左氧氟沙星联合培菲康治疗腹泻型肠易激综合征的疗效分析

目的观察左氧氟沙星联合益生菌培菲康序贯治疗腹泻型肠易激综合征(IBS-D)的临床疗效。方法将86例IBS-D患者随机分为3组:A组(序贯治疗组)29例给予左氧氟沙星、匹维溴铵和复方谷氨酰胺胶囊(GLU)治疗1周后,再服用匹维溴铵、培菲康和GLU 8周;B组(培菲康治疗组)29例给予匹维溴铵、培菲康和GLU;C组(常规治疗组)28例给予匹维溴铵+GLU常规治疗,总疗程均8周。观察治疗前后症状评分,Bristol排便量表以及大便次数的变化情况。结果与治疗前比较,治疗后3组患者的症状总积分值均有不同程度下降(P均<0.01),在治疗后4～12周A组和B组症状总分处于较低水平,而C组在第12周时总分高于第8周(P<0.05),A组4～12周、B组8～12周均低于C组(P<0.05);与治疗前比较,3组治疗后腹痛发生时间、腹痛发生次数均下降(P均<0.01)。与B组相比,4周时A组的腹痛发生次数、腹痛发生时间均显著降低(P<0.05,P<0.01);与C组相比,A组均显著降低(P均<0.05),且该情况在停药后4周随访中持续体现。治疗后各组Bristol排便量表评分均显著下降(P<0.05),而3组间差异无统计学意义(P>0.05)。各组大便频率积分均有下降(P<0.05),第8周时,A组和B组的总分低于C组(P<0.05),第12周时,A组积分依然低于C组,而B组与C组评分无统计学差异(P>0.05),治疗后A组和B组黏液便比例明显下降(P<0.01),而C组变化不明显(P>0.05)。结论左氧氟沙星联合培菲康序贯治疗腹泻型肠易激综合征疗效更为显著、持久,对改善患者的症状可能更有优势。

Analysis efficacy of levofloxacin combined with bifid triple viable capsule in patients with diarrhea predominant irritable bowel syndrome

Objective To evaluate the efficacy of sequential therapy with levofloxacin and bifid triple viable capsule in patients with diarrhea predominant irritable bowel syndrome （IBS-D）. Methods 86 patients with IBS-D were divided into three groups randomly. Group A （sequential treatment, 29 cases） was given levofloxacin, pinaverium bromide and complex glutamine capsule （GLU） for 1 week, and then took pinaverium bromide, GLU and bifid triple viable capsule （BTVC）. Group B （BTVC treatment, 29 cases） received pinaverium bromide, GLU and BTVC for 8 weeks. Patients in Group C （routine treatment, 28 cases） only took pinaverium bromide and GLU, the period of treatment was 8 weeks. The scores of gastro-intestinal symptoms, Bristol score and stool frequency in each group were recorded before and after therapy. Results After treatment, the symptom scores in patients had varying degrees of decline （ P 〈 O. 01 ）. Compare to group B, the pain frequency, duration of abdominal pain were reduced in Group A （ P 〈 0.01 ）. Compare to Group C, the pain frequency, duration of abdominal pain were reduced in Group A （ P 〈 O. 05 ）. This kind of situation lasted for 4 weeks after stopping medication. After the treatment, the scores of stool frequency （SSF） showed a significant decrease in all three groups （ P 〈 0.05 ）. At the end of the 8th week, the SSFs were significantly lower in group A and group B than those in group C （ P 〈 0.05 ）, and at the end of the 12th week, SSF remained lower in group A, while not in group B and group C （ P 〉0.05）. Moreover, the proportion of mucous stool post treatment was lower in group A and group B （ P 〈0.01）, but not in group C （ P 〉0.05）. Conclusion Compare to BTVC treatment and routine treatment, the efficacy of sequential therapy with levofloxacin and bifid triple viable capsule is more effective and durable. It may have more advantages in relieving the symptoms of irritable bowel syndrome.