目的 觀察楓蓼腸胃康顆粒聯(lián)合匹維溴銨治療腸易激綜合征的臨床效果。方法 選取2018年6月—2021年6月北京市平谷區(qū)醫(yī)院收治的96例腸易激綜合征患者，按隨機數(shù)字表法分為對照組和治療組，每組各48例。對照組口服匹維溴銨片，1片/次，3次/d。治療組在對照組基礎(chǔ)上口服楓蓼腸胃康顆粒，1袋/次，3次/d。兩組均連續(xù)治療4周。觀察兩組臨床療效，比較兩組治療前后腹痛視覺模擬量表（VAS）評分、大便Bristol評分、腸易激綜合征癥狀嚴重程度量表（IBS-SSS）總分、腸易激綜合征生活質(zhì)量量表（IBS-QOL）總分、直腸感覺功能參數(shù)[初始感覺閾值（FST）和最大耐受閾值（MDT）]及血清5-羥色胺（5-HT）、內(nèi)皮素-1（ET-1）、一氧化氮（NO）和γ干擾素（IFN-γ）水平。結(jié)果 治療后，治療組總有效率為95.8%，顯著高于對照組的83.3%（P<0.05）。治療后兩組腹痛VAS評分、大便Bristol評分、IBS-SSS評分和IBS-QOL評分均顯著降低（P<0.05）；治療后，治療組相關(guān)評分顯著低于對照組（P<0.05）。治療后，兩組直腸FST和MDT均較治療前顯著提高（P<0.05）；且治療后，治療組直腸FST和MDT均顯著高于對照組（P<0.05）。治療后，兩組血清5-HT、ET-1和IFN-γ水平均顯著低于治療前，血清NO水平均顯著高于治療前（P<0.05）；且治療后，治療組血清5-HT、ET-1及IFN-γ水平均顯著低于對照組，血清NO水平則顯著高于對照組（P<0.05）。結(jié)論 楓蓼腸胃康顆粒聯(lián)合匹維溴銨治療腸易激綜合征總體效果確切，能安全有效地減輕患者腹痛、腹瀉等癥狀，提高生活質(zhì)量，降低內(nèi)臟敏感性，糾正體內(nèi)腦腸肽分泌失衡，抑制機體炎癥反應，值得臨床推廣應用。

Objective To observe the clinical effect of Fenglian Changweikang Granules combined with pinaverium bromide in treatment of irritable bowel syndrome. Methods A total of 96 patients with irritable bowel syndrome admitted to Pinggu District Hospital of Beijing from June 2018 to June 2021 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were po administered with Pinaverium Bromide Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Fenglian Changweikang Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. The clinical efficacy of the two groups was observed. Visual analogue scale (VAS) score, stool Bristol score, total score of irritable bowel syndrome Symptom Severity Scale (IBS-SSS), total score of Irritable bowel syndrome Quality of Life Scale (IBS-QOL), rectal sensory function parameters[initial sensory threshold (FST) and maximum tolerance threshold (MDT)], serum serotonin (5-HT), endothelin-1 (ET-1), nitric oxide (NO) and interferon γ (IFN-γ) levels were compared between the two groups before and after treatment.Results After treatment, the total effective rate in the treatment group was 95.8%, significantly higher than that in the control group (83.3%, P< 0.05). After treatment, VAS score, stool Bristol score, IBS-SSS score and IBS-QOL score in two groups were significantly decreased (P < 0.05). After treatment, the correlation score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, rectal FST and MDT in two groups were significantly increased compared with before treatment (P < 0.05). After treatment, rectal FST and MDT in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum 5-HT, ET-1 and IFN-γ levels in two groups were significantly lower than before treatment, and the serum NO level was significantly higher than before treatment (P< 0.05). After treatment, the serum 5-HT, ET-1 and IFN-γ levels in the treatment group were significantly lower than those in the control group, while the serum NO level was significantly higher than that in the control group (P< 0.05). Conclusion Fenglian Changweikang Granules combined with pinaverium bromide has a definite overall effect in treatment of irritable bowel syndrome, and can safely and effectively relieve abdominal pain, diarrhea and other symptoms, improve the life quality, reduce visceral sensitivity, correct the imbalance of brain gut peptide secretion in the body, and inhibit the inflammatory response of the body, which is worthy of clinical application.

R975

北京市衛(wèi)生健康委員會科研課題項目（pgwjw2020-06）