和胃解逆汤治疗便秘型肠易激综合征对血清5-羟色胺和降钙素基因相关肽的影响

马军　宋雨鸿　韩棉梅　张彦红

【摘要】 目的：探討和胃解逆汤治疗便秘型肠易激综合征（IBS-C）对血清5-羟色胺（5-HT）和降钙素基因相关肽（CGRP）的影响。方法：选取2016年3月-2018年6月本院收治的IBS-C患者80例，依据随机数字表法分为双药组和单药组，每组40例。单药组给予马来酸曲美布汀治疗，双药组在此基础上给予和胃解逆汤治疗，比较两组血清5-HT、CGRP和临床症状、疗效、不良反应。结果：治疗3 d后，两组血清5-HT、CGRP水平均明显低于治疗前，且双药组治疗3 d后血清5-HT、CGRP水平均明显低于单药组，差异均有统计学意义（P<0.05）。治疗3 d后，两组腹胀腹痛、便秘等症状评分均明显低于治疗前，且双药组治疗3 d后腹胀腹痛、便秘等症状评分均明显低于单药组，差异均有统计学意义（P<0.05）。双药组治疗总有效率明显高于单药组，差异有统计学意义（字2=7.813，P=0.003）。两组不良反应发生率比较，差异无统计学意义（字2=0.105，P=0.745）。结论：和胃解逆汤治疗可有效改善IBS-C患者血清5-HT、CGRP和腹胀腹痛、便秘等症状，有利于提高治疗效果，且安全性好，值得临床推广。

【关键词】 和胃解逆汤; 便秘型肠易激综合征; 5-羟色胺; 降钙素基因相关肽

【Abstract】 Objective：To discuss the effect of Hewei Jieni Decoction on serum 5-hydroxytryptamine and calcitonin gene-related peptide in the treatment of constipation-predominant irritable bowel syndrome（IBS-C）.Method：80 patients with IBS-C were selected from March 2016 to June 2018 in our hospital，according to the random number table，the patients were divided into double drug group and single drug group，with 40 cases in each group.Single drug group was treated with Trimebutine Maleate，and double drug group was treated with Hewei Jieni Decoction.Serum 5-HT，CGRP and clinical symptoms，efficacy and adverse reactions were compared between the two groups.Result：After treatment for 3 days，serum 5-HT and CGRP levels in both groups were significantly lower than those before treatment，serum 5-HT and CGRP levels in the double drug group were significantly lower than those in the single drug group，with statistically significant differences（P<0.05）.After treatment for 3 days，the scores of symptoms such as abdominal distension，pain and constipation in both groups were significantly lower than those before treatment，and the scores of symptoms such as abdominal distension，pain and constipation in the double drug group were significantly lower than those in the single drug group，with statistically significant differences（P<0.05）.The total effective rate of the double drug group was significantly higher than that of the single drug group，the difference was statistically significant（字2=7.813，P=0.003）.There was no statistically significant difference in the incidence of adverse reactions between the two groups（字2=0.105，P=0.745）.Conclusion：Hewei Jieni Decoction can effectively improve serum 5-HT，CGRP，abdominal distension，abdominal pain，constipation and other symptoms of patients with IBS-C，which is conducive to improve the treatment effect，and has good safety，worthy of clinical promotion.

【Key words】 Hewei Jieni Decoction; Constipation irritable bowel syndrome; 5-serotonin; Calcitonin gene-related peptide

First-authors address：The First Peoples Hospital of Guangzhou City，Guangzhou 510180，China

doi：10.3969/j.issn.1674-4985.2019.08.017

便秘型肠易激综合征（IBS-C）是临床常见的内科疾病之一，其发病机制较为复杂，可能与饮食、遗传、肠道动力异常等因素有关，可导致患者各种腹部不适症状（腹痛、腹胀、便秘），严重影响患者的正常生活。目前，临床主要通过常规对症治疗及口服马来酸曲美布汀治疗，可有效控制患者病情发展，但可能由于患者的病情程度不一，导致其疗效欠佳[1-2]。据相关文献报道，通过改善血清5-羟色胺（5-HT）和降钙素基因相关肽（CGRP）可能对提高治疗效果有帮助[3]。同时也有研究显示，和胃解逆汤是温胃散寒的经典药方，具有温中散寒，缓急止痛之功效，但该药方对血清5-HT、CGRP的影響还有待进一步研究[4]。对此，本研究通过给予IBS-C患者和胃解逆汤治疗，探讨其对IBS-C患者的血清5-HT、CGRP影响，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年3月-2018年6月广州市第一人民医院IBS-C患者80例，纳入……