目的 探討人參健脾丸聯(lián)合復(fù)方嗜酸乳桿菌片治療腹瀉型腸易激綜合征的臨床療效。方法 選取2022年8月—2023年8月南京市溧水區(qū)中醫(yī)院治療的158例腹瀉型腸易激綜合征患者為研究對象，依據(jù)用藥方案不同將患者分為對照組和治療組，每組79例。對照組口服復(fù)方嗜酸乳桿菌，2片/次，3次/d。在對照組治療的基礎(chǔ)上，治療組口服人參健脾丸，2丸/次，2次/d。兩組均進(jìn)行4周治療。比較兩組患者的臨床療效、相關(guān)評分、腸道菌群和血清炎癥因子水平。結(jié)果 相較于對照組的總有效率84.81%，治療組的總有效率94.94%更高（P<0.05）。治療后，兩組視覺模擬評分量表（VAS）、Bristol和腸易激綜合征癥狀嚴(yán)重程度量表（IBS-SSS）評分均降低（P<0.05），且治療組的各項(xiàng)評分顯著低于對照組（P<0.05）。治療后，兩組雙歧桿菌、乳酸桿菌數(shù)量均增加，腸桿菌、腸球菌數(shù)量均減少（P<0.05），治療組雙歧桿菌、乳酸桿菌數(shù)量明顯高于對照組，腸桿菌、腸球菌數(shù)量明顯低于對照組（P<0.05）。治療后，兩組患者血清腫瘤壞死因子-α(TNF-α)、白細(xì)胞介素（IL）-1β、IL-6水平均降低（P<0.05），且治療組血清炎癥因子水平顯著低于對照組（P<0.05）。結(jié)論 在復(fù)方嗜酸乳桿菌片基礎(chǔ)上加用人參健脾丸治療腹瀉型腸易激綜合征的療效顯著，可改善臨床癥狀，調(diào)節(jié)腸道菌群平衡，降低機(jī)體炎癥反應(yīng)。

Objective To explore the efficacy of Renshen Jianpi Pills combined with Compound Eosinophil-Lactobacillus Tablets in treatment of diarrhea type irritable bowel syndrome. Methods 158 Patients with diarrhea predominant irritable bowel syndrome treated in Nanjing Lishui District Hospital of Traditional Chinese Medicine from August 2022 to August 2023 were selected as the study subjects, and were divided into control group（79 cases） and treatment group（79 cases） according to different medication regimens. The control group took Compound Eosinophil-Lactobacillus Tablets orally, 2 tablets/time, 3 times daily. On the basis of the control group, the treatment group took Renshen Jianpi Pills orally, 2 pills/time, twice daily. Two groups were treated for 4 weeks. The clinical efficacy, related scores, intestinal flora, and serum inflammatory factor levels between two groups were compared. Results The total effective rate of the treatment group was 94.94%, which was higher than 84.81% of the control group（P＜0.05）. After treatment, VAS, Bristol, and IBS-SSS scores of two groups were significantly decreased（P＜0.05）, and the scores of the treatment group were significantly lower than those of the control group（P＜0.05）. After treatment, the number of Bifidobacterium and Lactobacillus in both groups were increased, while the number of Escherichia coli and Enterococcus were decreased（P＜0.05）. The number of Bifidobacterium and Lactobacillus in the treatment group was significantly higher than those in the control group, while the number of Escherichia coli and Enterococcus was significantly lower than those in the control group（P＜0.05）. After treatment, the levels of serum TNF-α, IL-1β, and IL-6 in btwo groups were significantly decreased（P＜0.05）, and the levels of serum inflammatory factors in the treatment group were significantly lower than those in the control group（P＜0.05）. Conclusion Renshen Jianpi Pills combined with Compound Eosinophil-Lactobacillus Tablets has a significant therapeutic effect on diarrhea predominant irritable bowel syndrome, which can improve clinical symptoms, regulate intestinal microbiota balance, and reduce the body’s inflammatory response.

R975

江蘇省藥學(xué)會(huì)-奧賽康醫(yī)院藥學(xué)基金科研項(xiàng)目(A202114)