益气宣肺通便方对阴虚肠燥型功能性便秘患者血清炎性因子及胃肠激素的影响
|
摘要
目的探讨益气宣肺通便方对阴虚肠燥型功能性便秘患者血清炎性因子及胃肠激素的影响。方法选择2016年1月～2017年6月收治的阴虚肠燥型功能性便秘患者112例为研究对象,采用随机数字表法分为观察组和对照组各56例。对照组给予莫沙必利联合双歧杆菌三联活菌胶囊治疗,观察组在对照组基础上联合应用益气宣肺通便方治疗,随访1个月,比较两组患者临床疗效、临床症状、血清炎性因子、胃肠激素等指标。结果观察组总有效率(91.07%)明显高于对照组(75.00%)(χ~2=5.314,P<0.05);排便困难、大便性状积分明显低于对照组,排便时间明显短于对照组,排便频率明显多于对照组(t=20.806、8.570、13.056、20.273,P<0.01);血清白细胞介素-10(IL-10)含量明显高于对照组,肿瘤坏死因子-α(TNF-α)含量明显低于对照组(t=5.545、7.046,P<0.05);血清胃动素(MTL)、胃泌素(GAS)、血管活性肠肽(VIP)含量明显高于对照组(t=4.798、3.867、2.540,P<0.05)。结论益气宣肺通便方有助于改善阴虚肠燥型功能性便秘患者的临床症状,提高临床疗效,可能与抑制炎症反应、调节胃肠激素等因素有关。
Objective To investigate the effects of Yiqi Xuanfei Tongbian recipe on serum inflammatory factors and gastrointestinal hormones in the patients with functional constipation of Yin deficiency and intestinal dryness. Methods112 patients with functional constipation of Yin deficiency and intestinal dryness who were admitted from January 2016 to June 2017 were selected as study subjects. The random number table method was used to divide the patients into observation group and control group, with 56 cases in each group. The control group was given mosapride combined with Bifidobacterium triple live capsules. The observation group was given combined Yiqi Xuanfei Tongbian recipe on the basis of the control group. The patients were followed up for 1 month. The clinical efficacy, clinical symptoms,serum inflammatory factors, and gastrointestinal hormones were compared between the two groups. Results The total effective rate in the observation group was 91.07%, which was significantly higher than that in the control group(75.00%)(χ~2=5.314, P<0.05); Scores of difficulty in defecation and stool traits were significantly lower than those in the control group, the defecation time was significantly shorter than that in the control group, the frequency of defecation was significantly higher than that in the control group(t=20.806, 8.570, 13.056, 20.273, P<0.01); serum interleukin-10(IL-10) level was significantly higher than that in the control group, the content of tumor necrosis factor-α(TNF-α) was significantly lower than that in the control group(t=5.545, 7.046, P<0.05). Serum motilin(MTL), gastrin(GAS), and vasoactive intestinal peptide(VIP) were significantly higher than those in the control group(t=4.798, 3.867, 2.540, P<0.05).Conclusion Xuanfei Tongbian recipe can help to improve the clinical symptoms of patients with functional constipation of Yin deficiency and intestinal dryness and improve clinical curative effect, which may be related to factors such as inhibition of inflammatory reaction and regulation of gastrointestinal hormones.
Objective To investigate the effects of Yiqi Xuanfei Tongbian recipe on serum inflammatory factors and gastrointestinal hormones in the patients with functional constipation of Yin deficiency and intestinal dryness. Methods112 patients with functional constipation of Yin deficiency and intestinal dryness who were admitted from January 2016 to June 2017 were selected as study subjects. The random number table method was used to divide the patients into observation group and control group, with 56 cases in each group. The control group was given mosapride combined with Bifidobacterium triple live capsules. The observation group was given combined Yiqi Xuanfei Tongbian recipe on the basis of the control group. The patients were followed up for 1 month. The clinical efficacy, clinical symptoms,serum inflammatory factors, and gastrointestinal hormones were compared between the two groups. Results The total effective rate in the observation group was 91.07%, which was significantly higher than that in the control group(75.00%)(χ~2=5.314, P<0.05); Scores of difficulty in defecation and stool traits were significantly lower than those in the control group, the defecation time was significantly shorter than that in the control group, the frequency of defecation was significantly higher than that in the control group(t=20.806, 8.570, 13.056, 20.273, P<0.01); serum interleukin-10(IL-10) level was significantly higher than that in the control group, the content of tumor necrosis factor-α(TNF-α) was significantly lower than that in the control group(t=5.545, 7.046, P<0.05). Serum motilin(MTL), gastrin(GAS), and vasoactive intestinal peptide(VIP) were significantly higher than those in the control group(t=4.798, 3.867, 2.540, P<0.05).Conclusion Xuanfei Tongbian recipe can help to improve the clinical symptoms of patients with functional constipation of Yin deficiency and intestinal dryness and improve clinical curative effect, which may be related to factors such as inhibition of inflammatory reaction and regulation of gastrointestinal hormones.
