调肝理脾方治疗小儿腹泻型肠易激综合征的疗效观察及其对CGRP、NPY和VIP水平的影响
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摘要
目的:观察调肝理脾方治疗小儿腹泻型肠易激综合征的临床疗效及其对血清降钙素基因相关肽(CGRP)、神经肽(NPY)及血管活性肠肽(VIP)的影响。方法:94例小儿腹泻型肠易激综合征患儿随机分为对照组和观察组,对照组给予常规治疗,观察组在对照组基础上加以调肝理脾方治疗,2组均以7 d为1个疗程,持续治疗4个疗程。治疗结束后观察2组患儿临床疗效及不良反应,检测血清CGRP、NPY、VIP水平。结果:观察组临床总有效率为93.6%,明显高于对照组的74.8%;治疗后,2组患儿的主、次症状评分均较治疗前降低(均P<0.05),观察组低于对照组(均P<0.05)。治疗后,2组患儿血清CGRP、NPY、VIP均较治疗前改善(均P<0.05),观察组明显优于对照组(均P<0.05),2组患儿用药期间均未见明显不良反应。结论:调肝理脾方治疗小儿腹泻型肠易激综合征安全有效,改善胃肠激素水平。
Objective: To observe the curative effect of irritable bowel syndrome( IBS) in children treated with Tiaogan Lipi Fang. Methods: 94 Cases of IBS in children were randomly divided into control group and observation group,47 cases in each group. The routine treatment was given the control group,and Tiaogan Lipi Fang was given the observation group on the basis of the control group,all children were treated,one treatment course of 7 days,4 courses of treatment continuously. The clinical efficacy and adverse reactions of the 2 groups were observed after treatment,and the levels of serum calcitonin gene-related peptide( CGRP),neuropeptide( NPY) and vasoactive intestinal peptide( VIP) were detected. Results: The total effective rate was 93. 6% in the observation group,which was better than that in the control group( 74. 8%). The primary and secondary symptom scores of all children after treating were lower than those before treatment( P < 0. 05),the scores in the observation group were significantly lower than those in the control group( P < 0. 05); after treatment,the levels of serum CGRP,NPY and VIP in the 2 groups were improved,which were significantly better in the observation group than the control group( P < 0. 05), all children had no obvious adverse reaction during the treatment. Conclusion: Tiaogan Lipi Fang can effectively and safely treat irritable bowel syndrome( IBS) in children,improve the level of gastrointestinal hormone.
Objective: To observe the curative effect of irritable bowel syndrome( IBS) in children treated with Tiaogan Lipi Fang. Methods: 94 Cases of IBS in children were randomly divided into control group and observation group,47 cases in each group. The routine treatment was given the control group,and Tiaogan Lipi Fang was given the observation group on the basis of the control group,all children were treated,one treatment course of 7 days,4 courses of treatment continuously. The clinical efficacy and adverse reactions of the 2 groups were observed after treatment,and the levels of serum calcitonin gene-related peptide( CGRP),neuropeptide( NPY) and vasoactive intestinal peptide( VIP) were detected. Results: The total effective rate was 93. 6% in the observation group,which was better than that in the control group( 74. 8%). The primary and secondary symptom scores of all children after treating were lower than those before treatment( P < 0. 05),the scores in the observation group were significantly lower than those in the control group( P < 0. 05); after treatment,the levels of serum CGRP,NPY and VIP in the 2 groups were improved,which were significantly better in the observation group than the control group( P < 0. 05), all children had no obvious adverse reaction during the treatment. Conclusion: Tiaogan Lipi Fang can effectively and safely treat irritable bowel syndrome( IBS) in children,improve the level of gastrointestinal hormone.
引文
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[18]张旭,纪忠岐,赵长敏,等.陈皮提取物对小鼠胃排空、肠推进及家兔离体回肠平滑肌的影响[J].河南大学学报(医学版),2012,31(1):12-14.
[19]张利.白芍的药理作用及现代研究进展[J].中医临床研究,2014,29(6):25-26.
[20]周进,吴正祥,杨九华,等.白芍总苷对TNBS诱导的大鼠实验性结肠炎的影响[J].胃肠病学,2009,14(3):154-158.
[21]刘振清,魏睦新.防风对大鼠和小鼠胃肠运动的抑制作用及机制研究[J].现代中西医结合杂志,2011,20(15):1840-1843.
[22]王影,刘文娟,崔瑛.黄连现代研究进展[J].中医学报,2014,29(11):1642-1645.
[23]Grider J R.CGRP as a transmitter in the sensory pathway mediating peristaltic reflex[J].Am J Physiol,1994,266(1):1139-1145.
[24]王巍峰,杨云生,孙刚,等.肠易激综合征大鼠模型脊髓后角神经递质表达的改变[J].胃肠病学和肝病学杂志,2006,15(4):405-408.
