芪连结肠宁方治疗腹泻型肠易激综合征脾虚湿热证临床研究  

Clinical Study on Qilian Jiechangning Decoction for Treatment of Diarrhea-predominant Irritable Bowel Syndrome with Spleen Deficiency and Damp Heat Syndrome

作　　者：谭华梁[1] 徐寅[2] 肖麟[2] 蒋士生 TAN Hualiang;XU Yin;XIAO Lin;JIANG Shisheng(Hunan University of Chinese Medicine,Changsha 410036,China;The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Hunan Institute of Traditional Chinese Medicine,Changsha 410006,China)

机构地区：[1]湖南中医药大学,湖南长沙410036 [2]湖南中医药大学第一附属医院,湖南长沙410007 [3]湖南中医药研究院,湖南长沙410006

出　　处：《中国中医药信息杂志》2021年第2期92-96,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(2013年);湖南中医药大学国内一流学科建设资助项目(2018-2020年)。

摘　　要：目的观察芪连结肠宁方治疗腹泻型肠易激综合征(IBS-D)脾虚湿热证的临床疗效、安全性,以及对脑肠肽、肠黏膜屏障功能的影响。方法采用随机数字表法将96例患者分为观察组和对照组各48例,治疗期间观察组脱落3例,对照组脱落2例、失访1例。观察组予芪连结肠宁方,每日1剂,每日2次,口服。对照组予马来酸曲美布汀胶囊,0.2 g/次,3次/d,口服;双歧杆菌四联活菌片,0.5 g/次,3次/d,口服。2组均连续治疗4周。观察2组临床疗效,比较2组治疗前后中医症状评分、肠易激综合征症状严重程度量表(IBS-SSS)积分、肠易激综合征生活质量量表(IBS-QOL)评分及血清5-羟色胺(5-HT)、血管活性肠肽(VIP)、P物质、二胺氧化酶(DAO)、D-乳酸、内毒素(ET)水平,并进行安全性评价。结果观察组总有效率为91.11%(41/45),对照组为82.22%(37/45),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后腹痛、大便稀溏、神疲倦怠、大便频次、纳呆评分及IBS-BSS积分降低,IBS-QOL积分升高(P<0.05);2组治疗后比较,观察组腹痛、大便稀溏、神疲倦怠、大便频次、纳呆评分明显低于对照组(P<0.05),IBS-BSS评分低于对照组(P<0.01),IBS-QOL评分高于对照组(P<0.01)。与本组治疗前比较,2组治疗后5-HT、VIP、P物质、DAO、D-乳酸及ET水平降低(P<0.05);2组治疗后比较,观察组5-HT、VIP、P物质、DAO、D-乳酸及ET水平低于对照组(P<0.01)。2组均未见不良反应。结论芪连结肠宁方治疗IBS-D脾虚湿热证疗效较好,可改善患者中医症状评分,提高生活质量,调节脑肠肽水平,改善肠黏膜屏障功能,安全性较好。Objective To observe the clinical efficacy and safety of Qilian Jiechangning Decoction for the treatment of diarrhea-predominant irritable bowel syndrome(IBS-D) with spleen deficiency and damp heat syndrome and its effects on brain-gut peptide and intestinal mucosal barrier function. Methods Totally 96 patients were divided into the observation group and the control group(48 cases in each group) by random number table method. 45 patients in observation group completed the therapy(3 patients were falling off), and 45 patients in control group completed the therapy(2 patients were falling off and 1 patient was missing). The observation group was given Qilian Jiechangning Decoction, 1 dosage a day, twice a day, orally. The control group was given trimebutine maleate capsules, 0.2 g per time, three time a day, orally;and Bifidobacterium quadruple viable tablets, 0.5 g per time, three time a day, orally. The course of treatment in both groups was 4 weeks. The clinical efficacy of the two groups was observed. TCM symptom scores, IBS-SSS score, IBS-QOL score, serum 5-HT, VIP, SP, DAO, D-lactic acid, endotoxin(ET), levels were compared between the two groups before and after treatment. Clinical safety was evaluated. Results The total effective rate of the observation group was 91.11%(41/45) and that of the control group was 82.22%(37/45), with statistical significance(P<0.05). Compared with before treatment, the scores of abdominal pain, loose stool, mental fatigue, stool frequency and anorexia, and IBS-BSS score of the two groups decreased after treatment, IBS-QOL score increased(P<0.05). After treatment, the scores of abdominal pain, loose stool, mental fatigue, stool frequency and anorexia in the observation group were lower than those in the control group(P<0.05), the IBS-BSS score was lower than that in the control group(P<0.01), the IBS-QOL score was higher than that of the control group(P<0.01). Compared with before treatment, the levels of 5-HT, VIP, SP, DAO, D-lactic acid and ET in the two groups decreased(P<0.0

关 键 词：腹泻型肠易激综合征 脾虚湿热证 芪连结肠宁方 脑肠肽 肠黏膜屏障功能 

分 类 号：R259.746.2[医药卫生—中西医结合]