目的 观察枫蓼肠胃康颗粒联合匹维溴铵治疗肠易激综合征的临床效果。方法 选取2018年6月—2021年6月北京市平谷区医院收治的96例肠易激综合征患者，按随机数字表法分为对照组和治疗组，每组各48例。对照组口服匹维溴铵片，1片/次，3次/d。治疗组在对照组基础上口服枫蓼肠胃康颗粒，1袋/次，3次/d。两组均连续治疗4周。观察两组临床疗效，比较两组治疗前后腹痛视觉模拟量表（VAS）评分、大便Bristol评分、肠易激综合征症状严重程度量表（IBS-SSS）总分、肠易激综合征生活质量量表（IBS-QOL）总分、直肠感觉功能参数[初始感觉阈值（FST）和最大耐受阈值（MDT）]及血清5-羟色胺（5-HT）、内皮素-1（ET-1）、一氧化氮（NO）和γ干扰素（IFN-γ）水平。结果 治疗后，治疗组总有效率为95.8%，显著高于对照组的83.3%（P<0.05）。治疗后两组腹痛VAS评分、大便Bristol评分、IBS-SSS评分和IBS-QOL评分均显著降低（P<0.05）；治疗后，治疗组相关评分显著低于对照组（P<0.05）。治疗后，两组直肠FST和MDT均较治疗前显著提高（P<0.05）；且治疗后，治疗组直肠FST和MDT均显著高于对照组（P<0.05）。治疗后，两组血清5-HT、ET-1和IFN-γ水平均显著低于治疗前，血清NO水平均显著高于治疗前（P<0.05）；且治疗后，治疗组血清5-HT、ET-1及IFN-γ水平均显著低于对照组，血清NO水平则显著高于对照组（P<0.05）。结论 枫蓼肠胃康颗粒联合匹维溴铵治疗肠易激综合征总体效果确切，能安全有效地减轻患者腹痛、腹泻等症状，提高生活质量，降低内脏敏感性，纠正体内脑肠肽分泌失衡，抑制机体炎症反应，值得临床推广应用。

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

北京市卫生健康委员会科研课题项目（pgwjw2020-06）