[25]Husum H,Van K D,Termeer E,et al.Topiramate normalizes hippocampal NPY-LI in flinders sensitive line'depressed'rats and upregulates NPY,galanin,and CRH-LI in the hypothalamus:implications for mood-stabilizing and weight loss-inducing effects[J].Neuropsychopharmacology,2003,28(7):1292-1299.
[26]程晓雯,林中,郑清华,等.重症急性胰腺炎伴胃肠动力障碍大鼠结肠黏膜下血管活性肠肽神经元的变化[J].南京医科大学学报(自然科学版),2012,32(2):183-187.
[2]潘国宗.肠易激综合征-诊断流行病学、病理生理及病因探讨,现代消化病学进展[M].北京:北京医科大学-协和医科大学联合出版社,1997:259-270.
[3]Grundmann O,Yoon S L.Irritable bowel syndrome:Epidemiology,diagnosis and treatment:An update for health-care practitioners[J].J Gastroenterol Hepatol,2010,25(4):691-699.
[4]Chang F Y,Lu C L.Irritable bowel syndrome in the 21st century:perspectives from Asia or South-east Asia[J].J Gastroenterol Hepatol,2007,22(1):4-12.
[5]卢璐,袁建业,费晓燕,等.肠易激综合征发病机制研究及治疗进展[J].中国中西医结合消化杂志,2015,13(9):661-665.
[6]张北华,高蕊,李振华,等.中医药治疗肠易激综合征的专家经验挖掘分析[J].中国中西医结合杂志,2013,33(6):757-760.
[7]张声生,汪红兵,李振华,等.360例腹泻型肠易激综合征的聚类分析及证候特征研究[J].中华中医药杂志,2010,25(8):1183-1187.
[8]李梅,刘凤斌,李培武.基于因子分析与聚类分析对肠易激综合征中医证候的初步研究[J].中华中医药学刊,2013,31(8):1605-1608.
[9]张声生,李乾构,魏玮,等.肠易激综合征中医诊疗共识意见[J].中华中医药杂志,2010,25(7):1062-1065.
[10]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:139-143.
[11]Ghoshal UC,Shukla R,Ghoshal U.Small intestinal bacterial overgrowth and irritable bowel syndrome:A bridge between functional organic dichotomy[J].Gut Liver,2017,11(2):196-208.
[12]Whitehead WE,Duffy K,Sharpe J,et al.Editorial:ONO-2952 in irritable bowel syndrome with diarrhoeaauthors'reply[J].Aliment Pharmacol Ther,2017,45(7):1005.
[13]李秀清.综合疗法治疗腹泻型肠易激综合征的疗效及作用机制[J].现代中西医结合杂志,2014,23(23):2545-2547.
[14]戈宏焱.柴胡皂苷抗抑郁作用及其机制的研究[D].长春:吉林大学,2010.
[15]王少根,徐慧芹,陈侠英.党参对严重烫伤豚鼠肠道的保护作用[J].中国中西医结合急救杂志,2005,12(3):144-145.
[16]贾彦敏,陈杰.黄芪、党参、白术对脾虚大鼠脑肠轴β-EP的影响[J].实用中医内科杂志,2010,24(8):17-18.
[17]祝金泉,张焜和,黄德强,等.白术对胃粘膜上皮细胞功能作用的实验研究[J].中国内镜杂志,2003,9(2):15-17.
[18]张旭,纪忠岐,赵长敏,等.陈皮提取物对小鼠胃排空、肠推进及家兔离体回肠平滑肌的影响[J].河南大学学报(医学版),2012,31(1):12-14.
[19]张利.白芍的药理作用及现代研究进展[J].中医临床研究,2014,29(6):25-26.
[20]周进,吴正祥,杨九华,等.白芍总苷对TNBS诱导的大鼠实验性结肠炎的影响[J].胃肠病学,2009,14(3):154-158.
[21]刘振清,魏睦新.防风对大鼠和小鼠胃肠运动的抑制作用及机制研究[J].现代中西医结合杂志,2011,20(15):1840-1843.
[22]王影,刘文娟,崔瑛.黄连现代研究进展[J].中医学报,2014,29(11):1642-1645.
[23]Grider J R.CGRP as a transmitter in the sensory pathway mediating peristaltic reflex[J].Am J Physiol,1994,266(1):1139-1145.
[24]王巍峰,杨云生,孙刚,等.肠易激综合征大鼠模型脊髓后角神经递质表达的改变[J].胃肠病学和肝病学杂志,2006,15(4):405-408.
[25]Husum H,Van K D,Termeer E,et al.Topiramate normalizes hippocampal NPY-LI in flinders sensitive line'depressed'rats and upregulates NPY,galanin,and CRH-LI in the hypothalamus:implications for mood-stabilizing and weight loss-inducing effects[J].Neuropsychopharmacology,2003,28(7):1292-1299.
[26]程晓雯,林中,郑清华,等.重症急性胰腺炎伴胃肠动力障碍大鼠结肠黏膜下血管活性肠肽神经元的变化[J].南京医科大学学报(自然科学版),2012,32(2):183-187.