柴胡桂枝干姜汤加减联合西药治疗功能性消化不良重叠肠易激综合征临床研究  

Clinical Study on Modified Chaihu Guizhi Ganjiang Decoction Combined with Western Medicine for Functional Dyspepsia Complicated with Irritable Bowel Syndrome

作　　者：康年松 谷红苹 倪约翰 韩旭丰 KANG Niansong;GU Hongping;NI Yuehan;HAN Xufeng

机构地区：[1]余姚市中医医院中医内科,浙江余姚315400 [2]余姚市中医医院内科,浙江余姚315400

出　　处：《新中医》2023年第9期59-63,共5页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2020ZA110)。

摘　　要：目的:观察柴胡桂枝干姜汤加减联合西药治疗功能性消化不良重叠肠易激综合征的临床疗效及对患者肠道菌群的影响。方法:采用随机数字表法将60例功能性消化不良重叠肠易激综合征患者分为对照组与观察组各30例。对照组给予常规西药治疗,观察组在对照组基础上联用柴胡桂枝干姜汤加减治疗。比较2组中医证候评分、生活质量综合评定量表(GQOLI-74)、血清胃肠激素及肠道菌群水平,并评估2组临床疗效及不良反应发生情况。结果:治疗后,观察组总有效率显著高于对照组(P<0.05)。治疗后,2组餐后饱胀不适、早饱感、上腹痛、上腹烧灼感中医证候评分较治疗前降低(P<0.05),CQOLI-74评分升高(P<0.05),且观察组治疗后中医证候评分低于对照组(P<0.05),CQOLI-74评分高于对照组(P<0.05)。治疗后,2组血清胃动素(MTL)、胆囊收缩素(CCK)水平较治疗前降低(P<0.05),降钙素基因相关肽(CGRP)水平升高(P<0.05);观察组治疗后血清MTL、CCK水平低于对照组(P<0.05),CGRP水平高于对照组(P<0.05)。治疗后,2组双歧杆菌、乳酸杆菌水平较治疗前升高(P<0.05),肠杆菌、肠球菌水平降低(P<0.05),且观察组治疗后肠杆菌、肠球菌水平低于对照组(P<0.05),双歧杆菌、乳酸杆菌水平高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:柴胡桂枝干姜汤加减联合西药治疗功能性消化不良重叠肠易激综合征疗效确切,能够有效改善患者胃肠功能,调节肠道菌群平衡,提高患者生活质量。Objective:To observe the clinical effect of modified Chaihu Guizhi Ganjiang Decoction combined with western medicine for functional dyspepsia complicated with irritable bowel syndrome(IBS)and its effect on intestinal flora in patients.Methods:A total of 60 cases of patients with functional dyspepsia complicated with IBS were divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with modified Chaihu Guizhi Ganjiang Decoction based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores,Generic Quality Of Life Inventory-74(GQOLI-74)scores and levels of gastrointestinal hormones and intestinal flora in serum were compared between the two groups.The clinical effects and the incidence of adverse reactions were evaluated in the two groups.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,TCM syndrome scores including discomfort due to postprandial fullness,early satiety,and pain and burning sensation in the upper abdomen in the two groups were decreased when compared with those before treatment(P<0.05),and GQOLI-74 scores were increased(P<0.05);TCM syndrome scores in the observation group were lower than those in the control group(P<0.05),and GQOLI-74 score was higher than that in the control group(P<0.05).After treatment,the levels of motilin(MTL)and cholecystokinin(CCK)in serum in the two groups were decreased when compared with those before treatment(P<0.05),and calcitonin gene-related peptide(CGRP)levels were increased(P<0.05);the levels of MTL and CCK in the observation group were lower than those in the control group(P<0.05),and CGRP level was higher than that in the control group(P<0.05).After treatment,the levels of bifidobacterium and lactobacillus in the two groups were increased when compared with those

关 键 词：功能性消化不良 肠易激综合征 柴胡桂枝干姜汤 胃肠激素 肠道菌群 

分 类 号：R574.4[医药卫生—消化系统]