和胃解逆汤治疗便秘型肠易激综合征对血清5-羟色胺和降钙素基因相关肽的影响
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摘要
目的:探讨和胃解逆汤治疗便秘型肠易激综合征(IBS-C)对血清5-羟色胺(5-HT)和降钙素基因相关肽(CGRP)的影响。方法:选取2016年3月-2018年6月本院收治的IBS-C患者80例,依据随机数字表法分为双药组和单药组,每组40例。单药组给予马来酸曲美布汀治疗,双药组在此基础上给予和胃解逆汤治疗,比较两组血清5-HT、CGRP和临床症状、疗效、不良反应。结果:治疗3 d后,两组血清5-HT、CGRP水平均明显低于治疗前,且双药组治疗3 d后血清5-HT、CGRP水平均明显低于单药组,差异均有统计学意义(P<0.05)。治疗3 d后,两组腹胀腹痛、便秘等症状评分均明显低于治疗前,且双药组治疗3 d后腹胀腹痛、便秘等症状评分均明显低于单药组,差异均有统计学意义(P<0.05)。双药组治疗总有效率明显高于单药组,差异有统计学意义(χ~2=7.813,P=0.003)。两组不良反应发生率比较,差异无统计学意义(χ~2=0.105,P=0.745)。结论:和胃解逆汤治疗可有效改善IBS-C患者血清5-HT、CGRP和腹胀腹痛、便秘等症状,有利于提高治疗效果,且安全性好,值得临床推广。
Objective:To discuss the effect of Hewei Jieni Decoction on serum 5-hydroxytryptamine and calcitonin gene-related peptide in the treatment of constipation-predominant irritable bowel syndrome(IBS-C).Method:80 patients with IBS-C were selected from March 2016 to June 2018 in our hospital,according to the random number table,the patients were divided into double drug group and single drug group,with 40 cases in each group.Single drug group was treated with Trimebutine Maleate,and double drug group was treated with Hewei Jieni Decoction.Serum 5-HT,CGRP and clinical symptoms,efficacy and adverse reactions were compared between the two groups.Result:After treatment for 3 days,serum 5-HT and CGRP levels in both groups were significantly lower than those before treatment,serum 5-HT and CGRP levels in the double drug group were significantly lower than those in the single drug group,with statistically significant differences(P<0.05).After treatment for 3 days,the scores of symptoms such as abdominal distension,pain and constipation in both groups were significantly lower than those before treatment,and the scores of symptoms such as abdominal distension,pain and constipation in the double drug group were significantly lower than those in the single drug group,with statistically significant differences(P<0.05).The total effective rate of the double drug group was significantly higher than that of the single drug group,the difference was statistically significant( χ~2=7.813,P=0.003).There was no statistically significant difference in the incidence of adverse reactions between the two groups( χ~2=0.105,P=0.745).Conclusion:Hewei Jieni Decoction can effectively improve serum 5-HT,CGRP,abdominal distension,abdominal pain,constipation and other symptoms of patients with IBS-C,which is conducive to improve the treatment effect,and has good safety,worthy of clinical promotion.
Objective:To discuss the effect of Hewei Jieni Decoction on serum 5-hydroxytryptamine and calcitonin gene-related peptide in the treatment of constipation-predominant irritable bowel syndrome(IBS-C).Method:80 patients with IBS-C were selected from March 2016 to June 2018 in our hospital,according to the random number table,the patients were divided into double drug group and single drug group,with 40 cases in each group.Single drug group was treated with Trimebutine Maleate,and double drug group was treated with Hewei Jieni Decoction.Serum 5-HT,CGRP and clinical symptoms,efficacy and adverse reactions were compared between the two groups.Result:After treatment for 3 days,serum 5-HT and CGRP levels in both groups were significantly lower than those before treatment,serum 5-HT and CGRP levels in the double drug group were significantly lower than those in the single drug group,with statistically significant differences(P<0.05).After treatment for 3 days,the scores of symptoms such as abdominal distension,pain and constipation in both groups were significantly lower than those before treatment,and the scores of symptoms such as abdominal distension,pain and constipation in the double drug group were significantly lower than those in the single drug group,with statistically significant differences(P<0.05).The total effective rate of the double drug group was significantly higher than that of the single drug group,the difference was statistically significant( χ~2=7.813,P=0.003).There was no statistically significant difference in the incidence of adverse reactions between the two groups( χ~2=0.105,P=0.745).Conclusion:Hewei Jieni Decoction can effectively improve serum 5-HT,CGRP,abdominal distension,abdominal pain,constipation and other symptoms of patients with IBS-C,which is conducive to improve the treatment effect,and has good safety,worthy of clinical promotion.
