醒脾升陷汤加味治疗腹泻型肠易激综合征的临床研究

目的 观察醒脾升陷汤加味治疗腹泻型肠易激综合征（irritable bowel syndrome with predominant diarrhea，IBS-D）的临床疗效，并探讨其作用机制。方法 将IBS-D患者随机分为对照组和治疗组，每组65例，对照组口服匹维溴铵片治疗，治疗组口服醒脾升陷汤加味治疗，两组均治疗4周。观察两组治疗前后临床症状积分、IBS症状严重程度评分量表（IBS bowel symptom severity scale，IBS-BSS）、IBS生活质量量表（IBS quality of life scale，IBS-QOL）及血清5-羟色胺（5-hydroxytryptamine，5-HT）、血管活性肽（vasoactive intestinal peptide，VIP）和P物质（substance P，SP）水平。结果 治疗组总有效率为92.31%，明显高于对照组总有效率81.54%（P<0.05）；治疗组可以降低临床症状积分、IBS-BSS积分，升高IBS-QOL积分（P<0.05），且治疗组改善上述指标均优于对照组（P<0.05）；治疗组可以降低血清5-HT、VIP、SP水平（P<0.05），且明显优于对照组（P<0.05）。结论 醒脾升陷汤加味治疗IBS-D临床疗效肯定，可改善患者的临床症状、缓解病情程度、提高生活质量，其机制可能与调节脑肠肽水平相关。

Clinical Research on Jiawei Xingpi Shengxian Decoction in Treating Irritable Bowel Syndrome with Predominant Diarrhea

Objective To observe the clinical efficacy of Jiawei Xingpi Shengxian Decoction in treating irritable bowel syndrome with predominant diarrhea (IBS-D) and to explore its mechanism. Methods Patients with IBS-D were randomly divided into the control group and the treatment group, with 65 cases in each group. The control group received oral administration of pivaviron bromide tablets. The treatment group received oral administration of Jiawei Xingpi Shengxian Decoction, and both groups were treated for 4 weeks. The clinical symptom scores, IBS bowel symptom severity scale (IBS-BSS), IBS quality of life scale (IBS-QOL) and serum serotonin 5-hydroxytryptamine (5-HT), vasoactive intestinal peptide (VIP) and substance P (SP) levels before and after treatment were compared. Results The total effective rate of the treatment group was 92.31%, which was significantly higher than the total effective rate of the control group (81.54%, P<0.05). The treatment group could reduce the clinical symptom score, IBS-BSS score and increase the IBS-QOL score (P<0.05). The improvement of the above indicators in the treatment group was better than the control group (P<0.05); the treatment group can reduce serum 5-HT, VIP, SP levels (P<0.05), and significantly better than the control group (P<0.05). Conclusion The clinical efficacy of Jiawei Xingpi Shengxian Decoction in the treatment of IBS-D is positive, which can improve the clinical symptoms, relieve the severity of the disease and improve the quality of life of patients with IBS-D. The mechanism may be related to the regulation of brain-gut peptide levels.