马来酸曲美布汀联合西兰司琼治疗腹泻型肠易激综合征的疗效
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摘要
目的探讨马来酸曲美布汀联合西兰司琼治疗腹泻型肠易激综合征的疗效。方法选择2015年5月至2017年5月在武警四川总队医院就诊的100例肠易激综合征(IBS)患者作为研究对象,以随机数表法分为观察组(n=55)和对照组(n=45)。对照组使用马来酸曲美布汀治疗,观察组采用马来酸曲美布汀联合西兰司琼进行治疗。比较两组治疗后的有效率、胃肠道症状及血清P物质(SP)、生长抑素(SS)、神经肽Y(NPY)、5-羟色胺(5-HT)、降钙素基因相关肽(CGRP)表达水平的变化。结果治疗后,观察组的临床总有效率(94.55%)高于对照组(73.33%),差异有统计学意义(P<0.05);治疗后,两组患者血清SP、SS表达水平均明显下降,且观察组血清SP、SS表达水平显著低于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者血清5-HT、CGRP表达水平均明显下降,NPY表达水平明显上升,且观察组血清5-HT、CGRP表达水平显著低于对照组,NPY水平明显高于对照组,差异均有统计学意义(P均<0.05);治疗后,两组腹泻、腹痛、恶心呕吐评分及总积分均明显下降,且观察组各项评分及总积分均显著低于对照组,差异均具有统计学意义(P均<0.05)。结论对IBS患者应用马来酸曲美布汀联合西兰司琼的疗效显著,可有效改善患者血清5-HT、CGRP及NPY表达水平,改善胃肠道症状,值得临床推广和应用。
Objective An attempt was made in this paper to study the curative efficacy of trimebutine maleate in combination with cilansetron in the treatment of diarrheal irritable bowel syndrome.Methods One hundred cases of irritable bowel syndrome diagnosed in Sichuan Provincial General Hospital of Armed Police Force from May 2015 to May 2017 were randomly divided into the observation group(n=55)and the control group(n=45).The control group was treated with trimebutine maleate whereas the observation group was treated with trimebutine maleate combined with cilansetron.After treatment,the efficacy,gastrointestinal symptoms and serum levels of substance P(SP),somatostatin(SS),neuropeptide Y(NPY)and serotonin(5-HT),and calcitonin gene related peptide(CGRP)of both groups were compared.Results After treatment,the total effective rate of the observation group was higher than that of the control group(94.55%vs 73.33%,P<0.05);the serum SP and SS levels of both groups were significantly decreased,but the serum SP and SS levels of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05);serum5-HT and CGRP levels both groups decreased significantly,while NPY levels increased drastically.Serum5-HT and CGRP levels of the observation group were significantly lower than those of the control group,and NPY levels were significantly higher than those of the control group(P<0.05);scores and total scores of diarrhea,abdominal pain,nausea and vomiting of both groups were significantly decreased,and scores and total scores of diarrhea,abdominal pain,nausea and vomiting of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).Conclusion The therapeutic effect of trimebutine maleate combined with cilansetron on patients with irritable bowel syndrome,which can effectively improve the serum5-HT,CGRP and NPY levels,and improve gastrointestinal symptoms,is remarkable and worthy of promotion and application.
Objective An attempt was made in this paper to study the curative efficacy of trimebutine maleate in combination with cilansetron in the treatment of diarrheal irritable bowel syndrome.Methods One hundred cases of irritable bowel syndrome diagnosed in Sichuan Provincial General Hospital of Armed Police Force from May 2015 to May 2017 were randomly divided into the observation group(n=55)and the control group(n=45).The control group was treated with trimebutine maleate whereas the observation group was treated with trimebutine maleate combined with cilansetron.After treatment,the efficacy,gastrointestinal symptoms and serum levels of substance P(SP),somatostatin(SS),neuropeptide Y(NPY)and serotonin(5-HT),and calcitonin gene related peptide(CGRP)of both groups were compared.Results After treatment,the total effective rate of the observation group was higher than that of the control group(94.55%vs 73.33%,P<0.05);the serum SP and SS levels of both groups were significantly decreased,but the serum SP and SS levels of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05);serum5-HT and CGRP levels both groups decreased significantly,while NPY levels increased drastically.Serum5-HT and CGRP levels of the observation group were significantly lower than those of the control group,and NPY levels were significantly higher than those of the control group(P<0.05);scores and total scores of diarrhea,abdominal pain,nausea and vomiting of both groups were significantly decreased,and scores and total scores of diarrhea,abdominal pain,nausea and vomiting of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).Conclusion The therapeutic effect of trimebutine maleate combined with cilansetron on patients with irritable bowel syndrome,which can effectively improve the serum5-HT,CGRP and NPY levels,and improve gastrointestinal symptoms,is remarkable and worthy of promotion and application.
