补中益气汤治疗便秘型肠易激综合征  

Effect of Buzhong Yiqi decoction in the treatment of irritable bowel syndrome with constipation

作　　者：李宇栋[1] 张书信[2] 许云霞 吴承东[1] 刘建乔 芦煜 李雪[1] 周仲伍 LI Yudong;ZHANG Shuxin;XU Yunxia;WU Chengdong;LIU Jianqiao;LU Yu;LI Xue;ZHOU Zhongwu(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京中医药大学东直门医院,北京100700

出　　处：《吉林中医药》2024年第6期687-691,共5页Jilin Journal of Chinese Medicine

基　　金：中华中医药学会青年人才托举工程项目(CACM-2022-QNRC2-A03);北京市医院管理中心创新梦工场经费资。

摘　　要：目的探索补中益气汤治疗便秘型肠易激综合征的效果。方法选取首都医科大学附属北京中医医院2021年1月-2023年9月收治的110例进行常规治疗的便秘型肠易激综合征患者采用随机数字表法分为联合双歧杆菌四联活菌片治疗的对照组和联合双歧杆菌四联活菌片、补中益气汤治疗的观察组,各55例,2组均治疗4周。比较2组临床疗效、中医证候积分、TLR4/MyD88/NF-κB信号通路指标、血清细胞因子水平、便秘症状、生活质量及心理状态、不良反应。结果治疗4周后,观察组总有效率高于对照组(P<0.05)。2组治疗4周后大便干结、腹痛、排便困难、神倦乏力、CCS、SAS、SDS评分及血清TLR4、MyD88、NF-κB p65、NPY、SP、5-HT、VIP、SS水平与治疗前比较,降低,观察组低于对照组(P<0.05);IBS-QOL评分与治疗前比较,升高,观察组高于对照组(P<0.05)。观察组与对照组治疗期间总不良反应发生率差异无统计学意义(P>0.05)。结论补中益气汤治疗便秘型肠易激综合征患者,可有效改善其中医证候,调节TLR4/MyD88/NF-κB信号通路指标及相关细胞因子表达水平,改善其便秘症状及心理状态,提高患者生活质量,具有较好的治疗效果,且不会增加不良反应的发生。Objective To explore the effect of Buzhong Yiqi decoction in the treatment of irritable bowel syndrome with constipation,Methods From January 2021 to September 2023 in Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University,110 patients with constipation-predominant irritable bowel syndrome were divided into two groups by the random number table method:the probiotic group treated with bifidobacterium quadruple live bacteria tablets and the decoction group treated with bifidobacterium quadruple live bacteria tablets and Buzhong Yiqi decoction,with 55 cases in each group,and both groups were treated for 4 weeks.The clinical efficacy,TCM syndrome scores,TLR4/MyD88/NF-kB signaling pathway indexes,serum cytokine levels,constipation symptoms,quality of life and psychological state,and adverse reactions were compared between the two groups.Results After 4 weeks of treatment,the total effective rate of the decoction group was higher than that of the probiotic group(P<0.05).After 4 weeks of treatment,the scores of dry stool,abdominal pain,dificulty in defecation,fatigue,CCS,SAS and SDS,and the levels of serum TLR4,MyD88,NF-kB p65,NPY,SP,5-HT VIP and SS were decreased in the two groups,and the decoction group was lower than the probiotic group(P<0.05).Compared with before treatment,the score of IBS-QOL was increased,and the decoction group was higher than the probiotic group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups during treatment(P>0.05).Conclusion Buzhong Yiqi decoction can effectively improve the TCM syndromes of the patients with constipation-predominant irritable bowel syndrome,regulate the indicators of TLR4/MyD88/NF-kB signaling pathway and the expression levels of related cytokines,improve their constipation symptoms and psychological state,and improve their quality of life,which has a good therapeutic effect and will not increase the occurrence of adverse reactions.

关 键 词：肠易激综合征 便秘型 补中益气汤 双歧杆菌四联活菌 TLR4/MyD88/NF-κB信号通路 

分 类 号：R256[医药卫生—中医内科学]