CAJ | 학술논문

目的：观察参苓白术丸治疗肠易激综合征（IBS）的临床效果。方法90例 IBS 患者采用随机数字法分为中成药组和西药组，每组45例。中成药组给予参苓白术丸治疗，西药组给予蒙脱石散治疗。比较两组患者治疗前后的临床症状评分、肠道微生物和血清炎性因子变化，采用问卷调查评价临床症状，用培养法测定粪便中乳酸杆菌、双歧杆菌、肠杆菌和酵母菌，血酶标免疫吸附测定法（ELISA）检测血清 IL-10、IL-18和TNF-α水平。结果两组患者治疗前粪便中厌氧菌减少、需氧菌增多，患者血清 IL-18和 TNF-α含量升高， IL-10含量降低。中成药组干预8周后患者肠道厌氧菌[（B／E 值1．07±0．49）]和血清 IL-10[（43．65±9．52）mg／L]含量上升，需氧菌[（B／E 值1．07±0．49）]、IL-18[（82．06±21．07）mg／L]和 TNF-α[（28．44±10.20）mg／L]含量下降，其中 IL-18下降最明显，与西药组比较差异有统计学意义（t ＝9．926，P ＜0．01）。两组均无不良反应发生。结论参苓白术丸能改善肠道微环境，促进益生菌生长和重塑肠道生物屏障功能，降低促炎性因子水平和提升抑炎因子水平，具有较好的临床效果。
목적：관찰삼령백술환치료장역격종합정（IBS）적림상효과。방법90례 IBS 환자채용수궤수자법분위중성약조화서약조，매조45례。중성약조급여삼령백술환치료，서약조급여몽탈석산치료。비교량조환자치료전후적림상증상평분、장도미생물화혈청염성인자변화，채용문권조사평개림상증상，용배양법측정분편중유산간균、쌍기간균、장간균화효모균，혈매표면역흡부측정법（ELISA）검측혈청 IL-10、IL-18화TNF-α수평。결과량조환자치료전분편중염양균감소、수양균증다，환자혈청 IL-18화 TNF-α함량승고， IL-10함량강저。중성약조간예8주후환자장도염양균[（B／E 치1．07±0．49）]화혈청 IL-10[（43．65±9．52）mg／L]함량상승，수양균[（B／E 치1．07±0．49）]、IL-18[（82．06±21．07）mg／L]화 TNF-α[（28．44±10.20）mg／L]함량하강，기중 IL-18하강최명현，여서약조비교차이유통계학의의（t ＝9．926，P ＜0．01）。량조균무불량반응발생。결론삼령백술환능개선장도미배경，촉진익생균생장화중소장도생물병장공능，강저촉염성인자수평화제승억염인자수평，구유교호적림상효과。
Objective To observe the clinic efficacy of Shenling Baizhu Pill on patients with irritable bowel syndrome(IBS).Methods Ninety patients with IBS were collected and divided into Chinese patent medicine group and western medicine group by random number method,45 patients in each group,the Chinese patent medicine group received Shenling Baizhu pill group treatment,the western medicine group was gave Smectite Powder treatment.The changes of clinical symptoms,intestinal tract microorganism and serum inflammatory factor of patients were observed and compared between two groups before and after treatment.The clinical symptoms was evaluated by questionnaire, the Lactobacillus,Bifidobacterium,enterobacteria and yeast were determined by cultivation,the levels of IL -10,IL -18 and TNF -αwere detected by enzyme linked immunosorbent assay(ELISA).Results Two groups before treat-ment of anaerobic bacteria in feces reduction,aerobic bacteria increased serum IL -18 and TNF -alpha content, increased,the content of IL -10 decreased.Shenling Baizhu Pill intervention for 8 weeks in patients with intestinal anaerobic bacteria[(B/E 1.07 ±0.49)]and serum IL -10[(43.65 ±9.52)mg/L]content increased,aerobic bacte-ria[(B/E 1.07 ±0.49)],IL -18[(82.06 ±21.07)mg/L]and TNF -alpha[(28.44 ±10.20)mg/L]decreased. The IL -18 decreased the most,was different with the western medicine group,there was a statistical significance(t =9.926,P <0.01).Two groups had no bad reaction.Conclusion Shenling Baizhu Pill can effectively regulates and improves the intestinal micro -environment,promote the growth of intestinal probiotics and remodeling the intestinal function of biological barrier,decrease the levels of proinflammatory factors and rise the anti -inflammatory factors level,which has a good clinic effect in treating IBS.