参苓白术散联合匹维溴铵片治疗腹泻型肠易激综合征的临床疗效及安全性评价〖JZ)〗〖HS)〗

目的:评介参苓白术散联合匹维溴铵片治疗腹泻型肠易激综合征(IBS-D)的临床疗效和安全性。方法:选取2013年1月至2016年1月山东中医药大学附属医院收治的IBS-D患者117例作为研究对象,随机分为对照组(n=59)与观察组(n=58)。对照组采用匹维溴铵片治疗,观察组在对照组基础上加用参苓白术散治疗,2组治疗周期均为1个月。比较2组患者临床疗效;统计治疗前后2组患者临床症状评分、脑肠肽指标及直肠敏感性指标的变化;比较2组治疗期间不良反应发生情况。结果:治疗后观察组总有效率(93. 10%)高于对照组的(76. 27%),差异有统计学意义(P 0. 05);与治疗前比较,治疗后2组腹痛、腹胀、腹泻评分及总评分均下降,且观察组低于对照组,差异有统计学意义(P 0. 05);与治疗前比较,2组血清5-羟色胺(5-HT)、血管活性肠肽(VIP)及P物质(SP)水平均下降,且观察组低于对照组,差异有统计学意义(P 0. 05);与治疗前比较,2组患者肛管静息压、直肠感知阈值、腹痛阈值、排便阈值均升高,且观察组高于对照组,差异有统计学意义(P 0. 05);治疗期间2组患者不良反应发生率(5. 08%,1. 72%)比较,差异无统计学意义(P 0. 05)。结论:参苓白术散联合匹维溴铵片治疗IBS-D可有效缓解患者腹胀、腹痛及腹泻等临床症状,降低血清脑肠肽水平,改善其直肠功能,不良反应少,临床疗效显著。

Clinical Observation and Safety Evaluation of Shenling Baizhu Powder Combined with Pinaverium Bromide Tablets in the Treatment of Diarrhea Type Irritable Bowel Syndrome

To observe the clinical efficacy of Shenling Baizhu Powder combined with pinaverium bromide tablets in the treatment of diarrhea type irritable bowel syndrome (IBS-D),and to evaluate its safety.Methods:A total of 117 cases with IBS-D in Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2013 to January 2016 were selected and randomly divided into an observation group (n=58) and a control group (n=59).The control group was treated with pinaverium bromide tablets,and the observation group was treated with Shenling Baizhu Powder on the basis of control group.Both groups were treated for 1 month.The clinical efficacy of the 2 groups was compared.The score of clinical symptom,brain-gut peptides index and rectal sensitivity index before and after treatment in 2 groups were calculated.The occurrence of adverse reaction in 2 groups during treatment was also compared.Results:The total efficiency rate of the observation group (93.10%) was higher than that of the control group (76.27%) (P<0.05); Compared with before treatment,the score of abdominal pain,abdominal distention and diarrhea as well as total score of the 2 groups were all decreased after treatment,and observation group was lower than control group (P<0.01); Compared with before treatment,the levels of serum 5-HT,VIP and SP in the 2 groups decreased after treatment,and the observation group was lower than the control group (P<0.01); Compared with before treatment,the anal canal resting pressure,rectal perception threshold,abdominal pain and defecation threshold increased after treatment in the 2 groups,and the observation group was higher than the control group (P<0.01); The adverse reaction incidence of the 2 groups (5.08%,1.72%) had no significant difference (P>0.05).Conclusion:Shenling Baizhu Powder combined with pinaverium bromide tablets in the treatment of IBS-D can relief the clinical symptoms of abdominal pain,abdominal distension and diarrhea,reduce the level of serum brain-gut peptides,improve the rectal function.The adverse reaction is less and the curative efficacy is remarkable.