半夏泻心汤加减治疗肠易激综合征患者腹痛的疗效及对血清5-HT、VIP、SP水平的影响  

Modified Banxia Xiexin Tang(Decoction)in the Treatment of Irritable Bowel Syndrome:The Efficacy of Decoction on Patients’ Abdominal Pain,as well as the Influence of Decoction on the Levels of Serum 5-HT,VIP and SP

作　　者：杜光信 冯群虎[1] 胡建文[1] 梁小霞[1] DU Guang-rin;FENG Qun-hu;HU Jian-wen;LIANG Xiao-ria(Dept.of Coloproctology,the TCMHospital of Baoan District,Shenzhen,Guangdong 518101)

机构地区：[1]深圳市宝安区中医院肛肠科,广东深圳518101

出　　处：《中国肛肠病杂志》2022年第8期44-47,共4页Chinese Journal of Coloproctology

基　　金：深圳市宝安区科技计划基础研究资助项目(2020JD552)。

摘　　要：目的:通过观察半夏泻心汤加减治疗肠易激综合征(IBS)患者腹痛的疗效,分析治疗前后血清5-羟色胺(5-HT)、血管活性肠肽(VIP)、P物质(SP)水平的变化,初步探讨其作用机制。方法:选取2020年10月至2021年10月于我院就诊且符合IBS诊断标准的80例患者,按随机数字表法分为观察组和对照组,每组40例,观察组予半夏泻心汤加减方口服治疗,对照组予马来酸曲美布汀片及双歧杆菌乳杆菌三联活菌片口服治疗,2组均治疗10d。比较2组患者治疗前后腹痛缓解情况及血清5-HT、VIP、SP水平的变化。结果:2组患者治疗第1、3、5、7、9天血清5-HT、VIP、SP水平及腹痛评分均逐渐下降。治疗后不同时间点组间比较:治疗第1、3天,2组患者血清5-HT、VIP、SP水平及腹痛评分比较差异无统计学意义(P>0.05);治疗第5、7天,观察组患者血清5-HT、SP水平及腹痛评分明显低于对照组(P <0.05),而血清VIP水平2组间无明显差异(P>0.05);治疗第9天,观察组患者血清5-HT、VIP、SP水平及腹痛评分均明显低于对照组(P <0.05)。结论:半夏泻心汤加减治疗IBS腹痛疗效确切,其治疗机制可能是通过干预肠道神经递质分泌、传导及改善内脏高敏性等实现的。Objective To observe the efficacy of Decoction(a TCM formula) on irritable bowel syndrome(IBS) patients’ abdominal pain,further to analyse the change of levels of serum 5-hydroxy tryptamine(5-HT),vasoactive intestinal peptide(VIP) and substance P(SP) before and after treatment,and to explore its action mechanism.Methods Randomly divded 80 IBS patients confirmed and treated in authors’ hospital(2020-10—2021-10) into observation group(40 cases,orally administered Decoction) and control group [40 cases,orally trimebutine maleate tablets and bifidobacterium triplet tablets(live)],both groups’ treatment course were all 10 days;then,compared the status on abdominal pain relieved,and the change of levels of serum 5-HT,VIP and SP between the two groups.Results On the 1 st,3 rd,5 th,7 th,and 9 th day of treatment both groups’ patients’ serum 5-HT,VIP,and SP levels,as well as the ratings on abdominal pain were gradually decreased;but between the two groups at different time-points:on the 1 st,3 rd day of treatment above levels’ change and ratings had all no statistical difference(P>0.05);on the 5 th,7 th day in observation group above levels’ change on 5-HT and ratings SP were significantly lower than in control group(P<0.05),except for the ratings on VIP had no statistical difference(P>0.05);on the 9 th day,in observation group above level’s change(of 5-HT,VIP and SP) and ratings were significantly lower than that in control group(P<0.05).Conclusion The Decoction in the treatment of abdominal pain of IBS patients has certain effect,its mechanism could be intervening intestinal canals’ neurotransmitter secretion,conduction,and improving high-sensitivity of organs.

关 键 词：肠易激综合征 腹痛 半夏泻心汤 5-羟色胺 血管活性肠肽 P物质 

分 类 号：R259[医药卫生—中西医结合]