引文
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[3]李晓玲,张声生,杨成,等.仁术健脾理气方对功能性消化不良大鼠胃排空功能及Ghrelin、5-HT、CGRP的影响[J].中国中西医结合消化杂志,2014,22(7):355-359.
[4]胡正梅.温胃降逆颗粒的稳定性考察[J].新疆中医药,2014,32(5):59-62.
[5]Aziz I,Mumtaz S,Bholah H,et al.High Prevalence of Idiopathic Bile Acid Diarrhea Among Patients with Diarrhea-Predominant Irritable Bowel Syndrome Based on RomeⅢCriteria[J].Clin Gastroenterol Hepatol,2015,13(9):1650-1655.
[6]杨倩,王小天,杜姚,等.麻枳降浊方改善便秘型肠易激综合征胃肠功能的疗效观察[J].辽宁中医杂志,2015,42(8):1458-1460.
[7]中华医学会消化病学分会胃肠功能性疾病协作组,中华医学会消化病学分会胃肠动力学组.中国肠易激综合征专家共识意见(2015年,上海)[J].中华消化杂志,2016,36(5):299-312.
[8]Foxx-orenstin A E.New and emerging therapies for the treatment of irritable bowel syndrome:an update{or gastroen-terologists[J].Therp Adv Gastroenterol,2016,9(3):354-375.
[9]Sun J M,Tian Y Z.Professor TIAN Yaozhou in the treatment of constipation-predominant irritable bowel syndrome[J].Jilin J Tradit Chin Med,2017,37(2):122-124.
[10]周慧芬,徐安妗,祝方良.中医治疗便秘型肠易激综合征的临床观察[J].中华中医药学刊,2014,32(3):683-685.
[11]魏玮,杨俭勤,史海霞.便秘型和混合型肠易激综合征中医药疗效评价策略[J].中医杂志,2016,57(2):122-125.
[12]夏亮,谢其贵,赵秋枫,等.疏肝和胃降逆汤联合莫沙必利治疗胆汁反流性胃炎的临床分析[J].中华中医药学刊,2014,32(12):3058-3060.
[13]刘喜燕,王绪霖.香砂六君子汤配合吗丁啉对脾虚气滞型功能性消化不良患者血清5-HT、SS含量的影响[J].陕西中医,2016,37(7):856-857.
[14]张薇薇,苗润青,杨梅,等.温胃降逆颗粒联合磷酸铝凝胶治疗老年消化性溃疡患者的效果[J].中国老年学杂志,2018,38(6):1360-1362.
[15]崔秀芳,王颖,王惠,等.胃食管反流病患者血清5-HT、CGRP和SP的表达及其临床意义[J].江苏医药,2017,43(24):1779-1781.
[16]汤礼宾,章志福.滋水清肝饮对围绝经期抑郁症患者的临床疗效及对血清孤啡肽和5-羟色胺的影响分析[J].中国医学创新,2016,13(20):110-112.
[17]周海新.和胃降逆汤加减治疗胃食管反流病64例[J].中国实验方剂学杂志,2014,20(18):204-207.
[18]蒋静,李访贤,马光晔.温胃降逆颗粒联合尿囊素铝对消化性溃疡患者血清Gas、TGF-α和IL-8的影响[J].中国生化药物杂志,2017,37(4):84-86.
