维生素D联合匹维溴铵治疗腹泻型肠易激综合征患者疗效及对肠道屏障功能指标的影响研究  

Study on the therapeutic effect of vitamin D combined with povidone bromide tablets on diarrhea type patients with irritable bowel syndrome and its impact on intestinal barrier function indicators

作　　者：韩俊岭[1] 王刚[1] 马厉英 连颖 徐慧[2] Han Junling;Wang Gang;Ma Liying;Lian Ying;Xu Hui(Department of Gastroenterology,Qinhuangdao First Hospital,Qinhuangdao 066000,China;Department of Ophthalmology,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院消化科,河北省066000 [2]秦皇岛市第一医院眼科,河北省066000

出　　处：《中华消化病与影像杂志（电子版）》2024年第6期560-564,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：秦皇岛市重点研发计划科技支撑项目(202101A097)。

摘　　要：目的探讨维生素D联合匹维溴铵治疗腹泻型肠易激综合征(IBS-D)疗效及对肠道屏障功能指标的影响。方法选取2022年1月至2024年1月在秦皇岛市第一医院接受治疗的108例IBS-D患者,根据入院时间先后顺序随机分为两组,其中对照组54例接受匹维溴铵治疗,观察组54例接受维生素D联合匹维溴铵治疗,均治疗4周。比较两组临床疗效、肠道菌群、肠道屏障功能指标、25羟基维生素D水平及IBS临床症状严重评分系统(IBS-SSS)评分。结果观察组临床总有效率94.44%高于对照组临床总有效率79.63%(χ^(2)=5.441,P<0.05)。治疗2周、4周后,观察组乳酸杆菌、双歧杆菌数量高于对照组,肠杆菌数量低于对照组(t=2.164、2.843、3.016、2.850、3.117、2963,P<0.05);观察组血清25羟基维生素D高于对照组,血清二胺氧化酶、D-乳酸、肠脂肪酸结合蛋白水平均低于对照组(t=3.152、4.274、3.975、4.628、3.728、3.415、4.416、3.521,P<0.05);观察组IBS-SSS各维度评分均低于对照组(t=5.729、5.823、4.962、4.683、5.382、5143、4.670、4.527、5.106、5.317,P<0.05)。结论维生素D联合匹维溴铵治疗IBS-D可有效缓解临床症状、调节肠道微生态、修复肠道屏障功能,从而提高疗效。Objective To explore the therapeutic effect of vitamin D combined with povidone bromide tablets in the treatment of diarrhea predominant irritable bowel syndrome(IBS-D)and its impact on intestinal barrier function indicators.Methods A total of 108 patients with IBS-D who received treatment at Qinhuangdao First Hospital from January 2022 to January 2024 were selected and randomly divided into two groups based on the order of admission.Among them,54 patients in the control group received treatment with povidone bromide tablets,while 54 patients in the observation group received treatment with vitamin D combined with povidone bromide tablets,both of which were treated for 4 weeks.The clinical efficacy,gut microbiota,gut barrier function indicators,25 hydroxyvitamin D[25-(OH)]levels,and IBS Clinical Symptom Severity Scale(IBS-SSS)scores were compared between the two groups.Results The total clinical effective rate of the observation group was 94.44%,which was higher than that of the control group(79.63%,χ^(2)=5.441,P<0.05).After 2 and 4 weeks of treatment,the numbers of Lactobacilli and Bifidobacteria in the observation group were higher than those in the control group,and the number of Enterobacilli was lower than that in the control group(t=2.164,2.843,3.016,2.850,3.117,2963,P<0.05).The serum 25 hydroxyvitamin D[25-(OH)]in the observation group was higher than that in the control group,and the serum diamine oxidase(DAO),D-lactate,and intestinal fatty acid binding protein(IFBP)were lower than those in the control group(t=3.152,4.274,3.975,4.628,3.728,3.415,4.416,3.521,P<0.05).The IBS-SSS scores in all dimensions in the observation group were lower than those in the control group(t=5.729,5.823,4.962,4.683,5.382,5143,4.670,4.527,5.106,5.317,P<0.05).Conclusion The combination of vitamin D and povidone bromide tablets can effectively alleviate the clinical symptoms of IBS-D,regulate intestinal microbiota,repair intestinal barrier function,and thus improve the therapeutic effect.

关 键 词：腹泻型肠易激综合征 维生素D 匹维溴铵 肠道屏障功能 临床疗效 

分 类 号：R574.4[医药卫生—消化系统]