参苓白术散加减治疗对老年慢性功能性腹泻的疗效及脑肠轴调控机制  

Efficacy of Shenling Baizhu Powder in treatment of elderly patients with chronic functional diarrhea and Its regulation mechanism of brain-gut axis

作　　者：胡聪 HU Cong(Department of Traditional Chinese Medicine,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院中医科,武汉430014

出　　处：《实用医学杂志》2020年第18期2593-2597,共5页The Journal of Practical Medicine

摘　　要：目的探讨参苓白术散加减治疗老年慢性功能性腹泻(CFD)的疗效及对脑肠轴的调控机制。方法将老年CFD患者116例随机分为对照组与观察组,各58例。对照组给予常规治疗,观察组给予常规治疗联合参苓白术散加减治疗。比较两组临床疗效及症状改善情况,测定血清炎症因子、氧化应激指标、脑肠轴相关激素水平。结果观察组临床治愈率高于对照组而复发率显著低于对照组(P<0.05)。治疗后,观察组的中医证候积分、周排便次数及Bristol大便性状分型值均低于对照组(P<0.05);观察组的血清干扰素γ(IFN-γ)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、二胺氧化酶(DAO)、丙二醛(MDA)、5-羟色胺(5-HT)、生长激素释放肽(GHRL)均低于对照组,白介素-4(IL-4)、谷胱甘肽过氧化物酶(GSH-Px)、胃泌素(GAS)、胃动素(MLT)、胆缩素(CCK)、血管活性肠肽(VIP)均高于对照组(P<0.05)。结论参苓白术散加减可提高老年CFD的近期疗效并降低远期复发率,调节脑肠轴功能及脑肠肽。Objective The aim of this study was to explore the efficacy of Shenling Baizhu Powder in treat-ment of elderly patients with chronic functional diarrhea(CFD)and its regulation mechanism of brain-gut axis.Methods 116 elderly CFD patients were randomly divided into control group and observation group.There were 58 cases in each group.The control group received conventional treatment for 8 weeks and the observation group received conventional treatment combined with Shenling Baizhu Powder for 8 weeks.The clinical efficacy of and symptom improvement of the two groups were compared.The serum inflammatory factors,oxidative stress indicators and brain-gut axis related hormones were determined.Results Compared with control group,the clinical cure rate of observation group was significantly higher while the recurrence rate was lower(P<0.05).After treatment,the syndrome scores,weekly defecation times and Bristol stool phenotype were lower than control group(P<0.05).Moreover,the serum levels of IFN-γ,IL-6,TNF-α,DAO,MDA,5-HT,GHRL of observation group were lower than those of control group while the IL-4,GSH-Px,GAS,MLT,CCK and VIP were higher(P<0.05).Conclusion Shenling Baizhu Powder could improve the short-term efficacy and reduce the long-term recurrence rate of elderly CFD as well as regulate the function of brain-gut axis and neuropeptides.

关 键 词：慢性功能性腹泻 老年 参苓白术散 脑肠轴 机制 

分 类 号：R57[医药卫生—消化系统] R256[医药卫生—内科学]