Effect of Xianhecao-Baizhu in treatment of diarrhea irritable bowel syndrome with spleen deficiency and dampness type
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摘要:目的
探讨仙鹤草-白术治疗腹泻型肠易激综合征脾虚湿阻证的临床效果及机制。
方法将120例患者随机分为治疗组和对照组，每组60例。治疗组予以仙鹤草-白术汤剂口服治疗，对照组予以培菲康联合蒙脱石散口服治疗，疗程1个月。观察治疗后2组主要症状改善情况、综合疗效以及治疗前后血清5-羟色胺(5-HT)、白细胞介素-1β(IL-1β)水平。
结果治疗组腹胀或腹痛症状改善率高于对照组，差异有统计学意义(P < 0.05)。治疗组总有效率高于对照组，差异有统计学意义(P < 0.05)。2组治疗后血清5-HT、IL-1β均下降，但治疗组较对照组下降更明显，差异有统计学意义(P < 0.05)。治疗后, 2组腹痛积分和腹泻积分下降，且治疗组较对照组下降更明显，差异有统计学意义(P < 0.05)。2组治疗后汉密尔顿焦虑量表(HAMA)评分和肠易激综合征生活质量量表(IBS-QOL)评分均较治疗前下降，且治疗组HAMA评分和IBS-QOL评分低于对照组，差异有统计学意义(P < 0.01)。
结论仙鹤草-白术可能通过降低5-HT、IL-1β的分泌水平，达到治疗腹泻型肠易激综合征脾虚湿阻证的作用。
Abstract:ObjectiveTo explore the clinical effect and mechanism of Xianhecao-Baizhu in treatment of diarrhea irritable bowel syndrome with spleen deficiency and dampness type.
MethodsA total of 120 patients were randomly divided into treatment group and control group, with 60 cases in each group. The treatment group was given Xianhecao-Baizhu Decoction orally, and the control group was given pefican combined with montmorillonite powder orally. The course of treatment lasted for 1 month. The improvement of main symptoms, comprehensive efficacy, serum levels of 5-HT and IL-1β before and after treatment in two groups were observed.
ResultsThe improvement rate of abdominal distension or abdominal pain in the treatment group was higher than that in the control group (P < 0.05). The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, serum 5-hydroxytryptamine (5-HT) and interleukin -1β(IL-1β) levels were decreased in both groups, but the decrease was more obvious in the treatment group than in the control group (P < 0.05). After treatment, abdominal pain scores and diarrhea scores in the two groups decreased, and the decrease in the treatment group was more obvious than that in the control group (P < 0.05). The scores of Hamilton Anxiety Scale (HAMA) and IBS Quality of Life Scale (IBS-QOL) in the two groups after treatment were decreased compared with those before treatment, and the HAMA and IBS-QOL scores in the treatment group were lower than those in the control group (P < 0.01).
ConclusionXianhecao-Baizhu can treat diarrhea irritable bowel syndrome with spleen deficiency and dampness type by reducing the secretion levels of 5-HT and IL-1β.
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表 1 2组患者基线资料比较(x±s)
组别 n 年龄/岁 病程/年 IBS-SSS评分/分 体质量指数/(kg/m2) 治疗组 60 42.85±7.52 8.13±2.34 245.46±78.66 21.67±1.63 对照组 60 44.13±7.65 7.96±2.25 268.88±81.25 21.39±1.71 IBS-SSS: 肠易激综合征临床症状严重程度评分系统。 
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表 3 2组治疗前后血清5-HT、IL-1β水平比较(x±s)
ng/L 指标 治疗组(n=60) 对照组(n=60) 治疗前 治疗后 治疗前 治疗后 5-HT 38.96±6.24 22.37±4.36*# 37.84±5.97 26.31±5.03* IL-1β 96.23±3.45 22.35±2.68*# 93.86±4.12 29.37±3.31* 5-HT: 5-羟色胺; IL-1β: 白细胞介素-1β。与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 4 2组患者治疗前后腹痛、腹泻积分比较(x±s)
分 积分 治疗组(n=60) 对照组(n=60) 治疗前 治疗后 治疗前 治疗后 腹痛积分 2.16±0.41 0.31±0.49*# 2.14±0.37 0.81±0.70* 腹泻积分 4.23±0.79 0.65±0.89*# 4.26±0.81 1.75±0.92* 与治疗前比较, *P < 0.05; 与对照组比较, #P < 0.05。
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表 5 2组患者治疗前后HAMA评分和IBS-QOL评分比较(x±s)
分 评分 时点 治疗组(n=60) 对照组(n=60) HAMA评分 治疗前 20.21±6.27 19.98±5.82 治疗后 9.83±6.01**## 14.11±5.82** IBS-QOL评分 治疗前 111.40±19.75 112.28±20.42 治疗后 64.45±10.57 79.31±11.88 与治疗前比较, **P < 0.01; 与对照组比较, ##P < 0.01。
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