四神丸合附子理中汤加减治疗腹泻型肠易激综合征的疗效及对肠道菌群的影响  

TCurative effect of modified Sishen Pills plus Fuzi Lizhong Decoction for diarrhea-predominant irritable bowel syndrome and its influence on intestinal flora

作　　者：胡朋 符燕[1] 王锋 HU Peng;FU Yan;WANG Feng(Department of Traditional Chinese Medicine,Haikou People's Hospital,Haikou,Hainan 570208;Department of Emergency,Hubei Provincial Hospital of TCM,Wuhan,Hubei 430061)

机构地区：[1]海南省海口市人民医院中医科,海南海口570208 [2]湖北省中医院急诊科,湖北武汉430061

出　　处：《河北中医》2023年第9期1472-1475,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：海南省卫生健康行业科研项目(编号:20A200516)。

摘　　要：目的 观察四神丸合附子理中汤加减治疗腹泻型肠易激综合征(IBS-D)的疗效及对肠道菌群的影响。方法 将120例IBS-D患者按照随机数字表法分为2组,治疗组60例在凝结芽孢杆菌活菌片联合精灸治疗基础上应用四神丸合附子理中汤加减治疗,对照组60例予凝结芽孢杆菌活菌片联合精灸治疗。2组均治疗4周。比较2组疗效;比较2组治疗前后症状评分变化;比较2组治疗前后肠道菌群变化;比较2组治疗前后血清酪酪肽(PYY)、胃动素(MTL)、肿瘤坏死因子α(TNF-α)、网络紧密连接蛋白1 (claudin-1)水平变化。结果 治疗组总有效率93.33%(56/60),对照组总有效率68.33%(41/60),治疗组疗效优于对照组(P<0.05)。2组治疗后症状评分均较本组治疗前降低(P<0.05);治疗后治疗组症状评分均低于对照组(P<0.05)。2组治疗后双歧杆菌、乳酸杆菌均较本组治疗前升高(P<0.05),大肠杆菌、肠球菌较本组治疗前降低(P<0.05);治疗后治疗组双歧杆菌、乳酸杆菌均高于对照组(P<0.05),大肠杆菌、肠球菌均低于对照组(P<0.05)。2组治疗后血清PYY、MTL水平均较本组治疗前降低(P<0.05);治疗后治疗组血清PYY、MTL水平均低于对照组(P<0.05)。2组治疗后血清TNF-α水平均较本组治疗前降低(P<0.05),claudin-1水平较本组治疗前升高(P<0.05);治疗后治疗组血清TNF-α水平低于对照组(P<0.05),claudin-1水平高于对照组(P<0.05)。结论 在凝结芽孢杆菌活菌片联合精灸治疗基础上应用四神丸合附子理中汤加减治疗IBS-D,能减轻患者临床症状,改善患者肠内菌群,提高临床疗效。Objective To observe the curative effect of modified Sishen Pills plus Fuzi Lizhong Decoction for diarrhea-predominant irritable bowel syndrome(IBS-D)and its influence on intestinal flora.Methods A total of 120 IBS-D patients were randomly assigned into the treatment group(n=60)and the control group(n=60).All patients were managed by bacillus coagulans tablets combined withrefined moxibustion,and those in the treatment group were additionally treated with modified Sishen Pills plus Fuzi Lizhong Decoction.Treated for 4 weeks,the aim was to compare traditional Chinese medicine(TCM)symptom score,intestinal flora,peptide tyrosine tyrosine(PYY),motilin(MTL),tumor necrosis factor-α(TNF-α),tight junction proteins(claudin-1).The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(93.33%[56/60]vs 68.33%[41/60],[P<0.05],respectively).After treatment,TCM symptom scores in groups were decreased(P<0.05),which decreased in the treatment group compared with the control group(P<0.05).Increased bifidobacterium dentium and lactobacillus,and decreased escherichia coli and enterococcus were detected in the two groups(all P<0.05),and the different was significant between groups for the above indexes(all P<0.05).After treatment,PYY and MTL in groups were significantly lower(P<0.05),which were significantly lower inthe treatment group than in the control group(P<0.05).Reduced TNF-αand elevated claudin-1 were found in the two groups than those before treatment(all P<0.05),and the treatment group was superior to the control group for TNF-αand claudin-1(all P<0.05).Conclusion For IBS-D patients,modified Sishen Pills plus Fuzi Lizhong Decoction based on bacillus coagulans tablets combined with refined moxibustion can relieve clinical symptoms,improve intestinal flora,clinical efficacy.

关 键 词：腹泻 中药疗法 结肠疾病 功能性 

分 类 号：R442.2[医药卫生—诊断学] R289.6[医药卫生—临床医学]