痛泻安脾汤联合马来酸曲美布汀片对腹泻型肠易激综合征肝郁脾虚证患者血清5-HT和CGRP的影响

目的:探讨痛泻安脾汤联合马来酸曲美布汀片治疗腹泻型肠易激综合征肝郁脾虚证的疗效及对5-羟色胺(5-HT),降钙素基因相关肽(CGRP)的影响。方法:80例患者随机分为治疗组和对照组,每组40例,对照组采用马来酸曲美布汀片治疗,治疗组加用痛泻安脾汤中药汤剂,4周为1疗程。观察两组中医证候疗效,治疗前后中医症状积分的变化,治疗前后血清5-HT,CGRP水平变化。结果:治疗组中医证候总有效率优于对照组(P0.05)。两组治疗前后中医症状积分均有改善(P0.05,P0.01),且治疗组对腹泻、腹痛、腹胀、排便窘迫及黏液便的改善均优于对照组(P0.05,P0.01)。两组治疗后血清5-HT,CGRP水平均降低(P0.05,P0.01),且治疗组5-HT,CGRP水平的降低幅度均明显大于对照组(P0.05)。结论:痛泻安脾汤联合马来酸曲美布汀片治疗腹泻型肠易激综合征肝郁脾虚证具有较好的临床疗效,其机制可能是通过降低患者血清5-HT,CGRP水平而达到治疗作用。

Effects of Tongxie Anpi Decoction Combined with Trimebutine Maleate Tablets on Serum 5-HT and CGRP in Patients with Diarrhea-predominant Irritable Bowel Syndrome with Hepatic Stagnation and Splenic Deficiency

Objective: To explore clinical efficacy of Tongxie Anpi decoction combined with trimebutine maleate tablets for treating diarrhea-predominant irritable bowel syndrome (IBS-D) with hepatic stagnation and splenic deficiency as well as its effect on 5-hydroxytryptamine (5-HT) and calcitonin gene related peptide (CGRP). Method: The 80 patients were randomly divided into treatment group and control group (n=40 in each group). Patients in two groups were both given with trimebutine maleate tablets treatment, and Tongxie Anpi decoction was added in the treatment group. Therapeutic course was 4 weeks for both groups. Changes in curative effect of traditional Chinese medicine (TCM) syndrome and TCM symptom scores were observed for both groups. Serum levels of 5-HT and CGRP of patients in two groups were observed before and after treatment. Result: Total effective rate of TCM syndromes was 87.5% in treatment group, superior to 65.0% in control group (P<0.05). In comparison of TCM symptom scores before and after treatment in two groups, differences were statistically significant except bowel distress and mucous stool in control group (P<0.05, P<0.01), and improvement of diarrhea, abdominal pain, abdominal distension, bowel distress and mucous stool in treatment group was superior to that in control group (P<0.05, P<0.01). Serum levels of 5-HT and CGRP in two groups were significantly decreased after treatment (P<0.05, P<0.01), and decrement of serum levels of 5-HT and CGRP was significantly larger in treatment group than that in control group (P<0.05). Conclusion: Tongxie Anpi decoction combined with Trimebutine Maleate tablets has clinical effect in treating diarrhea-predominant irritable bowel syndrome with hepatic stagnation and splenic deficiency, and can obviously improve the patients' symptoms. Mechanism may be associated with reducing patients' serum levels of 5-HT and CGRP.