论文部分内容阅读
目的探讨综合疗法在腹泻型肠易激综合征(IBS)中的应用价值和作用机制。方法将106例腹泻型IBS患者随机分为A组35例、B组35例、C组36例,患者均进行心理干预,并口服蒙脱石散,A组加用双歧杆菌三联活菌,B组加用马来酸曲美布汀,C组两药联用。比较3组患者消化系统症状评分、病情严重程度评分、生活质量评分和炎症因子的变化,以及不良反应和复发率的差异。结果 C组消化系统症状、病情严重程度和生活质量评分,以及血清IL-6、IL-12、IL-18水平下降幅度均显著大于A、B组(P均<0.01)。A组未发现明显不良反应,B、C组不良反应均较轻微。C组随访1个月时复发率和总复发率显著低于A、B组(P均<0.05)。结论在心理干预和常规止泻治疗基础上,联合应用双歧杆菌三联活菌和马来酸曲美布汀可有效改善腹泻型IBS患者的消化系统症状,提高生活质量,降低短期复发率,且安全性有保障。两药联用可能通过下调血清IL-6、IL-12、IL-18含量,从微环境角度抑制炎症级联反应来发挥疗效。
Objective To investigate the value and mechanism of comprehensive therapy in diarrhea-predominant irritable bowel syndrome (IBS). Methods 106 patients with diarrhea IBS were randomly divided into A group of 35 cases, B group of 35 cases, C group of 36 cases, the patients were psychological intervention, and oral montmorillonite powder, A group with Bifidobacterium triple viable bacteria, B group with trimebutine maleate, C combination of two drugs. The digestive system symptom score, severity of illness score, quality of life score and inflammatory factors in the three groups were compared, and the differences of adverse reactions and recurrence rates were compared. Results The digestive system symptom, severity of illness and quality of life score, as well as the decreasing degree of serum IL-6, IL-12 and IL-18 in group C were significantly higher than those in group A and B (all P <0.01). No obvious adverse reactions were found in group A, and the adverse reactions in groups B and C were mild. The recurrence rate and total recurrence rate in group C at 1 month follow-up were significantly lower than those in groups A and B (all P <0.05). Conclusions On the basis of psychological intervention and conventional antidiarrheal therapy, the combined use of live bifidobacteria and trimebutine maleate can effectively improve the digestive system symptoms, improve the quality of life and reduce the short-term recurrence rate in diarrhea-predominant IBS patients Safe and secure. The combination of the two drugs may exert curative effect by downregulating the levels of serum IL-6, IL-12 and IL-18 and inhibiting inflammation cascade from the microenvironment.