温肾健脾法对腹泻型肠易激综合征伴睡眠障碍患者的临床疗效及脑-肠轴的影响  

Effect of warming kidney and strengthening spleen on the patients with IBS-D combined with sleep disorders and its influence on the brain-gut axis

作　　者：张旖晴[1] 牛然 杨俭勤[1] 苏晓兰[1] 孙晓红[1] 魏玮[1] ZHANG Yiqing;NIU Ran;YANG Jianqin;SU Xiaolan;SUN Xiaohong;WEI Wei(Bejing Key Laboratory of TCM Diagnosis and Treatment of Functional Gastointestinal Diseases/Department of Spleen and Stomach Diseases,Wangjing Hospital,China Academy of Chinese Medical Sciences,Bijing 100102,China)

机构地区：[1]功能性胃肠病中医诊治北京市重点实验室/中国中医科学院望京医院脾胃病科,北京100102

出　　处：《长春中医药大学学报》2022年第7期766-769,共4页Journal of Changchun University of Chinese Medicine

基　　金：中国中医科学院基本科研业务费自主选题项目(ZZ11-083)。

摘　　要：目的探讨温肾健脾法对腹泻型肠易激综合征(IBS-D)伴睡眠障碍患者的疗效以及脑-肠轴的影响。方法选择IBS-D患者116例,按随机数表法分成对照组与观察组,各58例。对照组予马来酸曲美布汀胶囊治疗,观察组在对照组基础上予温肾健脾法治疗。2组连续治疗4周。比较症状、匹兹堡睡眠质量指数(PSQI)、生活质量评分、临床疗效、血清5-羟色胺(5-HT)、血管活性肠肽(VIP)、P物质(SP)、生长抑素(SS)水平。结果治疗后,2组腹痛、腹胀、腹泻频率以及PSQI评分均明显减少,中文版健康调查简表(SF-36)评分显著增加,且观察组以,上指标改善程度均明显优于对照组(P<0.01);观察组总有效率(96.55%,56/58)优于对照组(82.76%,48/58)(P<0.01);治疗后,2组血清5-HT、VIP、SS水平均明显下降,SP显著上升,观察组优于对照组(P<0.01)。结论在西医常规治疗基础上,温肾健脾法能进一步改善IBS-D患者的症状、睡眠障碍以及生活质量,提高治疗效果,改善脑-肠轴紊乱。Objective To investigate the effect of twarming kidney and strengthening spleen on the patients with the irritable bowel syndrome with diarrhea (IBS-D) combined with sleep disorders and its influence on the brain-gut axis.Methods A total of 116 patients with IBS-D were selected and randomly divided into a control group and an observation group,with 58 cases in each group.The control group was treated with trimebutine maleate capsules,while the observation group was treated with the Wenshen Jianpi Decoction on the basis of the control group,both for 4 weeks continuously.The scores of symptoms,Pittsburgh Sleep Quality Index (PSQI),quality of life,and the clinical efficacy,the serum levels of 5-hydroxytryptophan (5-HT),vasoactive intestinal peptide (VIP),substance P (SP),and somatostatin(SS) were compared between the two groups.Results After treatment,the scores of the abdominal pain,abdominal distension,diarrhea frequency and PSQI were significantly decreased in both groups,while the scores of the Chinese version of the Health Survey Short Form (SF-36) was significantly increased,and the improvement of the above indicators in the observation group was significantly better than that in the control group (P<0.01).The total effective rate of the observation group (96.55%,56/58) was better than that of the control group (82.76%,48/58) (P<0.01).After treatment,the serum levels of 5-HT,VIP and SS in both groups were significantly decreased,while the level of SP was increased significantly,and the observation group was better than the control group (P<0.01).Conclusion On the basis of a conventional Western medicine treatment,the Wenshen Jianpi Decoction can further improve the symptoms,sleep disorders and life quality of patients with IBS-D,improve the therapeutic effect,and improve the brain-gut axis disorder.

关 键 词：腹泻型肠易激综合征 温肾健脾法 睡眠障碍 脑-肠轴 

分 类 号：R256.3[医药卫生—中医内科学]