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目的选用胃肠动力调节剂、肠道微生态制剂以及三环类抗抑郁药,针对IBS发病可能的病因干预治疗,观察单药、双药及三药治疗对腹泻型肠易激综合征(D-IBS)的临床疗效及交互治疗作用。方法选择D-IBS患者128例,均符合罗马Ⅱ标准,并经肠镜排除肠道器质性疾病,其中103例按规定要求完成。患者按用药分为以下4组:单用匹维溴铵(商品名:得舒特)组26例,匹维溴铵+双歧三联活菌(商品名:培菲康)组28例,匹维溴铵+多塞平组25例,匹维溴铵+双歧三联活菌+多塞平组24例。用药前后4周分别作IBS症状评分及SF-36生活质量评分。结果针对IBS可能的发病因素给于干预阻断治疗后,4组治疗前后自身对照在肠道症状的控制和生活质量的改善方面都有十分明显作用,联合干预则作用更明显;多塞平和双歧三联活菌对IBS患者生活活力及社会功能的影响效应存在协同作用(P<0.05);多塞平对缓解IBS患者躯体疼痛及提高情感职能起主效应(P<0.05)。结论针对IBS发病相关因素进行不同干预都可有效治疗IBS患者,IBS发病因素间互为影响,从治疗角度支持脑-肠互动在IBS发病中的重要作用。
Objective To select gastrointestinal motility regulators, gut microecological agents and tricyclic antidepressants for the possible etiological intervention in the pathogenesis of IBS. To observe the effects of single, double and triple drug treatment on diarrhea-predominant irritable bowel syndrome (D -IBS) clinical efficacy and interactive treatment. Methods 128 cases of D-IBS patients were selected, all of them were in accordance with the standard of Rome II. Intestinal organic diseases were excluded by colonoscopy, of which 103 cases were completed as required. The patients were divided into the following 4 groups by medication: 26 cases were treated with pinaverium bromide (trade name: Desiproxel), 28 cases were treated with pinaverium bromide and bifidobacterium triple viable (Peifukang) 25 cases of verapamil + doxepin group, pipivironium + bifidobacterium viable + 24 cases of doxepin group. Four weeks before and after treatment, IBS symptom score and SF-36 quality of life score respectively. Results The possible causes of IBS were significantly different from the control group before and after treatment in the control of intestinal symptoms and the improvement of the quality of life after the treatment intervention. The combination intervention was more effective. The combination of doxepin and bis (P <0.05). Docetaxel played a major role in alleviating the pain of body and improving the emotional function in patients with IBS (P <0.05). Conclusions Different interventions for the pathogenesis of IBS can effectively treat patients with IBS. The pathogenesis of IBS affects each other and supports the important role of brain-intestine interaction in the pathogenesis of IBS from the perspective of treatment.