西兰司琼辅助匹维溴铵治疗肠易激综合征老年患者效果研究  

Efficacy of cilansetron combined with pivirium bromide in treatment of elderly patients with irritable bowel syndrome

作　　者：邵义舜[1] 谢民 卢蓉[1] Yi-Shun Shao;Min Xie;Rong Lu(Department of Internal Medicine,Huazhong University of Science and Technology Hospital,Wuhan 430074,Hubei Province,China)

机构地区：[1]华中科技大学医院内科,湖北省武汉市430074

出　　处：《世界华人消化杂志》2022年第10期458-464,共7页World Chinese Journal of Digestology

摘　　要：背景肠易激综合征(irritable bowel syndrome,IBS)治疗多以匹维溴铵等对症治疗为主,通过阻滞胃肠道平滑肌电压依赖性钙通道,促进正常肠道动力恢复,控制肠易激综合征症状.目前,关于匹维溴铵、西兰司琼两者联合治疗肠易激综合征的效果报道较少.目的探究西兰司琼辅助匹维溴铵治疗肠易激综合征IBS老年患者的应用效果.方法选取2017-06/2019-06我院126例老年IBS患者,简单随机化分为3组,各42例.A组给予匹维溴铵,B组给予西兰司琼,联合组给予匹维溴铵+西兰司琼.统计3组疗效、不良反应,对比治疗前后胃肠道症状、肠屏障功能[D-乳酸、二胺氧化酶(diamine oxidase,DAO)、内毒素]、胃肠激素指标[5-羟色氨酸(5-hydroxytryptophan,5-HT)、胆囊收缩素(cholecystokinin,CCK)、血管活性肠肽(vasoactive intestinal peptide,VIP)].结果联合组总有效率95.24%高于A组69.05%、B组73.81%(P<0.05);治疗后联合组腹泻、腹痛、恶心呕吐评分低于A组、B组(P<0.05);治疗后联合组、B组肠球菌低于治疗前,拟杆菌、乳酸杆菌、双歧杆菌高于治疗前(P<0.05);治疗后联合组D-乳酸、DAO、内毒素水平低于A组、B组(P<0.05);治疗后联合组血清5-HT、CCK、VIP水平低于A组、B组(P<0.05);3组不良反应发生率比较无显著差异(P>0.05).结论西兰司琼及匹维溴铵治疗均能调节老年IBS患者症状,但西兰司琼辅助匹维溴铵治疗老年IBS,能进一步提高疗效,改善胃肠道症状,修复受损肠屏障功能,降低胃肠激素水平.BACKGROUND Piveronium bromide and other symptomatic treatments are mainly used in the treatment of irritable bowel syndrome(IBS),which can block the volt-dependent calcium channel of gastrointestinal smooth muscle to promote the recovery of normal intestinal motility and control the symptoms of IBS.At present,there are few reports on the efficacy of piveronium bromide combined with cilansetron in the treatment of IBS.AIM To evaluate the efficacy of cilansetron combined with pivirium bromide in the treatment of elderly patients with IBS.METHODS From June 2017 to June 2019,126 elderly IBS patients treated at our hospital were selected and randomly randomized into three groups with 42 cases each.Group A was given pinaverium bromide,group B was given cilansetron,and the combination group was given pinaverium bromide+cilansetron.The efficacy and adverse reactions of the three groups were recorded.Gastrointestinal symptoms,intestinal flora,and intestinal barrier function[D-lactic acid,diamine oxidase(DAO),and endotoxin],and gastrointestinal hormone indicators[5-hydroxytryptophan(5-HT),cholecystokinin(CCK),and vasoactive intestinal peptide(VIP)]were compared before and after treatment.RESULTS The total effective rate of the combined group was 95.24%,which was higher than those of group A(69.05%)and group B(73.81%)(P<0.05).After treatment,the scores of diarrhea,abdominal pain,nausea,and vomiting in the combined group were lower than those of groups A and B(P<0.05).The number of enterococci in the combined group and group B was lower than that before treatment,and the number of bacteroides,lactobacillus,and bifidobacterium was higher than that before treatment(P<0.05).The levels of D-lactic acid,DAO,and endotoxin in the combined group were lower than those in groups A and B(P<0.05).The serum levels of 5-HT,CCK,and VIP in the combined group were lower than those of group A and group B(P<0.05).The incidence of adverse reactions in the three groups was not significantly different(P>0.05).CONCLUSION Both cilansetron and pinav

关 键 词：西兰司琼 匹维溴铵 肠易激综合征 肠屏障功能 胃肠激素 

分 类 号：R574[医药卫生—消化系统]