加味痛泻要方对腹泻型肠易激综合征患者胃肠激素的影响

目的观察加味痛泻要方治疗腹泻型肠易激综合征(IBS)的疗效及其对患者血浆胃肠激素的影响。方法85例符合罗马Ⅱ诊断标准的腹泻型IBS患者(中医分型为肝郁脾虚)随机分成中药组(n=45,予以加味痛泻要方随证加减,每日1剂)和西药组(n=40,得舒特50mg,3次/d),疗程2个月。观察各组患者临床症状及血浆中胃肠激素(生长抑素(SS)、血管活性肠肽(VIP)、胆囊收缩素(CCK))的变化情况。结果中药组的总有效率为89%,优于西药组的70%,中药在改善患者的大便次数及便意窘迫上优于得舒特(P均<0.05),而得舒特对缓解腹痛、肠鸣方面要优于中药(P均<0.05)。治疗前2组患者血浆中SS、VIP、CCK都较正常人明显升高,有显著性差异(P均<0.05),经治疗后2组患者血浆中3种胃肠激素的含量均有不同程度的下降,而中药组似乎下降得更明显,尤其是SS(P<0.05)。结论加味痛泻要方能有效地改善腹泻型肠易激综合征患者的临床症状,可能是通过调整紊乱的胃肠激素分泌、释放来达到治疗目的。

Effect of Additional Tongxie Yaofang decoction on gastrointestinal hormone in patients with diarrhea- predominant IBS

Objective It is to study the therapeutic effect and the influence on gastrointestinal hormone of additional Tongxie Yaofang decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS).Methods 85 patients with diarrhea-predominant IBS whose diagnosis conformed to the RomeⅡdiagnostic standard(TCM Syndrome typing was Liver-Stagnancy with Spleen Deficiency),were divided into herb group(n=45,additional Tongxie Yaofang decoction peros,once a day) and western medicine group(n=40,Dicetel 50 mg peros,thrice a day) randomly.The course of treatment was 2 months.The changes of clinical symptom and plasma contents of gastrointestinal hormone(somatostatin(SS),vasoactive intestinal peptide(VIP),cholecystokinin(CCK)) were evaluated.Results The total efficacy rate of herb group was 89%,obviously higher than western medicine group's 70%.Additional Tongxie Yaofang decoction was more effective in improving sedes frequency and embarrassed awareness of defecation,while Dicetel was better at relieve abdominal pain and rugitus than the other(P<0.05). Plasma contents of SS,VIP,CCK in each group were significantly higher than that in normal group before treatment(P<0.05),and all decreased in different degree after treatment.Herb group's seemed more notably,especially in SS(P<0.05).Conclusion Additional Tongxie Yaofang decoction has satisfactory therapeutic effects on diarrhea-predominant IBS,by means of adjusting the disordered secretion,release of gastrointestinal hormone probably.