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目的:观察酪酸梭菌活菌胶囊与乳果糖联合对便秘型肠易激综合征(IBS-C)血清胃肠激素水平的影响及疗效。方法:90例IBS-C患者随机分为联合组和对照组。对照组予乳果糖10 ml,po tid治疗;联合组在此基础上加用酪酸梭菌活菌胶囊0.6 g,bid,温开水送服。观察治疗前与治疗10周后两组患者血清血管活性肠肽(VIP)、一氧化氮(NO)水平和症状总评分变化,比较两组临床疗效及药品不良反应,并随访3个月及6个月观察复发情况。结果:治疗10周后,两组血清VIP和NO水平及症状总评分均明显下降(P<0.05和P<0.01),且联合组下降幅度较对照组更明显(P<0.05)。联合组临床总有效率较对照组更佳(P<0.05)。两组药品不良反应例数比较,差异无统计学意义(P>0.05)。随访3个月及6个月,联合组复发率均明显低于对照组(P<0.05)。讨论:酪酸梭菌活菌胶囊联合乳果糖用于IBS-C具有协同增效作用,安全性良好,并可降低其近期复发率,与其能降低血清VIP和NO水平,纠正血清胃肠激素水平异常有关。
Objective: To investigate the effect of Clostridium butyricum and lactulose combined with serum gastrointestinal hormones on constipation-induced irritable bowel syndrome (IBS-C) and its therapeutic effect. Methods: Ninety patients with IBS-C were randomly divided into combined group and control group. Control group to lactulose 10 ml, po tid treatment; combined group on this basis with Clostridium butyricum viable capsule 0.6 g, bid, warm water delivery. The levels of serum vasoactive intestinal peptide (VIP), nitric oxide (NO) and the total score of symptoms in both groups before and 10 weeks after treatment were observed. The clinical efficacy and adverse drug reactions were compared between the two groups and were followed up for 3 months and 6 Month to observe the recurrence. Results: After 10 weeks of treatment, the levels of serum VIP and NO and the total score of symptoms in both groups were significantly decreased (P <0.05 and P <0.01), and the decreasing extent in the combination group was more obvious than that in the control group (P <0.05). The total clinical effective rate in the combined group was better than that in the control group (P <0.05). Two groups of adverse drug reaction cases, the difference was not statistically significant (P> 0.05). Followed up for 3 months and 6 months, the recurrence rate of the combined group was significantly lower than that of the control group (P <0.05). Discussion: Clostridium butyricum capsule combined with lactulose has synergistic effect on IBS-C with good safety and can reduce its recent relapse rate, which can reduce the level of serum VIP and NO, and correct the abnormal level of serum gastrointestinal hormone related.