引文
[1]Reck-Burneo CA,Vilanova-Sanchez A,Gasior AC,et al.A structured bowel management program for patients with severe functional constipation can help decrease emergency department visits,hospital admi ssions,and healthcare costs[J].J Pediatr Surg,2018,53(9):1737-1741.
[2]周峰,张旗,张永安,等.益气养阴方治疗慢性功能性便秘(气阴两虚证)的临床研究[J].河北中医,2017,39(11):1646-1649.
[3]韩常安.滋肾通便汤治疗老年阴虚肠燥型便秘临床观察[J].新中医,2016,48(8):79-80.
[4]曾明曦,康长明,陈小红,等.不同症型肠易激综合征患者血浆白细胞介素与肿瘤坏死因子的表达及其意义[J].医学临床研究,2017,34(5):901-902,905.
[5]中华医学会消化病学分会胃肠动力学组.中华医学会外科学分会结肠肛门外科学组.中国慢性便秘诊治指南(2013年,武汉)[J].中华消化杂志,2013,33(5):291-297.
[6]中华中医药学会脾胃病分会.慢性便秘中医诊疗共识意见(2009,深圳)[J].中国中西医结合消化杂志,2010,18(2):136-139.
[7]中华人民共和国卫生部药政司.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:134-139.
[8]Koppen IJN,Van Wassenaer EA,Barendsen RW,et al.Adherence to Polyethylene Glycol Treatment in Children with Functional Constipation Is Associated with Parental Illness Perceptions,Satisfaction with Treatment,and Perceived Treatment Convenience[J].J Pediatr,2018,199:132-139.
[9]张少坡,张敏,赵娜,等.润肠生津方联合耳穴贴压治疗阴虚型功能性便秘88例疗效观察[J].河北中医,2015,37(12):1824-1826.
[10]赵红波,吴晓晶,杨云,等.慢性功能性便秘与中医体质类型及相关危险因素的Logistic回归分析[J].中医杂志,2017,58(16):1393-1398.
[11]潘以丰,蔡海荣,陈锦锋,等.宣肺润肠汤治疗阴虚肠燥型功能性便秘疗效观察[J].山西中医,2017,33(11):14-16,19.
[12]Sharifi-Rad L,Ladi-Seyedian SS,Manouchehri N,et al Effects of interferential electrical stimulation plus pelvic floor muscles exercises on functional constipation in children:A randomized clinical trial[J].Am J Gastroenterol,2018,113(2):295-302.
[13]任海霞,罗和生,王倩,等.白介素-10基因多态性与肠易激综合征易感性关系的Meta分析[J].胃肠病学与肝病学杂志,2017,26(5):506-513.
[14]刘億,赵海梅,岳海洋,等.黄芪多糖对结肠炎小鼠结肠黏膜IL-12p40、IL-12p70、IL-15和IL-21表达的影响[J]中医研究,2017,30(9):58-60.
[15]臧凯宏,吴建军,秦红岩,等.黄芪多糖对溃疡性结肠炎大鼠肠道黏膜屏障的影响[J].中药材,2017,40(1):208-211.
[16]罗霞,胡明华,马励,等.中药多糖对免疫抑制小鼠T细胞亚群影响的差异研究[J].实用医药杂志,2016,33(7):621-624.
[17]牟凤辉,周小平,刘昕,等.中药玉竹甾体皂苷类成分及其对小鼠脾细胞增殖的影响[J].中国药物评价,2017,34(1):36-39,43.
[18]范亚楠,王佳,贾天柱,等.肉苁蓉炮制前后对大鼠肠神经递质及VIP、SP表达的影响[J].医学研究杂志,2017,46(5):51-55.
[19]孙伟义,孔建兄,吴杰英,等.中药鼻饲加灌肠联合西医治疗ICU机械通气伴胃肠功能障碍临床观察[J].浙江中西医结合杂志,2015,25(5):461-463.
[20]Bashashati M,Rezaei N,Shafieyoun A,et al.Cytokine imbalance in irritable bowel syndrome:A systematic review and meta-analysis[J].Neurogastroentterol Motil,2014,26(7):1036-1048.
