理肠饮对腹泻型肠易激综合征患者肠道菌群及生活质量的影响  

Effects of Lichang Decoction(理肠饮)on Intestinal Flora and Quality of Life in Patients with Diarrhea Predominant Irritable Bowel Syndrome

作　　者：尹德菲 魏秀楠 刘佳卉[2] 程艳[1] 迟莉丽[1] IN Defei;WEI Xiunan;LIU Jiahui;CHENG Yan;CHI Lili(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东中医药大学,山东济南250355

出　　处：《山东中医杂志》2022年第9期946-953,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(编号:2019-1058);国家重点研发计划项目(编号:2019YFC1712103)。

摘　　要：目的:观察理肠饮对腹泻型肠易激综合征(IBS-D)肝郁脾虚证患者肠道菌群及生活质量的影响,为该病的治疗及预后改善提供参考。方法:选取2020年9月至2021年10月就诊于山东中医药大学附属医院的61例肝郁脾虚证IBS-D患者作为研究对象,随机分为中药组41例和西药组20例,中药组予理肠饮,西药组予双歧杆菌三联活菌胶囊联合匹维溴铵片,连续治疗4周,分别检测治疗前后的肠道菌群,在不同观察时点(治疗前,治疗第2周、第4周、第8周、第12周)评价IBS生活质量量表(IBS-QOL),并评价其安全性。结果:①两组患者经过治疗,肠道菌群特征性扩增子序列变异(ASV)均较治疗前减少;拟杆菌门相对丰度增加(P<0.05),厚壁菌门相对丰度减少(P<0.05),厚壁菌门/拟杆菌门(F/B)值显著下调,其他含量较低的菌属总的相对丰度显著减少(P<0.05)。②两组患者IBS-QOL总积分均较治疗前显著升高(P<0.01),随访期均有所回落,但较治疗前仍有改善;中药组在治疗后各观察时点IBS-QOL总积分均不同程度优于西药组(P<0.05,P<0.01),随着干预时间延长,优势更加显著;中药组在心境恶劣、健康担忧、进食逃避、行为障碍改善方面均不同程度优于西药组(P<0.01,P<0.05),在自体意向、社会功能、关系扩展改善方面两组疗效相当(P>0.05)。结论:理肠饮可正向调节IBS-D患者肠道菌群结构,改善菌群紊乱状态,并能改善IBS-D患者焦虑抑郁情绪、提高其生活质量,具有一定的远期疗效。Objective:To observe the effect of Lichang Decoction(LCD,理肠饮)on intestinal flora and quality of life in patients with diarrhea predominant irritable bowel syndrome(IBS-D)of liver depression and spleen deficiency syndrome,so as to provide references for the treatment and prognosis improvement of this disease.Methods:A total of 61 patients with IBS-D of liver depression and spleen deficiency syndrome from The Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September 2020 to October 2021 were included for this study and randomly divided into LCD group(41 cases)and western medicine group(20 cases).The LCD group was given LCD,and the western medicine group was given live combined bifidobacterium,lactobacillus and enterococcus capsules combined with pinaverium bromide tablets.The treatment lasted for 4 weeks.The intestinal flora was detected before and after treatment,and the IBS quality of life scale(IBS-QOL)was evaluated at different time points(before treatment,the 2nd,4th,8th,and 12th week of the treatment),and its safety was also evaluated.Results:①After the treatment,the characteristic amplicon sequence variants(ASVs)of intestinal flora decreased in both groups compared with those before the treatment,and the relative abundance of Bacteroidota increased(P<0.05),the relative abundance of Firmicutes decreased(P<0.05),the ratio of Firmicutes/Bacteroidetes(F/B)was significantly down-regulated,and the total relative abundance of other genera with lower content was significant decreased compared with before the treatment(P<0.05).②In both groups the total IBS-QOL score after the treatment was significantly increased compared with those before the treatment(P<0.01),and decreased in follow-up period,but still improved compared with before the treatment.The IBS-QOL total score of LCD group was better than the western medicine group at different time points after the treatment(P<0.05,P<0.01),and the difference was more significant with the extension of intervention time.LCD group wa

关 键 词：腹泻型肠易激综合征 理肠饮 肠道菌群 菌-脑-肠轴 生活质量 焦虑抑郁 

分 类 号：R256.34[医药卫生—中医内科学]