ; obser- vation group of combined use of Trimebutine Maleate Tablets 50mg based on the treatment in control group. Two groups of pa- tients were treated for 4 weeks. The clinical efficacy, clinical symptom score, TNF-α, IL-10, IL-18 and the incidence of ad- verse reactions were compared between the 2 groups. Results After treatment, the total effective rate of observation group was 89.6% , significantly higher than the control group 70.8% （ χ2 = 5.315, P = 0. 021 ） ; stool, defecation, abdominal pain symptoms, TNF-α,IL-18 levels lower than the control group, IL-10 higher than that of the control group （ t = 2. 513, t = 2.813, t =6.012, t =4.487, t =8. 197, t =4.722, P 〈0.01）; nausea, vomiting, dizziness, headache, drowsiness, dry mouth, fatigue and other adverse symptoms occurred during the treatment period, but the 2 groups were compared, there were no significant differences （ P 〉 0.05）. Conclusion Effect of trimebutine in the treatment significantly improved the IBS exact, inflammatory reaction, effectively relieve the clinical symptoms, good safety, it is worthy of clinical application.

关 键 词：马来酸曲美布汀 肠易激综合征 炎性介质 

分 类 号：R574[医药卫生—消化系统]