摘要
目的:探讨中药自组方剂黄术灌肠液对肠易激综合征(irritable bowel syndrome diarrhea,IBS)患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响及其治疗IBS的可能机制.方法:将60名IBS患者随机分为观察组和对照组,观察组运用黄术灌肠液灌肠治疗10 d,对照组给予匹维溴铵(得舒特)治疗10 d,其中观察组腹泻型肠易激综合征(irritable bowel syndrome diarrhea,IBS-D)18例,便秘型肠易激综合征(irritable bowel syndrome with constipation,IBS-C)12例,对照组中IBS-D 17例,IBS-C 13例,并记录治疗前后TNF-α浓度水平及症状积分.结果:(1)对于IBS-D患者,观察组治疗后腹泻积分、腹痛积分、腹胀积分及总积分、TNF-α水平明显低于治疗前(1.44±0.70 vs2.17±0.79;1.00±0.77 vs 2.22±0.55;0.73±0.67 vs 1.22±0.72;3.12±1.34 vs 5.61±1.42;42.73±11.45 vs 53.06±6.49,均P<0.05),对照组治疗后的腹痛积分低于治疗前(1.53±0.62 vs 2.24±0.56,P<0.05),但腹泻积分、腹胀积分及总积分、TNF-α水平与治疗前无明显差异(2.17±0.73 vs 2.24±0.75;1.35±0.49vs 1.29±0.69;5.00±1.71 vs 5.76±1.30;44.34±10.25 vs 50.00±6.75,均P<0.05).(2)对于IBS-C患者,观察组治疗后便秘、腹痛、腹胀积分及总积分明显低于治疗前(1.42±0.52 vs2.08±0.79;1.17±0.71 vs 2.17±0.58;0.72±0.52 vs 1.17±0.50;1.08±1.00 vs 5.42±3.08,均P<0.05),但TNF-α水平与治疗前无明显差异(23.89 pg/mL±5.92 pg/mL vs 23.94 pg/mL±4.62 pg/mL,P<0.05),对照组治疗后腹痛积分低于治疗前积分(1.46±0.66 vs 2.23±0.60,P<0.05),而治疗后的便秘积分、腹胀积分及总积分、TNF-α水平与治疗前无明显差异(2.08±0.76 vs 2.15±0.80;1.30±0.48 vs 1.23±0.73;4.77±1.09vs 5.62±1.26;22.87 pg/mL±1.64 pg/mLvs 23.53 pg/mL±4.53 pg/mL,均P<0.05).结论:黄术灌肠液能有效改善肠易激综合征的症状,并与血清TNF-α浓度水平调节有关.
AIM： To investigate the effects of Chinese medicine Huangshu enema （HSE） on the level of tumor necrosis factor-α （TNF-α） in serum of patients with irritable bowel syndrome （IBS） and to explore the underlying mechanism.
METHODS： Sixty IBS patients were randomly divided into an observation group and a control group. The observation group was given Huangshu enema for 10 d, and the control group was given pinaverium bromide tablets for 10 d. The observation group included 18 patients with IBS-D （IBS with diarrhea）, 12 patients with IBS-C （IBS with constipation）, while the control group included 17 patients with IBS-D and 13 patients with IBS-C. Serum levels of TNF-α and symptom score were measured before and after treatment.
RESULTS： For patients with IBS-D, diarrhea score, abdominal pain score, abdominal distention score, total symptom score and serum level of TNF-α after treatment were significantly lower than those before treatment in the observation group （1.44 ± 0.70 vs 2.17 ± 0.79; 1.00 ± 0.77 vs 2.22 ± 0.55; 0.73 ± 0.67 vs 1.22 ± 0.72; 3.12 ± 1.34 vs 5.61 ± 1.42; 42.73 ± 11.45 vs 53.06 ± 6.49, all P 〈 0.05）; abdominal pain score after treatment was lower than that before treatment in the control group （1.53 ± 0.62 vs 2.24 ± 0.56, P 〈 0.05）, but the diarrhea score, abdominal distension score, total symptom score and serum level of TNF-α did not differ significantly between before and after treatment （2.17 ± 0.73 vs 2.24 ± 0.75; 1.35 ± 0.49 vs 1.29 ± 0.69; 5.00 ± 1.71 vs 5.76 ± 1.30; 44.34 ± 10.25 vs 50.00 ± 6.75, all P 〉 0.05）. For patients with IBS-C, constipation score, abdominal pain score, abdominal distention score and total symptom score after treatment were significantly lower than those before treatment in the observation group （1.42 ± 0.52 vs 2.08 ± 0.79; 1.17 ± 0.71 vs 2.17 ± 0.58; 0.72 ± 0.52 vs 1.17 ± 0.50; 1.08 ± 1.00 vs 5.42 ± 3.08, all P 〈 0.05）, but serum level of TNF-α showed no significant difference between
出处
《世界华人消化杂志》
CAS
北大核心
2014年第1期144-148,共5页
World Chinese Journal of Digestology
基金
南京军区"十一五"医药卫生科研基金资助项目
No.09M A075~~
