目的 探讨人参健脾丸联合复方嗜酸乳杆菌片治疗腹泻型肠易激综合征的临床疗效。方法 选取2022年8月—2023年8月南京市溧水区中医院治疗的158例腹泻型肠易激综合征患者为研究对象，依据用药方案不同将患者分为对照组和治疗组，每组79例。对照组口服复方嗜酸乳杆菌，2片/次，3次/d。在对照组治疗的基础上，治疗组口服人参健脾丸，2丸/次，2次/d。两组均进行4周治疗。比较两组患者的临床疗效、相关评分、肠道菌群和血清炎症因子水平。结果 相较于对照组的总有效率84.81%，治疗组的总有效率94.94%更高（P<0.05）。治疗后，两组视觉模拟评分量表（VAS）、Bristol和肠易激综合征症状严重程度量表（IBS-SSS）评分均降低（P<0.05），且治疗组的各项评分显著低于对照组（P<0.05）。治疗后，两组双歧杆菌、乳酸杆菌数量均增加，肠杆菌、肠球菌数量均减少（P<0.05），治疗组双歧杆菌、乳酸杆菌数量明显高于对照组，肠杆菌、肠球菌数量明显低于对照组（P<0.05）。治疗后，两组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素（IL）-1β、IL-6水平均降低（P<0.05），且治疗组血清炎症因子水平显著低于对照组（P<0.05）。结论 在复方嗜酸乳杆菌片基础上加用人参健脾丸治疗腹泻型肠易激综合征的疗效显著，可改善临床症状，调节肠道菌群平衡，降低机体炎症反应。

Objective To explore the efficacy of Renshen Jianpi Pills combined with Compound Eosinophil-Lactobacillus Tablets in treatment of diarrhea type irritable bowel syndrome. Methods 158 Patients with diarrhea predominant irritable bowel syndrome treated in Nanjing Lishui District Hospital of Traditional Chinese Medicine from August 2022 to August 2023 were selected as the study subjects, and were divided into control group（79 cases） and treatment group（79 cases） according to different medication regimens. The control group took Compound Eosinophil-Lactobacillus Tablets orally, 2 tablets/time, 3 times daily. On the basis of the control group, the treatment group took Renshen Jianpi Pills orally, 2 pills/time, twice daily. Two groups were treated for 4 weeks. The clinical efficacy, related scores, intestinal flora, and serum inflammatory factor levels between two groups were compared. Results The total effective rate of the treatment group was 94.94%, which was higher than 84.81% of the control group（P＜0.05）. After treatment, VAS, Bristol, and IBS-SSS scores of two groups were significantly decreased（P＜0.05）, and the scores of the treatment group were significantly lower than those of the control group（P＜0.05）. After treatment, the number of Bifidobacterium and Lactobacillus in both groups were increased, while the number of Escherichia coli and Enterococcus were decreased（P＜0.05）. The number of Bifidobacterium and Lactobacillus in the treatment group was significantly higher than those in the control group, while the number of Escherichia coli and Enterococcus was significantly lower than those in the control group（P＜0.05）. After treatment, the levels of serum TNF-α, IL-1β, and IL-6 in btwo groups were significantly decreased（P＜0.05）, and the levels of serum inflammatory factors in the treatment group were significantly lower than those in the control group（P＜0.05）. Conclusion Renshen Jianpi Pills combined with Compound Eosinophil-Lactobacillus Tablets has a significant therapeutic effect on diarrhea predominant irritable bowel syndrome, which can improve clinical symptoms, regulate intestinal microbiota balance, and reduce the body’s inflammatory response.

R975

江苏省药学会-奥赛康医院药学基金科研项目(A202114)