目的 探討奧替溴銨片聯(lián)合雙歧桿菌四聯(lián)活菌片治療腹瀉型腸易激綜合征的臨床療效。方法 選取2015年6月-2017年1月新鄉(xiāng)市中心醫(yī)院收治的腹瀉性腸易激綜合征患者126例為研究對(duì)象，按隨機(jī)分組法將所有患者分為奧替溴銨組、雙歧桿菌四聯(lián)活菌組和聯(lián)合組，每組各42例。奧替溴銨組口服奧替溴銨片，1片/次，3次/d。雙歧桿菌四聯(lián)活菌組口服雙歧桿菌四聯(lián)活菌片，3片/次，3次/d。聯(lián)合組給予奧替溴銨片聯(lián)合雙歧桿菌四聯(lián)活菌片，方法同上。3組患者均治療2個(gè)月。觀察3組的臨床療效，比較3組的消化道癥狀改善、血清細(xì)胞因子水平和生活質(zhì)量量表（IBS-QOL）評(píng)分。結(jié)果 治療后，奧替溴銨組、雙歧桿菌四聯(lián)活菌組和聯(lián)合組總有效率分別為76.2%、69.0%、95.2%，聯(lián)合組總有效率顯著高于奧替溴銨組和雙歧桿菌四聯(lián)活菌組，總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組癥狀嚴(yán)重程度評(píng)分和癥狀頻率評(píng)分均顯著下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且聯(lián)合組這些觀察指標(biāo)明顯低于奧替溴銨組和雙歧桿菌四聯(lián)活菌組，3組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，聯(lián)合組大便次數(shù)恢復(fù)正常時(shí)間和大便性狀恢復(fù)正常時(shí)間顯著短于奧替溴銨組和雙歧桿菌四聯(lián)活菌組，比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組腫瘤壞死因子（TNF-α）、白細(xì)胞介素-6（IL-6）和白細(xì)胞介素-8（IL-8）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且聯(lián)合組這些觀察指標(biāo)明顯低于奧替溴銨組和雙歧桿菌四聯(lián)活菌組，比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，3組腸易激綜合征IBS-QOL評(píng)分顯著下降，生活質(zhì)量評(píng)分量表（SF-36）評(píng)分顯著升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且聯(lián)合組這些觀察指標(biāo)的改善程度明顯優(yōu)于奧替溴銨組和雙歧桿菌四聯(lián)活菌組，比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 奧替溴銨片聯(lián)合雙歧桿菌四聯(lián)活菌片治療腹瀉型腸易激綜合征具有較好的臨床療效，可改善消化道癥狀，提高生活質(zhì)量，調(diào)節(jié)TNF-α、IL-6和IL-8水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Otilonium Bromide Tablets combined with Bifidobacterium Quadruple Viable Tablets in treatment of diarrhea irritable bowel syndrome. Methods Patients (126 cases) with diarrhea irritable bowel syndrome in Xinxiang Central Hospital from June 2015 to January 2017 were randomly divided into otilonium bromide, bifidobacterium quadruple viable, and treatment groups, and each group had 42 cases. Patients in the otilonium bromide group were po administered with Otilonium Bromide Tablets, 1 tablet/time, three times daily. Patients in the bifidobacterium quadruple viable group were po administered with Bifidobacterium Quadruple Viable Tablets, 3 tablets/time, three times daily. Patients in the treatment group were given Otilonium Bromide Tablets and Bifidobacterium Quadruple Viable Tablets, usage and dosage were the same as the above. Patients in three groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and improvements of digestive symptoms, serum cytokine levels, quality of life scores in three groups were compared. Results After treatment, the clinical efficacies in the otilonium bromide, bifidobacterium quadruple viable, and treatment groups were 76.2%, 69.0%, and 95.2%, respectively, and there was difference among three groups (P<0.05). After treatment, symptom severity scores and symptom frequency scores in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the otilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). After treatment, the recovery time of stool frequency and stool traits in the treatment group were significantly shorter than those in the otilonium bromide and bifidobacterium quadruple viable groups, and there was difference among three groups (P<0.05). After treatment, the levels of TNF-α, IL-6, and IL-8 in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in theotilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). After treatment, the IBS-QOL scores in three groups were significantly decreased, but the SF-36 scores in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the otilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). Conclusion Otilonium Bromide Tablets combined with Bifidobacterium Quadruple Viable Tablets has clinical curative effect in treatment of diarrhea irritable bowel syndrome, can improve digestive symptoms, enhance the quality of life, and regulate the levels of TNF-α, IL-6, and IL-8, which has a certain clinical application value.