中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
19期
1-4
,共4页
吴蓉%姒健敏%王侃%陈淑洁
吳蓉%姒健敏%王侃%陳淑潔
오용%사건민%왕간%진숙길
肠易激综合征%药物疗法,联合%腹泻%微生态制剂
腸易激綜閤徵%藥物療法,聯閤%腹瀉%微生態製劑
장역격종합정%약물요법,연합%복사%미생태제제
Irritable bowel syndrome%Drug therapy,combination%Dianhea%Probiotics
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+多寒平组[68.00%(17/25)],差异有统计学意义(P<0.05).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.
目的 選用胃腸動力調節劑、腸道微生態製劑以及三環類抗抑鬱藥,針對腸易激綜閤徵(IBS)可能的病因榦預治療,觀察單藥、雙藥及三藥治療對IBS的影響,從治療學的角度來驗證可能存在的交互髮病因素.方法 選擇腹瀉型IBS(D-IBS)患者103例,均符閤囉馬Ⅱ診斷標準,均經電子腸鏡檢查排除腸道器質性疾病,併能按規定要求完成隨訪.將103例患者按隨機數字錶法分為四組:單用匹維溴銨組26例,匹維溴銨+雙歧桿菌三聯活菌組28例,匹維溴銨+多塞平組25例,匹維溴銨+雙歧桿菌三聯活菌+多塞平組24例.用藥前、用藥後4週分彆進行IBS癥狀評分、腸道菌群培養、SCL-90精神評分.結果 匹維溴銨+雙歧桿菌三聯活菌+多塞平組總有效率[83.33%(20/24)]顯著高于單用匹維溴銨組[65.38%(17/26)]、匹維溴銨+雙歧桿菌三聯活菌組[71.43%(20/28)]、匹維溴銨+多寒平組[68.00%(17/25)],差異有統計學意義(P<0.05).四組用藥後對五種腸道益生菌及精神癥狀都有明顯影響,聯閤榦預更為顯著.結論 針對IBS髮病相關因素進行不同榦預可有效治療IBS患者,IBS髮病因素互為影響,從治療角度支持腦.腸互動在IBS髮病中的重要作用.
목적 선용위장동력조절제、장도미생태제제이급삼배류항억욱약,침대장역격종합정(IBS)가능적병인간예치료,관찰단약、쌍약급삼약치료대IBS적영향,종치료학적각도래험증가능존재적교호발병인소.방법 선택복사형IBS(D-IBS)환자103례,균부합라마Ⅱ진단표준,균경전자장경검사배제장도기질성질병,병능안규정요구완성수방.장103례환자안수궤수자표법분위사조:단용필유추안조26례,필유추안+쌍기간균삼련활균조28례,필유추안+다새평조25례,필유추안+쌍기간균삼련활균+다새평조24례.용약전、용약후4주분별진행IBS증상평분、장도균군배양、SCL-90정신평분.결과 필유추안+쌍기간균삼련활균+다새평조총유효솔[83.33%(20/24)]현저고우단용필유추안조[65.38%(17/26)]、필유추안+쌍기간균삼련활균조[71.43%(20/28)]、필유추안+다한평조[68.00%(17/25)],차이유통계학의의(P<0.05).사조용약후대오충장도익생균급정신증상도유명현영향,연합간예경위현저.결론 침대IBS발병상관인소진행불동간예가유효치료IBS환자,IBS발병인소호위영향,종치료각도지지뇌.장호동재IBS발병중적중요작용.
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 entewscope 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 cases ) 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.
