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目的探讨双歧三联活菌胶囊联合莫沙必利片对便秘型肠易激综合征(IBS-C)患者血清胃肠激素水平的影响及疗效。方法将内科门诊治疗的IBS-C患者72例随机分为联合组(n=36例)和对照组(n=36例)。联合组患者予以双歧三联活菌胶囊(420 mg/次,3次/d,温开水口服)联合莫沙必利片(5 mg/次,3次/d,饭前半小时服用)治疗8周,对照组患者予以单纯的莫沙必利片治疗,剂量、方法与疗程均同联合组。观察并记录两组患者治疗前后血清血管活性肠肽(VIP)和一氧化氮(NO)水平的变化,并评估其临床效果及药物不良反应。结果治疗8周后,两组患者血清VIP和NO水平较前均有不同程度下降(P<0.05或P<0.01),且联合组下降幅度较对照组更明显(P<0.05);联合组患者临床总有效率明显优于对照组(X~2=4.18,P<0.05);两组患者治疗中共出现不良反应8例,其中对照组5例,联合组3例,症状较轻,两组不良反应比较差异无统计学意义(X~2=0.14,P>0.05)。结论双歧三联活菌胶囊联合莫沙必利片治疗IBS-C患者的疗效较显著,两者具有协同增效作用,能明显改善患者便秘症状,其安全性较佳,作用机制可能与其能降低血清VIP和NO水平,纠正血清胃肠激素水平异常,从而改善其胃肠道动力功能密切相关。
Objective To investigate the effects and clinical effects of bifid triple-viable capsule combined with mosapride on serum gut-gut hormone in patients with constipation-induced irritable bowel syndrome (IBS-C). Methods 72 patients with IBS-C treated by internal medicine were randomly divided into combined group (n = 36) and control group (n = 36). Patients in the combined group were treated with bifidobacterium triple viable capsules (420 mg / time, 3 times / d, warm warm water oral) combined with mosapride (5 mg / time, 3 times / d, taking half an hour before meals) for 8 weeks , The control group patients were treated with mosapride alone, the dose, methods and treatment are the same combination group. The changes of serum vasoactive intestinal peptide (VIP) and nitric oxide (NO) levels in both groups before and after treatment were observed and recorded. The clinical effect and adverse drug reaction were evaluated. Results After 8 weeks of treatment, the levels of serum VIP and NO in both groups were significantly lower than those in the control group (P <0.05 or P <0.01), and the decrease in the combination group was more significant than that in the control group (P <0.05) The total clinical effective rate was significantly better than that of the control group (X ~ 2 = 4.18, P <0.05). There were 8 adverse reactions in the two groups, of which 5 were in the control group and 3 in the combined group. The symptoms were mild and the two groups were poor There was no significant difference in response (X ~ 2 = 0.14, P> 0.05). Conclusion Bifid triple viable capsule combined with mosapride tablets in the treatment of IBS-C patients with more significant effect, both synergistic effect, can significantly improve the symptoms of patients with constipation, its safety is better, the mechanism may be associated with its ability to reduce Serum levels of VIP and NO, correct abnormal levels of serum gastrointestinal hormones, thereby improving their gastrointestinal motility is closely related.