中药与匹维溴铵治疗腹泻型肠易激综合征的随机对照研究

目的探讨中药与匹维溴铵治疗腹泻型肠易激综合征（IBS）的临床疗效。方法将200例腹泻型IBS患者随机分为中药组和匹维溴铵组，每组各100例。中药组：IBS患者专用颗粒冲剂，1包／次，tid，3餐前30min温开水冲服，连服4周；匹维溴铵组：匹维溴铵50mg／次，tid，3餐前30min服用，连服4周。2组患者均进行治疗前后症状积分比较，分析有否统计学差异。结果中药组：症状严重程度指数、症状频率指数及总的症状严重程度指数，停药后3d及停药后4周分别与治疗前相比差异均有统计学意义（P均〈0．01）；匹维溴铵组：症状严重程度指数、症状频率指数及总的症状严重程度指数，停药后3d与治疗前相比差异均有统计学意义（P均〈0．01），但停药后4周与治疗前相比差异均无统计学意义（P均〉0．05）。中药组停药后4周的完全缓解率和总有效率均高于匹维溴铵组（81％、99％vs9％、27％）（P〈0．01）。结论匹维溴铵是控制腹泻型IBS患者症状发作的即时有效药物，但无远期巩固疗效；中药治疗腹泻型IBS具有满意而较持久的疗效。

Effects of Traditional Chinese Medicine and Pinaverium Bromide in the Treatment of Diarrhea-predominant Irritable Bowel Syndrome:A Randomized Controlled Trial

Objective To investigate the effects of traditional Chinese medicine and pinaverium bromide in the treatment of diarrhea-predominant irritable bowel syndrome（IBS）. Methods Two hundred patients with IBS were randomly divided into two groups（traditional Chinese medicine group and pinaverium bromide group）. There were one hundred patients in each group. Traditional Chinese medicine group treated with traditional Chineses medicine for IBS, a packet, tid, 30 minutes before meals. Pinaverium bromide group treated with pinaverium bromide 50 mg, tid, 30 minutes before meals. Two groups were treated for four weeks. Scores of symptoms were performed in each group before and after treatment, and differences between two groups were analyzed statistically. Results The index of severity of symptom, index of frequency of symptomand total index of severity of symptom at three days and four weeks after treatment were both significantly decreased compared with those before treatment in traditional Chinese medicine group （all P〈 0.01） ;The same circumstances were found in pinaverium bromide group at three days after（all P〈0.01）,but were not at four weeks after treatment （all P〉0.05）. The completed remissive rate and the total effective rate after stop treatment for four weeks in traditional Chinese medicine group were significantly higher than those in pinaverium bromide group（81 %, 99 % vs 9 % ,27 %） （P〈0.01）. Conclusion Pinaverium bromide is effective for deters the attack of symptoms of IBS-D,but isn＇t effective for long term. The effects of traditional Chinese medicine in the treatment of IBS are satisfactory and long.