肠宁方治疗腹泻型肠易激综合征临床观察

目的观察肠宁方治疗腹泻型肠易激综合征的效果。方法将2008年7月～2012年12月桂林市中医医院腹泻型肠易激综合征患者75例随机分成治疗组38例和对照组37例。治疗组采用肠宁方治疗,对照组采用匹维溴铵治疗。观察治疗前后临床症状、中医症候积分及血清中5-羟色胺（5-HT）、胃动素（MOT）水平。结果治疗组临床痊愈率和总有效率（47.4%、92.1%）均优于对照组（24.3%、81.1%）,两组比较差异有统计学意义（P〈0.05）。治疗组中医症候积分平均为（8.52±3.43）分,而对照组为（13.01±2.50）分,两组比较差异有高度统计学意义（P〈0.01）;在各中医症型疗效比较中,治疗组中脾虚湿阻证型、肝郁脾虚证型总疗效均为100.0%,优于对照组（77.8%、90.0%）,两组比较差异有统计学意义（P〈0.01或P〈0.05）,两组中脾肾阳虚证型、脾胃湿热证型比较差异无统计学意义（P〉0.05）;治疗组中5-HT、MOT血浆中表达水平分别为（433.4±72.6）ng/L、（240.1±11.8）ng/L,均低于对照组[（433.4±72.6）ng/L、（314.1±60.7）ng/L],两组比较差异有高度统计学意义（P〈0.01）。结论肠宁方可明显改善腹泻型肠易激综合征患者临床症状,其作用机制可能与调节5-HT、MOT水平有关。

Effect of Changningfang in treating diarrhea-predominant irritable bowel syndrome

Objective To observe the clinical effect of Changningfang in treating diarrhea-predominant irritable bowel syndrome（D-IBS）.Methods 75 patients with D-IBS treated with Changningfang from July 2008 to December 2012 in Guilin TCM Hospital were reviewed.Patients were randomized divided into 38 cases of treatment group and 37 cases of control group.The patients in treatment group were treated with Changningfang,the patients in control group were treated with Pinaverium.Before treatment and after treatment for 3 weeks,the clinical symptoms,symptom scores and the level of 5-hydroxytryptamine serotonin（5-HT）,motilin（MOT） in serum were compared.Results The total efficiency and cure rate of syndrome of treatment group（47.4%,92.1%） were better than those of the control group（24.3%,81.1%）,there were significant differences between the two groups（P 0.05）;the symptom scores of treatment group [（8.52±3.43） points] were better than that of the control group [（13.01±2.50） points],there were significant differences between two groups（P 0.01）.The effect of the spleen dampness syndrome type and the stagnation and spleen deficien cy syndrome type in the treatment group（both 100.0%） were better than the control group（77.8%,90.0%）,there were significant differences between two groups（P 0.01 or P 0.05）;the level of 5-HT,MOT in the treatment group were（433.4±72.6） ng/L,（240.1±11.8） ng/L,which were less than those of control group [（433.4±72.6） ng/L,（314.1±60.7） ng/L],there were significant differences between the two groups（P 0.01）.Conclusion Changningfang can significantly improve the D-IBS patients with clinical symptoms,its mechanism of action may be related to the regulation of 5-HT,MOT level.