目的 探讨奥替溴铵片联合双歧杆菌四联活菌片治疗腹泻型肠易激综合征的临床疗效。方法 选取2015年6月-2017年1月新乡市中心医院收治的腹泻性肠易激综合征患者126例为研究对象，按随机分组法将所有患者分为奥替溴铵组、双歧杆菌四联活菌组和联合组，每组各42例。奥替溴铵组口服奥替溴铵片，1片/次，3次/d。双歧杆菌四联活菌组口服双歧杆菌四联活菌片，3片/次，3次/d。联合组给予奥替溴铵片联合双歧杆菌四联活菌片，方法同上。3组患者均治疗2个月。观察3组的临床疗效，比较3组的消化道症状改善、血清细胞因子水平和生活质量量表（IBS-QOL）评分。结果 治疗后，奥替溴铵组、双歧杆菌四联活菌组和联合组总有效率分别为76.2%、69.0%、95.2%，联合组总有效率显著高于奥替溴铵组和双歧杆菌四联活菌组，总有效率比较差异有统计学意义（P<0.05）。治疗后，3组症状严重程度评分和症状频率评分均显著下降，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组这些观察指标明显低于奥替溴铵组和双歧杆菌四联活菌组，3组比较差异具有统计学意义（P<0.05）。治疗后，联合组大便次数恢复正常时间和大便性状恢复正常时间显著短于奥替溴铵组和双歧杆菌四联活菌组，比较差异有统计学意义（P<0.05）。治疗后，3组肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组这些观察指标明显低于奥替溴铵组和双歧杆菌四联活菌组，比较差异具有统计学意义（P<0.05）。治疗后，3组肠易激综合征IBS-QOL评分显著下降，生活质量评分量表（SF-36）评分显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组这些观察指标的改善程度明显优于奥替溴铵组和双歧杆菌四联活菌组，比较差异具有统计学意义（P<0.05）。结论 奥替溴铵片联合双歧杆菌四联活菌片治疗腹泻型肠易激综合征具有较好的临床疗效，可改善消化道症状，提高生活质量，调节TNF-α、IL-6和IL-8水平，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Otilonium Bromide Tablets combined with Bifidobacterium Quadruple Viable Tablets in treatment of diarrhea irritable bowel syndrome. Methods Patients (126 cases) with diarrhea irritable bowel syndrome in Xinxiang Central Hospital from June 2015 to January 2017 were randomly divided into otilonium bromide, bifidobacterium quadruple viable, and treatment groups, and each group had 42 cases. Patients in the otilonium bromide group were po administered with Otilonium Bromide Tablets, 1 tablet/time, three times daily. Patients in the bifidobacterium quadruple viable group were po administered with Bifidobacterium Quadruple Viable Tablets, 3 tablets/time, three times daily. Patients in the treatment group were given Otilonium Bromide Tablets and Bifidobacterium Quadruple Viable Tablets, usage and dosage were the same as the above. Patients in three groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and improvements of digestive symptoms, serum cytokine levels, quality of life scores in three groups were compared. Results After treatment, the clinical efficacies in the otilonium bromide, bifidobacterium quadruple viable, and treatment groups were 76.2%, 69.0%, and 95.2%, respectively, and there was difference among three groups (P<0.05). After treatment, symptom severity scores and symptom frequency scores in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the otilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). After treatment, the recovery time of stool frequency and stool traits in the treatment group were significantly shorter than those in the otilonium bromide and bifidobacterium quadruple viable groups, and there was difference among three groups (P<0.05). After treatment, the levels of TNF-α, IL-6, and IL-8 in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in theotilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). After treatment, the IBS-QOL scores in three groups were significantly decreased, but the SF-36 scores in three groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the otilonium bromide and bifidobacterium quadruple viable groups, with significant difference among three groups (P<0.05). Conclusion Otilonium Bromide Tablets combined with Bifidobacterium Quadruple Viable Tablets has clinical curative effect in treatment of diarrhea irritable bowel syndrome, can improve digestive symptoms, enhance the quality of life, and regulate the levels of TNF-α, IL-6, and IL-8, which has a certain clinical application value.