认知治疗联合匹维溴胺、益生菌治疗腹泻型肠易激综合征

目的探讨认知治疗结合匹维溴铵、益生菌治疗腹泻型肠易激综合征（D-IBS）的可行性。方法符合罗马Ⅲ标准的62例D-IBS患者随机分为2组,A组：匹维溴胺（50 mg/次,3次/d）＋双歧三联活菌制剂（粪链球菌、嗜酸乳杆菌、双歧杆菌3种肠道固有菌的活菌制剂）（420 mg/次,3次/d）;B组：认知治疗＋匹维溴胺（50 mg/次,3次/d）＋双歧三联活菌制剂（420 mg/次,3次/d）,疗程为8周。分别记录治疗前后患者SF-36生活质量评分和症状积分。结果 A组症状显效率和总有效率分别为35.5%和77.4%;B组分别为54.8%和90.3%;B组治疗后,患者生活质量明显改善,躯体疼痛（BP）、总体健康（GH）、活力（VT）、社会功能（SF）、情感职能（RE）和精神健康（MH）维度的积分有显著提高（P〈0.05）,优于A组。结论认知治疗联合匹维溴胺和益生菌对改善患者的生活质量和IBS症状疗效优越。

Effects of cognitive therapy combined with pinaverium bromide and probiotics in the treatment of patients with diarrhea-predominant irritable bowel syndrome

Objective To investigate the feasibility of cognitive therapy combined with pinaverium bromide and probiotics in the treatment of patients with diarrhea-predominant irritable bowel syndrome(D-IBS).Methods Sixty-two Roma Ⅲ positive-IBS patients were divided into group A: pinaverium bromide(150 mg/d,tid) plus probiotics live combined Bifidobacterium,Lactobacillus and Enterococcus capsules(1 260 mg/d,tid),and group B: cognitive therapy and pinaverium bromide(150 mg/d,tid) plus probiotics live combined Bifidobacterium,Lactobacillus and Enterococcus capsules(1 260 mg/d,tid). The course of the treatment was 8 weeks.The SF-36 Health Survey Scales and symptomatic scores were recorded before and after treatment.Results Symptom excellence rates achieved by 35.5% and 54.8% in group A and group B.The total symptom effective rates were 77.4% and 90.3% in group A and group B.Quality of life(QOL) in group A and group B had a obvious improvement.The scores of BP,GH,VT,SF,RE and MH scales had significant improvement in group B,more than group A(P<0.05).Conclusion Cognitive therapy combined with pinaverium bromide and probiotics can significantly improve symptoms and QOL,which is effective in the treatment of patients with D-IBS.