[21]王燕,刘欣,黄小平,等.肠易激综合征患者炎性细胞因子的表达与酪酪肽、密封蛋白-1的相关性[J].中华消化杂志,2016,36(12):805-810.
[22]常东,汪栋材,李健,等.中医辨证治疗功能性便秘对患者胃肠激素和NO含量的影响[J].中国中西医结合消化杂志,2015,23(11):756-759.
[2]周峰,张旗,张永安,等.益气养阴方治疗慢性功能性便秘(气阴两虚证)的临床研究[J].河北中医,2017,39(11):1646-1649.
[3]韩常安.滋肾通便汤治疗老年阴虚肠燥型便秘临床观察[J].新中医,2016,48(8):79-80.
[4]曾明曦,康长明,陈小红,等.不同症型肠易激综合征患者血浆白细胞介素与肿瘤坏死因子的表达及其意义[J].医学临床研究,2017,34(5):901-902,905.
[5]中华医学会消化病学分会胃肠动力学组.中华医学会外科学分会结肠肛门外科学组.中国慢性便秘诊治指南(2013年,武汉)[J].中华消化杂志,2013,33(5):291-297.
[6]中华中医药学会脾胃病分会.慢性便秘中医诊疗共识意见(2009,深圳)[J].中国中西医结合消化杂志,2010,18(2):136-139.
[7]中华人民共和国卫生部药政司.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:134-139.
[8]Koppen IJN,Van Wassenaer EA,Barendsen RW,et al.Adherence to Polyethylene Glycol Treatment in Children with Functional Constipation Is Associated with Parental Illness Perceptions,Satisfaction with Treatment,and Perceived Treatment Convenience[J].J Pediatr,2018,199:132-139.
[9]张少坡,张敏,赵娜,等.润肠生津方联合耳穴贴压治疗阴虚型功能性便秘88例疗效观察[J].河北中医,2015,37(12):1824-1826.
[10]赵红波,吴晓晶,杨云,等.慢性功能性便秘与中医体质类型及相关危险因素的Logistic回归分析[J].中医杂志,2017,58(16):1393-1398.
[11]潘以丰,蔡海荣,陈锦锋,等.宣肺润肠汤治疗阴虚肠燥型功能性便秘疗效观察[J].山西中医,2017,33(11):14-16,19.
[12]Sharifi-Rad L,Ladi-Seyedian SS,Manouchehri N,et al Effects of interferential electrical stimulation plus pelvic floor muscles exercises on functional constipation in children:A randomized clinical trial[J].Am J Gastroenterol,2018,113(2):295-302.
[13]任海霞,罗和生,王倩,等.白介素-10基因多态性与肠易激综合征易感性关系的Meta分析[J].胃肠病学与肝病学杂志,2017,26(5):506-513.
[14]刘億,赵海梅,岳海洋,等.黄芪多糖对结肠炎小鼠结肠黏膜IL-12p40、IL-12p70、IL-15和IL-21表达的影响[J]中医研究,2017,30(9):58-60.
[15]臧凯宏,吴建军,秦红岩,等.黄芪多糖对溃疡性结肠炎大鼠肠道黏膜屏障的影响[J].中药材,2017,40(1):208-211.
[16]罗霞,胡明华,马励,等.中药多糖对免疫抑制小鼠T细胞亚群影响的差异研究[J].实用医药杂志,2016,33(7):621-624.
[17]牟凤辉,周小平,刘昕,等.中药玉竹甾体皂苷类成分及其对小鼠脾细胞增殖的影响[J].中国药物评价,2017,34(1):36-39,43.
[18]范亚楠,王佳,贾天柱,等.肉苁蓉炮制前后对大鼠肠神经递质及VIP、SP表达的影响[J].医学研究杂志,2017,46(5):51-55.
[19]孙伟义,孔建兄,吴杰英,等.中药鼻饲加灌肠联合西医治疗ICU机械通气伴胃肠功能障碍临床观察[J].浙江中西医结合杂志,2015,25(5):461-463.
[20]Bashashati M,Rezaei N,Shafieyoun A,et al.Cytokine imbalance in irritable bowel syndrome:A systematic review and meta-analysis[J].Neurogastroentterol Motil,2014,26(7):1036-1048.
[21]王燕,刘欣,黄小平,等.肠易激综合征患者炎性细胞因子的表达与酪酪肽、密封蛋白-1的相关性[J].中华消化杂志,2016,36(12):805-810.
[22]常东,汪栋材,李健,等.中医辨证治疗功能性便秘对患者胃肠激素和NO含量的影响[J].中国中西医结合消化杂志,2015,23(11):756-759.