目的 探讨痛泻宁颗粒联合奥替溴铵片治疗腹泻型肠易激综合征的治疗效果。方法 选取2021年6月—2023年5月秦皇岛市北戴河医院收治80例腹泻型肠易激综合征患者，按随机数字表将患者分为对照组和治疗组组，每组40例。对照组口服奥替溴铵片，1片/次，3次/d。治疗组在对照组治疗的基础上口服痛泻宁颗粒，1袋/次，3次/d。两组患者连续治疗4周。比较两组的临床疗效、症状消失时间、腹泻症状、血清指标。结果 治疗后，治疗组总有效率为95.00%，对照组总有效率为75.00%，组间比较差异显著（P＜0.05）。治疗后，治疗组患者腹痛、腹泻、腹胀消失时间均短于对照组（P＜0.05）。治疗后，两组排便频率评分、大便性状评分均比治疗前小（P＜0.05）；治疗组患者排便频率评分、大便性状评分比对照组小（P＜0.05）。治疗后，两组的血清趋化因子C-C-基元配体16（CCL-16）、白细胞介素-17A（IL-17A）水平均低于治疗前，血清白细胞介素-12（IL-12）水平高于治疗前（P＜0.05）；治疗组的血清CCL-16、IL-17A水平低于对照组，血清IL-12水平高于对照组（P＜0.05）。治疗后，两组血清二胺氧化酶（DAO）、D-乳酸（D-LAC）水平低于治疗前（P＜0.05）；治疗组血清DAO、D-LAC水平低于对照组（P＜0.05）。结论 腹泻型肠易激综合征患者经痛泻宁颗粒联合奥替溴铵片治疗，疗效和症状改善效率明显提高，进一步减轻炎症反应，降低肠道屏障功能损伤。

Objective To investigate the therapeutic effect of Tongxiening Granules combined with Otilonium Bromide Tablets in treatment of diarrheal irritable bowel syndrome. Methods Patients (80 cases) with diarrheal irritable bowel syndrome in Qinhuangdao Beidaihe Hospital from June 2021 to May 2023 were divided into control and treatment groups according to the random number table, and each group had 40 cases. Patients in the control group were po administered with Otilonium Bromide Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tongxiening 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 efficacies, the symptom disappearance time, diarrhea symptoms, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, while the total effective rate of the control group was 75.00%, with a significant difference between the groups (P< 0.05). After treatment, the disappearance time of abdominal pain, diarrhea, and abdominal distension in the treatment group was shorter than that in the control group (Pv < 0.05). After treatment, the scores of defecation frequency and stool trait in two groups were lower than those before treatment (P < 0.05), and the scores of defecation frequency and stool trait of the treatment group were lower than those of the control group (P < 0.05). After treatment, the serum levels of CCL-16 and IL-17A were lower than before treatment, but the serum levels of IL-12 were higher than before treatment (P < 0.05). The serum levels of CCL-16 and IL-17A in the treatment group were lower than those in the control group, but the serum levels of IL-12 were higher than those in the control group (P < 0.05). After treatment, the serum levels of DAO and D-LAC were lower than those before treatment (P < 0.05), and the serum levels of DAO and D-LAC in the treatment group were lower than those in the control group (P < 0.05). Conclusion Tongxiening Granules combined with Otilonium Bromide Tablets can significantly improve the therapeutic effect in patients with diarrheal irritable bowel syndrome, further reduce the inflammatory response and intestinal barrier function damage.