四磨汤联合枸橼酸莫沙必利治疗便秘型肠易激综合征患者疗效及对微生物菌群和血清5-羟色胺、P物质、血管活性肠肽水平的影响  

Efficacy of Simo decoction combined with mosapride citrate in treating patients with constipation-predominant irritable bowel syndrome and influence on microbial flora and serum 5-hydroxytryptamine,substance P and vasoactive intestinal peptide levels

作　　者：冀花 张彦芬 JI Hua;ZHANG Yanfen(Department of Integrated Traditional Chinese and Western Medicine,Shangluo Central Hospital,Shangluo,Shaanxi 726000,China)

机构地区：[1]陕西省商洛市中心医院中西医结合科,陕西商洛726000

出　　处：《检验医学与临床》2024年第24期3657-3662,共6页Laboratory Medicine and Clinic

基　　金：陕西省中医药管理局课题计划项目(SZY-KJCYC-2023-100)。

摘　　要：目的分析四磨汤联合枸橼酸莫沙必利治疗便秘型肠易激综合征(IBS-C型)患者疗效及对微生物菌群和血清5-羟色胺(5-HT)、P物质(SP)、血管活性肠肽(VIP)水平的影响。方法回顾性分析该院中西医结合科2021年6月至2023年4月收治的肝郁气滞证IBS-C型患者的临床资料,选取单独采用枸橼酸莫沙必利治疗的60例肝郁气滞证IBS-C型患者纳入对照组,选取四磨汤联合枸橼酸莫沙必利治疗的60例肝郁气滞证IBS-C型患者纳入观察组。比较治疗1个月后两组的临床疗效及治疗期间不良反应发生情况;比较治疗前及治疗1个月后两组的中医证候积分、症状改善情况[肠易激综合征症状严重程度量表(IBS-SSS)]、肠道微生物菌群(双歧杆菌、乳酸杆菌、大肠埃希菌)水平、血清指标(5-HT、SP、VIP)水平、胃肠功能指标(胃泌素、胃动素、全胃肠排出率、胃排空率)。结果治疗1个月后,观察组与对照组总有效率分别为90.00%、70.00%,观察组明显高于对照组,差异有统计学意义(P<0.05)。治疗1个月后,观察组中医证候积分,IBS-SSS评分,血清5-HT、SP、VIP水平,胃泌素、胃动素水平均明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组双歧杆菌、乳酸杆菌水平及全胃肠排出率、胃排空率均明显升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗1个月内,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在IBS-C型患者中,四磨汤联合枸橼酸莫沙必利能帮助改善患者便秘症状,维持肠道菌群平衡,改善其血清指标与胃肠功能,且具有较高的安全性,值得临床推广使用。Objective To explore the efficacy of Simo decoction combined with mosapride citrate in the treatment of patients with constipation-predominant irritable bowel syndrome(IBS-C)and its influence on microbial flora and levels of serum 5-hydroxytryptamine(5-HT),substance P(SP)and vasoactive intestinal peptide(VIP).Methods A retrospective analysis was conducted on the clinical data of IBS-C patients with liver depression and qi stagnation syndrome admitted to the Department of Integrated Traditional Chinese and Western Medicine of Shangluo Central Hospital from June 2021 to April 2023,60 patients with liver depression and qi stagnation syndrome IBS-C treated with mosapride citrate alone were selected as the control group,and 60 patients with liver depression and qi stagnation syndrome IBS-C treated with Simo decoction combined with mosapride citrate were selected as the observation group.The clinical efficacy and incidence of adverse reactions between the two groups after one month of treatment was compared,the traditional Chinese medicine syndrome scores,symptom improvement status[IBS Symptom Severity Scale(IBS-SSS)],gut microbiota(Bifidobacterium,Lactobacillus,Escherichia coli)levels,serum indicators(5-HT,SP,VIP)levels and gastrointestinal function indicators(gastrin,motilin,total gastrointestinal excretion rate,gastric emptying rate)between the two groups before and after one month of treatment were compared.Results After one month of treatment,the total effective rates of the observation group and the control group were 90.00%and 70.00%respectively,which in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After one month of treatment,the medical syndrome score,IBS-SSS score,serum 5-HT,SP,VIP level,gastrin and motilin levels in the observation group reduced significantly,and which in the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The levels of Bifido

关 键 词：便秘型肠易激综合征 枸橼酸莫沙必利 四磨汤 临床疗效 微生物菌群 5-羟色胺 P物质 

分 类 号：R256.35[医药卫生—中医内科学] R574.4[医药卫生—中医学]