解郁安肠痛泻方联合匹维溴铵治疗腹泻型肠易激综合征肝郁脾虚证的疗效观察OA
The Efficacy of Jieyu Anchang Tongxie Formula Combined with Pinaverium Bromide in the Treatment of Liver-Depression and Spleen-Deficiency Syndrome of Irritable Bowel Syndrome with Predominant Diarrhea
目的:观察解郁安肠痛泻方联合匹维溴铵治疗腹泻型肠易激综合征(IBS-D)肝郁脾虚证的疗效及安全性.方法:选取2021 年8 月—2023 年9 月上海市第五人民医院,浦江社区卫生服务中心,吴泾社区卫生服务中心就诊的112 例IBS-D肝郁脾虚型患者,随机分为观察组与对照组,每组56 例,对照组接受匹维溴铵等常规性方案治疗4 周,观察组在对照组基础上予以解郁安肠痛泻方治疗,结束后安排8 周随访观察持续效应.对比两组临床疗效、治疗前后肠易激综合征症状严重程度问卷(IBS-SSS)、直肠敏感性[肛管静息压(ARP)、肛门括约肌最大收缩压(AMCP)、直肠静息压(RRP)、腹痛阈值、排便阈值]、血清血管活性肠肽(VIP)、神经递质[5-羟色胺(5-HT)、神经肽Y(NPY)、降钙素基因相关肽(CGRP)]、肠道菌群数量、生活质量[肠易激综合征患者生活质量(IBS-QOL)]与焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,记录不良反应.结果:观察组治疗有效率为92.86%(52/56)高于对照组的78.57%(44/56),差异有统计学意义(P<0.05);治疗结束后 4 周、治疗结束后 8 周观察组IBS-SSS评分均低于对照组(P<0.05);观察组治疗后ARP、腹痛阈值、排便阈值较对照组更高(P<0.05);治疗后观察组的血清VIP、5-HT、CGRP均较对照组更低(P<0.05),NPY及嗜酸乳杆菌、双歧杆菌数量较对照组更高(P<0.05);观察组的IBS-QOL评分、SAS评分、SDS 评分低于对照组(P<0.05);观察组与对照组的不良反应风险(7.14%vs 3.57%)比较,差异无统计学意义(P>0.05).结论:解郁安肠痛泻方与匹维溴铵联合对于IBS-D有较好疗效,可明显改善其症状,减少血清VIP、神经递质释放,维护肠黏膜屏障、直肠敏感性,调节肠道菌群及负性情绪,提高患者生活质量,安全性良好.
Objective:To observe the efficacy and safety of Jieyu Anchang Tongxie Formula combined with Pinaverium bromide in the treatment of liver-depression and spleen-deficiency syndrome of irritable bowel syndrome with predominant diarrheal(IBS-D).Methods:A total of 112 IBS-D patients with liver-depression and spleen-deficiency treated in Shanghai Fifth Peoples Hospital from August 2022 to September 2023 were chosen and randomly separated into the observation group(n=56,Jieyu Anchang Tongxie formula+Pinaverium bromide,4 weeks)and control group(n=56,Pinaverium bromide,4 weeks).8-week follow-up was arranged after the end to observe the sustained effect.The clinical efficacy,IBS symptom severity questionnaire(IBS-SSS),rectal sensitivity[anal canal resting pressure(ARP),anal maximum contraction pressure(AMCP),rectal resting pressure(RRP),abdominal pain threshold,defecation threshold],serum vasoactive intestinal peptide(VIP),neurotransmitter[5-serotonin(5-HT),Neuropeptide Y(NPY),calcitonin gene-related peptide(CGRP)],the number of intestinal flora,quality of life(IBS-QOL),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were compared between the two groups.The adverse reactions were recorded.Results:The observation group had higher effective rate(92.86%vs 78.57%)(P<0.05);IBS-SSS scores in the observation group were lower than those in the control group at 4 weeks and 8 weeks after treatment(P<0.05);After treatment,ARP,abdominal pain threshold and defecation threshold in the observation group were higher than those in the control group(P<0.05),while the levels of VIP,5-HT,and CGRP were lower,the levels of NPY were higher,and Lactobacillus acidophilus and bifidobacterium were also higher(P<0.05);The observation group had lower IBS-QOL scores,SAS scores and SDS scores(P<0.05).Th incidence of adverse reactions was similar in the two groups(7.14%and 3.57%,P>0.05).Conclusions:Jieyu Anchang Tongxie Formula combined with Pinaverium bromide has good efficacy in the treatment of IBS-D,which can significantly improve symptoms,reduce the release of serum VIP,neurotransmitter and inflammatory factors,maintain intestinal mucosal barrier and rectal sensitivity,regulate intestinal flora and negative emotions,and improve patients'quality of life with good safety.
陆云圻;周正;马玉斌;汪剑武;马赞颂
上海市第五人民医院中医科,上海 200240上海市第五人民医院中医科,上海 200240上海市第五人民医院中医科,上海 200240上海市第五人民医院中医科,上海 200240上海市第五人民医院中医科,上海 200240
医药卫生
解郁安肠痛泻方匹维溴铵腹泻型肠易激综合征肝郁脾虚证
Jieyu Anchang Tongxie FormulaPinaverium bromideIrritable bowel syndrome with predominant diarrheaLiver depression and spleen deficiency syndrome
《中医药学报》 2026 (3)
90-95,6
2020 年度综合医院中西医结合专项项目建设(ZHYY-ZXYJHZX-202005)
评论