摘要
目的:通过观察腹泻型肠易激综合征临床症状、血浆及结肠黏膜Ghrelin变化,探讨半夏泻心汤治疗腹泻型肠易激综合征的可能机制。方法:采用前瞻性、随机、平行对照设计,将120例符合诊断标准、纳入标准的腹泻型IBS患者,按1∶1随机分为两组,每组60例。治疗组予半夏泻心汤处理;对照组予得舒特处理,连续4周。记录治疗前、治疗2周、治疗4周后两组患者腹痛、腹部不适及大便性状等症状变化,分别应用ELISA和免疫组化技术检测治疗前、后患者血浆及结肠组织Ghrelin变化。结果:基于总体疗效结合主要效应指标改善分析,治疗组疗效与对照组相近,治疗组总有效率为83.33%,对照组总有效率为80%。治疗前,患者血浆及结肠黏膜Ghrelin呈高表达变化,两组比较无明显差异(P>0.05);治疗后,治疗组血浆及结肠黏膜Ghrelin表达呈下降趋势,与治疗前比较有统计学意义(P<0.05)。对照组治疗后血浆及结肠黏膜Ghrelin表达未见明显变化,与治疗前比较,无统计学意义(P>0.05)。治疗组与对照组治疗后Ghrelin变化比较,有统计学意义(P<0.05)。结论:半夏泻心汤可能通过影响Ghrelin的释放,调节胃肠运动功能,从而发挥缓解腹痛、腹部不适,改善大便性状的效应。
Objective： To discuss the mechanism of Banxia Xiexin Decoction treating diarrhea-predominated irritable bowel syndrome（D-IBS） on the basis of the expression of Ghrelin in serum and colon mucosa.Methods： It is a prospective,randomized,control trial.According to diagnostic criteria and selection criteria,120 patients are randomly divided into two equal groups.Such as group 1： intervention group,group 2： control group.Each group was given Banxia Xiexin Decoction and pinaverium respectively.The period of treatment was four weeks.After treatment for 2w and 4w,observing and collecting the clinical manifestations which include abdominal pain,abdominal distension,and stool characters.The changes of serum and colon mucosa Ghrelin were detected by ELISA and Immunohistochemistry.Results： The total effective rate in intervention group is 83.33%.However,that effective rate in control group is 80%.There is no significant difference in total effect between the two groups（P0.05）.Before treatment,the expression of Ghrelin in serum and colon mucosa is on the increment.There is no significant difference between two groups before treatment.Meanwhile,after treatment,the concentration of Ghrelin in intervention group is on the decline.The difference between intervention group and control group in the changes of Ghrelin is obvious（P0.05）.Conclusions： Banxia Xiexin Decoction maybe exert a treatment effect on D-IBS by regulating secretion of Ghrelin,which can improve the gastrointestinal function.
出处
《中华中医药学刊》
CAS
2011年第11期2588-2591,共4页
Chinese Archives of Traditional Chinese Medicine
关键词
半夏泻心汤
腹泻型肠易激综合征
GHRELIN
Banxia Xiexin Decoction
diarrhea predominated irritable bowel syndrome
Ghrelin
作者简介
詹程腼（1970-），女，浙江杭州人，副主任中医师，硕士，研究方向：中西医结合治疗消化系统疾病研究。
通讯作者：张涛（1976-），男，江西井冈山人，副教授，博士后，研究方向：中医药防治脾胃病研究。
