九味镇心颗粒联合氟哌噻吨美利曲辛片及双歧杆菌四联活菌治疗腹泻型肠易激综合征的临床观察  

Clinical Observation on Jiuwei Zhenxin Granules Combined with Flupentixol-Melitracen Tablets and Bifidobacterium Tetrad in the Treatment of Irritable Bowel Syndrome

作　　者：郑香伟 杨以良 金洋 石保平 李红 汪静 李士坤 程天厚 ZHENG Xiang-wei;YANG Yi-liang;JIN Yang;SHI Bao-ping;LI Hong;WANG Jing;LI Shi-kun;CHENG Tian-hou(Department of Gastroenterology,Xinyang Central Hospital,Xinyang Henan 464000;Medical Department,Xinyang Central Hospital,Xinyang Henan 464000)

机构地区：[1]信阳市中心医院消化内科,河南信阳464000 [2]信阳市中心医院医务科,河南信阳464000

出　　处：《世界中西医结合杂志》2024年第4期719-724,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局中医药科技项目(GZY-KJS-2022-023)。

摘　　要：目的 探讨九味镇心颗粒联合氟哌噻吨美利曲辛片及双歧杆菌四联活菌治疗腹泻型肠易激综合征的临床观察。方法 选取2020年1月—2021年1月期间信阳市中心医院收治的100例腹泻型肠易激综合征患者,按随机数字表法分为对照组和研究组,每组各50例。对照组给予氟哌噻吨美利曲辛联合双歧杆菌四联活菌治疗,研究组在对照组治疗的基础上给予九味镇心颗粒治疗。观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分、直肠敏感性(肛管静息压、直肠感知阈值、腹痛阈值、排便阈值)、神经递质[神经递质5-羟色胺(5-Hydroxy Tryptamine,5-HT)、降钙素基因相关肽(Calcitonin gene related peptide.CGRP)、胃肠激素神经肽Y(Neuropeptide Y,NPY)]、二胺氧化酶、D-乳酸、内毒素水平。结果 治疗后研究组总有效率98.00%(49/50)明显高于对照组86.00%(43/50),差异有统计学意义(P<0.05)。治疗后两组患者中医证候大便溏稀、腹痛隐隐、多梦易醒、便次增多、少气懒言、心悸怔忡、神疲乏力、食少纳呆、腹胀、面色不华评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组中医证候大便溏稀、腹痛隐隐、多梦易醒、便次增多、少气懒言、心悸怔忡、神疲乏力、食少纳呆、腹胀、面色不华评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者肛管静息压、直肠感知阈值、腹痛阈值、排便阈值水平均较治疗前升高,差异有统计学意义(P<0.05);且研究组肛管静息压、直肠感知阈值、腹痛阈值、排便阈值均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者神经递质5-HT、CGRP、NPY水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组神经递质5-HT、CGRP、NPY水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者二胺氧化酶、D-乳酸、内毒素水平均较治疗前降低,Objective To investigate the clinical efficacy of Jiuwei Zhenxin Granules combined with flupentixol-melitracen tablets and Bifidobacterium Tetrad in treating irritable bowel syndrome(IBS).Methods One hundred IBS patients admitted to Xinyang Central Hospital from January 2020 to January 2021 were selected and divided into a control group(50 cases)and a study group(50 cases)using a random number table method.The control group was given flupentixol-melitracen tablets plus Bifidobacterium Tetrad,while the study group was treated with Jiuwei Zhenxin Granules on the basis of the control group.Clinical efficacy,adverse reactions,and TCM syndrome scores before and after treatment were compared between the two groups.Additionally,rectal sensitivity(anal resting pressure,rectal perceptual threshold,abdominal pain threshold,defecation threshold),neurotransmitters[5-hydroxytryptamine(5-HT),calcitonin gene-related peptide(CGRP),neuropeptide Y(NPY)],diamine oxidase,D-lactic acid,and endotoxin were measured and compared before and after treatment.Results The total effective rate of the study group(98.00%,49/50)was higher than the control group(86.00%,43/50)(P<0.05).After treatment,scores for symptoms such as loose stools,faint abdominal pain,frequent awakening,increased defecation frequency,dyspnea and reticence,palpitations,fatigue,reduced appetite,bloating,and pallor,along with indices of anal canal resting pressure,rectal perception threshold,abdominal pain threshold,defecation threshold,and levels of 5-HT,CGRP,NPY,diamine oxidase,D-lactic acid,and endotoxin all showed improvement(all P<0.05),with the study group exhibiting more improvement than the control group(P<0.05).The incidence of adverse reactions during treatment was lower in the study group(1.44%,2/50)than the control group(16.00%,8/50)(χ^(2)=4.001,P=0.041).Conclusion Jiuwei Zhenxin Granules combined with flupentixol-melitracen tablets and Bifidobacterium Tetrad can alleviate the clinical symptoms of IBS patients,reduce TCM syndrome scores,and restore neurotransmi

关 键 词：九味镇心颗粒 氟哌噻吨美利曲辛片 双歧杆菌四联活菌 腹泻型肠易激综合征 中医证候积分 直肠敏感性 肠道屏障功能 神经递质 

分 类 号：R574[医药卫生—消化系统]