引文
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4 高玲,李明泉.文拉法辛联合双歧三联活菌及马来酸曲美布汀对难治性肠易激综合征的疗效分析[J].现代消化及介入诊疗,2016,21(4):592-594.
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8 林诚.复方谷氨酰胺联合三联活菌胶囊治疗腹泻型肠易激综合征的安全性和有效性分析[J].中国生化药物杂志,2014,34(5):149-151.
9 刘敏,吴运.益生菌联合马来酸曲美布汀治疗便秘型肠易激综合征的疗效分析[J].国际消化病杂志,2017,37(6):377-381.
10 Bardisi BM,Halawani AKH,Halawani HKH,et al.Efficiency of diet change in irritable bowel syndrome[J].J Family Med Prim Care,2018,7(5):946-951.
11 王敬东,杨阋楼.雷贝拉唑肠溶胶囊联合马来酸曲美布汀治疗胃食管返流性咳嗽的疗效观察[J].中国现代医学杂志,2016,26(20):137-141.
12 卢思超.马来酸曲美布汀联合复方消化酶对老年肠易激综合征患者临床症状及其对P物质、生长抑素及降钙素基因相肽的影响[J].中国中西医结合消化杂志,2016,4(8):616-619.
13 王谦,朱雁兵,张萌.西兰司琼治疗肠易激综合征的疗效观察及机制探讨[J].中国现代医学杂志,2017,27(18):102-105.
14 Mitchell H,Porter J,Gibson PR,et al.Review article:implementation of a diet low in FODMAPs for patients with irritable bowel syndrome-directions for future research[J].Aliment Pharmacol Ther,2019,49(2):124-139.
15 张慧,万坚,陆芳,等.美沙拉嗪联合马来酸曲美布汀治疗肠易激综合征患者的临床疗效观察[J].国际消化病杂志,2017,37(2):95-99.
2 季梦辰,崔立红.利福昔明联合复合乳酸菌胶囊治疗感染后肠易激综合征[J].中国新药杂志,2016,25(12):1407-1412.
3 黄欣,王萍.莫沙必利联合马来酸曲美布汀治疗功能性消化不良的疗效观察[J].临床消化病杂志,2017,29(2):65-68.
4 高玲,李明泉.文拉法辛联合双歧三联活菌及马来酸曲美布汀对难治性肠易激综合征的疗效分析[J].现代消化及介入诊疗,2016,21(4):592-594.
5 Lee SH,Kim CR,Kim KN.Changes in fecal calprotectin after rifaximin treatment in patients with nonconstipated irritable bowel syndrome[J].Am J Med Sci,2019,357(1):23-28.
6 孙菁,袁耀宗.肠易激综合征:罗马Ⅲ标准与我国共识意见解读[J].医学与哲学:临床决策论坛版,2008,29(6):12-14.
7 初晨,王巧民.肠易激综合征治疗进展[J].安徽医学,2013,34(7):1053-1055.
8 林诚.复方谷氨酰胺联合三联活菌胶囊治疗腹泻型肠易激综合征的安全性和有效性分析[J].中国生化药物杂志,2014,34(5):149-151.
9 刘敏,吴运.益生菌联合马来酸曲美布汀治疗便秘型肠易激综合征的疗效分析[J].国际消化病杂志,2017,37(6):377-381.
10 Bardisi BM,Halawani AKH,Halawani HKH,et al.Efficiency of diet change in irritable bowel syndrome[J].J Family Med Prim Care,2018,7(5):946-951.
11 王敬东,杨阋楼.雷贝拉唑肠溶胶囊联合马来酸曲美布汀治疗胃食管返流性咳嗽的疗效观察[J].中国现代医学杂志,2016,26(20):137-141.
12 卢思超.马来酸曲美布汀联合复方消化酶对老年肠易激综合征患者临床症状及其对P物质、生长抑素及降钙素基因相肽的影响[J].中国中西医结合消化杂志,2016,4(8):616-619.
13 王谦,朱雁兵,张萌.西兰司琼治疗肠易激综合征的疗效观察及机制探讨[J].中国现代医学杂志,2017,27(18):102-105.
14 Mitchell H,Porter J,Gibson PR,et al.Review article:implementation of a diet low in FODMAPs for patients with irritable bowel syndrome-directions for future research[J].Aliment Pharmacol Ther,2019,49(2):124-139.
15 张慧,万坚,陆芳,等.美沙拉嗪联合马来酸曲美布汀治疗肠易激综合征患者的临床疗效观察[J].国际消化病杂志,2017,37(2):95-99.