[19]夏迪娅·夏木西丁,于碧磬,段红霞.温胃降逆颗粒联合质子泵抑制剂治疗胃食管反流性咳嗽的疗效观察[J].中医药导报,2015,21(17):65-67.
[2]Rajindrajith S,Devanarayana N M,Benninga M A.Constipation and constipation predominant irritable bowel syndrome:a comparative study using RomeⅢcriteria[J].J Pediatr Gastroenterol Nutr,2017,64(5):679-684.
[3]李晓玲,张声生,杨成,等.仁术健脾理气方对功能性消化不良大鼠胃排空功能及Ghrelin、5-HT、CGRP的影响[J].中国中西医结合消化杂志,2014,22(7):355-359.
[4]胡正梅.温胃降逆颗粒的稳定性考察[J].新疆中医药,2014,32(5):59-62.
[5]Aziz I,Mumtaz S,Bholah H,et al.High Prevalence of Idiopathic Bile Acid Diarrhea Among Patients with Diarrhea-Predominant Irritable Bowel Syndrome Based on RomeⅢCriteria[J].Clin Gastroenterol Hepatol,2015,13(9):1650-1655.
[6]杨倩,王小天,杜姚,等.麻枳降浊方改善便秘型肠易激综合征胃肠功能的疗效观察[J].辽宁中医杂志,2015,42(8):1458-1460.
[7]中华医学会消化病学分会胃肠功能性疾病协作组,中华医学会消化病学分会胃肠动力学组.中国肠易激综合征专家共识意见(2015年,上海)[J].中华消化杂志,2016,36(5):299-312.
[8]Foxx-orenstin A E.New and emerging therapies for the treatment of irritable bowel syndrome:an update{or gastroen-terologists[J].Therp Adv Gastroenterol,2016,9(3):354-375.
[9]Sun J M,Tian Y Z.Professor TIAN Yaozhou in the treatment of constipation-predominant irritable bowel syndrome[J].Jilin J Tradit Chin Med,2017,37(2):122-124.
[10]周慧芬,徐安妗,祝方良.中医治疗便秘型肠易激综合征的临床观察[J].中华中医药学刊,2014,32(3):683-685.
[11]魏玮,杨俭勤,史海霞.便秘型和混合型肠易激综合征中医药疗效评价策略[J].中医杂志,2016,57(2):122-125.
[12]夏亮,谢其贵,赵秋枫,等.疏肝和胃降逆汤联合莫沙必利治疗胆汁反流性胃炎的临床分析[J].中华中医药学刊,2014,32(12):3058-3060.
[13]刘喜燕,王绪霖.香砂六君子汤配合吗丁啉对脾虚气滞型功能性消化不良患者血清5-HT、SS含量的影响[J].陕西中医,2016,37(7):856-857.
[14]张薇薇,苗润青,杨梅,等.温胃降逆颗粒联合磷酸铝凝胶治疗老年消化性溃疡患者的效果[J].中国老年学杂志,2018,38(6):1360-1362.
[15]崔秀芳,王颖,王惠,等.胃食管反流病患者血清5-HT、CGRP和SP的表达及其临床意义[J].江苏医药,2017,43(24):1779-1781.
[16]汤礼宾,章志福.滋水清肝饮对围绝经期抑郁症患者的临床疗效及对血清孤啡肽和5-羟色胺的影响分析[J].中国医学创新,2016,13(20):110-112.
[17]周海新.和胃降逆汤加减治疗胃食管反流病64例[J].中国实验方剂学杂志,2014,20(18):204-207.
[18]蒋静,李访贤,马光晔.温胃降逆颗粒联合尿囊素铝对消化性溃疡患者血清Gas、TGF-α和IL-8的影响[J].中国生化药物杂志,2017,37(4):84-86.
[19]夏迪娅·夏木西丁,于碧磬,段红霞.温胃降逆颗粒联合质子泵抑制剂治疗胃食管反流性咳嗽的疗效观察[J].中医药导报,2015,21(17):65-67.