目的 探究降脂通便胶囊联合莫沙必利治疗便秘型肠易激综合征患者的临床效果。方法 纳入2023年3月—2024年3月首都医科大学附属北京康复医院收治的便秘型肠易激综合征患者60例，采用随机数字表法分为对照组（n=30）与治疗组（n=30）。对照组餐前口服枸橼酸莫沙必利片5 mg/次，每天3次；治疗组在此基础上加服降脂通便胶囊0.5 g/次，每天2次。两组均持续治疗4周。通过对比两组患者的临床效果，统计分析治疗前后中医证候评分、肠易激综合征生活质量量表（IBS-QOL）评分、血清5-羟色胺（5-HT）、血管活性肠肽（VIP）和神经肽Y（NPY）、肛管静息压和最大缩榨压水平。结果 治疗组总有效率（93.33%）显著高于对照组（70.00%）（P＜0.05）。经治疗，治疗组患者中医证候评分大幅度下降，而IBS-QOL评分明显上升（P＜0.05），且治疗组患者评分改善程度明显好于对照组（P＜0.05）。治疗后，两组患者血清5-HT、NPY水平较治疗前显著提升，而VIP水平显著降低（P＜0.05），且治疗组患者各指标改善明显好于对照组（P＜0.05）。经治疗，两组肛管静息压和最大缩榨压水平较治疗前明显升高（P＜0.05），且治疗组直肠动力学指标改善程度均胜于对照组（P＜0.05）。结论 降脂通便胶囊联合莫沙必利可协同改善便秘型肠易激综合征患者的临床症状、生活质量及肛肠动力学参数，同时有效调节胃肠激素平衡。

Objective To explore the therapeutic effect of Jiangzhi Tongbian Capsules combined with mosapride in treatment of constipated irritable bowel syndrome. Methods Patients (60 cases) with constipated irritable bowel syndrome in Beijing Rehabilitation Hospital Affiliated to Capital Medical University from March 2023 to March 2024 were randomly divided into control (30 cases) and treatment (30 cases) group. Patients in the control group were po administered with Mosapride Citrate Tablets, 5 mg/time, three times daily. Patients in the treatment group were po administered with Jiangzhi Tongbian Capsules on the basis of the control group, 0.5 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the TCM syndrome score and IBS-QOL score, serum 5-HT, VIP, and NPY levels, resting pressure and maximum squeeze pressure of anal canalin two groups before and after treatment were compared. Results After treatment, there was a statistically significant difference in the clinical total effective rate between the control group (70.00%) and the treatment group (93.33%, P < 0.05). After treatment, the TCM syndrome score in the treatment group was significantly decreased, while the IBS-QOL score was significantly increased (P < 0.05), and the improvement of the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum 5-HT and NPY levels in two groups were significantly increased compared with before treatment, while the VIP level was significantly decreased (P < 0.05), and the improvement of each index in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the resting pressure and maximum squeeze pressure levels of anal canal in two groups were significantly higher than before treatment (P < 0.05), and the improvement of rectal dynamics indicators in the treatment group was better than that in the control group (P < 0.05). Conclusion Jiangzhi Tongbian Capsules combined with moxapride can synergically improve the clinical symptoms, quality of life and anorectal dynamic parameters of patients with constipated irritable bowel syndrome, and can effectively regulate gastrointestinal hormone balance.

R975