摘要
目的选用胃肠动力调节剂、肠道微生态制剂以及三环类抗抑郁药，针对肠易激综合征（IBS）可能的病因干预治疗，观察单药、双药及三药治疗对IBS的影响，从治疗学的角度来验证可能存在的交互发病因素。’方法选择腹泻型IBS（D—IBS）患者103例，均符合罗马Ⅱ诊断标准，均经电子肠镜检查排除肠道器质性疾病，并能按规定要求完成随访。将103例患者按随机数字表法分为四组：单用匹维溴铵组26例，匹维溴铵＋双歧杆菌三联活菌组28例，匹维溴铵＋多塞平组25例，匹维溴铵＋双歧杆菌三联活菌＋多塞平组24例。用药前、用药后4周分别进行IBS症状评分、肠道菌群培养、SCL．90精神评分。结果匹维溴铵＋双歧杆菌三联活菌＋多塞平组总有效率[83．33％（20／24）]显著高于单用匹维溴铵组[65．38％（17／26）]、匹维溴铵＋双歧杆菌三联活菌组[71．43％（20／28）]、匹维溴铵＋多塞平组[68．00％（17／25）]，差异有统计学意义（P〈O．05）。四组用药后对五种肠道益生菌及精神症状都有明显影响，联合干预更为显著。结论针对IBS发病相关因素进行不同干预可有效治疗IBS患者，IBS发病因素互为影响，从治疗角度支持脑．肠互动在IBS发病中的重要作用。
Objective To evaluate the efficacy of stomach intestine power regulator, intestinal microecology preparation and tricyclic antidepressant treatment in irritable bowel syndrome （IBS）, and to investigate its pathological mechanism. Methods From November 2006 to November 2010, 103 patients with diarrhea-dominant IBS （D-IBS）, who fulfilled the Rome II criteria and were excluded from organic disease by enteroscope were divided into pinaverium bromide group （26 cases ）, pinaverium bromide ＋ bifid triple viable group （28 cases）, pinaverium bromide ＋ doxepin group （25 cases） and pinaverium bromide ＋ bifid triple viable ＋ doxepin group（24 eases ） by random digits table. The symptom grade, intestinal flora and SCL-90 was tested before treatment and 4 weeks after treatment. Results The total effective rate of pinaverium bromide ＋ bifid triple viable ＋ doxepin group was 83.33% （20/24）, significant higher than that in pinaverium bromide group [65.38%（17/26） ], pinaverium bromide ＋ bifid triple viable group [71.43% （ 20/28 ） ], pinaverium bromide ＋ doxepin group [ 68.00% （ 17/25 ） ] （ P 〈 0.05 ）. Five kinds of intestinal flora and psychiatric symptoms were improved in the four groups, and those in pinaverium bromide ＋ bifid triple viable ＋ doxepin group improved significantly. Conclusions To interfere the correlation factor of IBS can have better efficacy. There is a close relation between brain and gut in patients with IBS, which may be involved in the pathogenesis of IBS.
出处
《中国医师进修杂志》
2011年第19期1-4,共4页
Chinese Journal of Postgraduates of Medicine
关键词
肠易激综合征
药物疗法
联合
腹泻
微生态制剂
Irritable bowel syndrome
Drug therapy,combination
Diarrhea
Probiotics
作者简介
通信作者：吴蓉，Email：wurong001662@163．com
