| 摘要: |
| 目的：探讨白石温脾汤治疗腹泻型肠易激综合征（IBS-D）的临床疗效。方法：选择60 例IBS-D患者，将其随机分为2组，每组各30 例。治疗组予白石温脾汤加减治疗，对照组予复方谷氨酰胺肠溶胶囊治疗，2组疗程均为4周。观察2组患者治疗前后的中医证候积分、炎症因子［包括白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）］水平、脑肠肽［包括血管活性肽（VIP）、5-羟色胺（5-HT）、P物质（SP）］水平，分别采用肠易激综合征生活质量量表（IBS-QOL）、焦虑自评量表（SAS）、抑郁自评量表（SDS）评估患者治疗前后的生活质量及焦虑、抑郁状况，并根据中医证候积分评定2组中医证候疗效，统计复发率。结果：中医证候疗效总有效率治疗组为86.66%（26/30），显著高于对照组的53.33%（16/30），2组比较，差异有统计学意义（P<0.01）；2组患者治疗后中医证候积分、炎症因子水平、脑肠肽水平及IBS-QOL、SAS、SDS评分均较治疗前显著降低（P<0.05），且治疗组低于对照组（P<0.05）；停药4周后对2组有效患者进行随访，治疗组的复发率为23.08%（6/26），显著低于对照组的43.75%（7/16），差异有统计学意义（P<0.01）。结论：白石温脾汤治疗IBS-D疗效确切，能够显著改善患者临床症状，提高生活质量，减轻炎症反应，促进肠黏膜愈合。 |
| 关键词: 腹泻型肠易激综合征 白石温脾汤 炎症因子 脑肠肽 |
| DOI： |
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| Clinical effect of Baishi Wenpi decoction in treatment of diarrhea-predominant irritable bowel syndrome：An analysis of 30 cases |
| GU Haoran,XU Luzhou |
| (Nantong Third Affiliated Hospital of Nantong University，Nantong 226000，Jiangsu，China;Jiangsu Provincial Hospital of Traditional Chinese Medicine，Nanjing 210004，Jiangsu，China) |
| Abstract: |
| Objective：To investigate the clinical effect of Baishi Wenpi decoction in treatment of diarrhea-predominant irritable bowel syndrome （IBS-D）.Methods：A total of 60 patients with IBS-D were randomly divided into treatment group and control group，with 30 patients in each group.The patients in the treatment group were given Baishi Wenpi decoction，and those in the control group were given compound glutamine enteric-coated capsules；the course of treatment was 4 weeks for both groups.The two groups were observed in terms of traditional Chinese medicine （TCM） syndrome score，inflammatory factors ［interleukin-6 （IL-6），interleukin-8 （IL-8），and tumor necrosis factor-α （TNF-α）］，and brain-gut peptides ［vasoactive intestinal peptide （VIP），5-hydroxytryptamine （5-HT），and substance P （SP）］，and Irritable Bowel Syndrome-Quality of Life （IBS-QOL），Self-Rating Anxiety Scale （SAS），and Self-Rating Depression Scale （SDS） were used to evaluate quality of life，anxiety，and depressive state before and after treatment.The treatment outcome of TCM syndrome was assessed based on TCM syndrome score，and occurrence rate was also analyzed.Results：The treatment group had a significantly higher overall response rate of TCM syndrome than the control group ［86.66% （26/30） vs 53.33% （16/30），P<0.01］.After treatment，both groups had significant reductions in syndrome score，inflammatory factors，brain-gut peptides，and IBS-QOL/SAS/SDS scores （P<0.05），and the treatment group had significantly lower levels than the control group （P<0.05）.The patients with response were followed up after 4 weeks of drug withdrawal，and the treatment group had a significantly lower recurrence rate than the control group ［23.08% （6/26） vs 43.75% （7/16），P<0.01］.Conclusion：Baishi Wenpi decoction has a marked clinical effect in the treatment of IBS-D and can improve clinical symptoms，increase quality of life，reduce inflammatory response，and promote the healing of intestinal mucosa. |
| Key words: diarrhea-predominant irritable bowel syndrome Baishi Wenpi decoction inflammatory factor brain-gut peptide |
