Efficacy of Jianpi Shugan Fomula on Intestinal Flora of Patients with Diarrhea Predominant Irritable Bowel Syndrome and Its Effect on Intestinal Flora

Xing-xing ZHANG; Jian WU; Li-xia PEI; Yi XU; Bai YE; Shen-lin LIU

doi:10.13422/j.cnki.syfjx.20191224

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Efficacy of Jianpi Shugan Fomula on Intestinal Flora of Patients with Diarrhea Predominant Irritable Bowel Syndrome and Its Effect on Intestinal Flora

Clinic | 更新时间：2021-02-09

- Efficacy of Jianpi Shugan Fomula on Intestinal Flora of Patients with Diarrhea Predominant Irritable Bowel Syndrome and Its Effect on Intestinal Flora
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 25, Issue 13, Pages: 79-86(2019)
- 作者机构：
  
  南京中医药大学　附属医院，南京　 210029
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20191224
  CLC： R22; R242; R2-031; R287
- Received：23 October 2018，
  
  Published Online：04 March 2019，
  
  Published：05 July 2019
- 稿件说明：
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Xing-xing ZHANG, Jian WU, Li-xia PEI, et al. Efficacy of Jianpi Shugan Fomula on Intestinal Flora of Patients with Diarrhea Predominant Irritable Bowel Syndrome and Its Effect on Intestinal Flora[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(13): 79-86.
DOI：

Xing-xing ZHANG, Jian WU, Li-xia PEI, et al. Efficacy of Jianpi Shugan Fomula on Intestinal Flora of Patients with Diarrhea Predominant Irritable Bowel Syndrome and Its Effect on Intestinal Flora[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(13): 79-86. DOI： 10.13422/j.cnki.syfjx.20191224.

摘要

目的：

观察健脾疏肝法指导下的健脾疏肝方联合针灸，对腹泻型肠易激综合征(irritable bowel syndrome with diarrhea，IBS-D)肝郁脾虚证临床症状及肠道菌群的影响。

方法：

采用数字随机表法，将70例IBS-D肝郁脾虚证患者随机分成2组。观察组35例，用健脾疏肝方联合针灸治疗4周。对照组35例，口服匹维溴铵(得舒特)治疗4周，并以30例健康人作为正常组。分别采用IBS症状尺度表(IBS bowel symptom severity scale，IBS-SSS)，IBS生活质量问卷(IBS quality of life questionnaire，IBS-QOL)和中医证候疗效评分表(traditional Chinese medicine pattern curative effect scoring system，TCM-PES)评估两组患者治疗后总体临床疗效、生活质量及中医证候疗效。并通过实时定量荧光聚合酶链式反应观察2组患者治疗前后粪便中双歧杆菌、乳酸杆菌、肠杆菌、拟杆菌的数量及肠道菌群定植抗力(colonization resistance

CR)的变化。

结果：

①IBS-SSS量表显示，与本组治疗前比较，观察组4，8，12周均能减少量表积分(

0.05)，对照组4，8周能减少量表积分(

0.05)，第4周观察组积分优于对照组(

0.05)。观察组总有效率优于对照组(

0.05)。②IBS-QOL量表显示，与本组治疗前比较，观察组4，8，12周，对照组4周均能增加量表积分(

0.05)，两组间无统计学差异。③两组在中医证候总有效率方面均有改善，且观察组优于对照组(

0.05)。④与本组治疗前比较，中医治疗4周后双歧杆菌、乳酸杆菌数量上升，肠杆菌数量下降，CR升高(

0.05)。对照组治疗后对各类菌群及CR值均无明显改变。与对照组比较，观察组双歧杆菌升高，肠杆菌下降，CR升高(

0.05)。各组治疗后对拟杆菌均无明显调节作用。

结论：

健脾疏肝法指导下的健脾疏肝方联合针灸对缓解肝郁脾虚证IBS-D患者临床症状有较好疗效，其机制可能与调节肠道菌群有关。

Abstract

Objective:

To observe the effect of Jianpi Shugan decoction combined with acupuncture on the clinical symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) with liver depression and spleen deficiency and the intestinal flora.

Method:

Seventy patients with IBS-D with liver depression and spleen deficiency were randomly divided into two groups by the random number table. The treatment group was given Jianpi Shugan decoction combined with acupuncture for 4 weeks

the control group was treated with Pivavironium bromide for 4 weeks

and 30 healthy people were used as healthy control. The total effective rate

IBS bowel symptom severity scale (IBS-BSS)

IBS quality of life questionnaire (IBS-QOL) and traditional Chinese medicine pattern curative effect scoring system (TCM-PES) were evaluated. The counts of

Bacillus bifidus

acidi lactici

Enterobacteria

and

Bacteroides

in feces and the colonization resistance (CR) were observed by Real-time PCR.

Result:

The IBS-SSS scale showed that the TCM treatment group could reduce the scores at the 4

and 12

weeks (

0.05)

and the control group could reduce the scores at 4

and 8

weeks (

0.05)

the 4

week scores of TCM treatment group were better than that of control group (

0.05). The total effective rate of TCM treatment group was better than that of control group

with statistical difference between two groups (

0.05). The IBS-QOL scale showed that the TCM treatment group increased the scale scores at the 4

and 12

weeks

and the control group increased the scores at the 4

week (

0.05). There was no statistical difference between two groups. The TCM treatment group was superior to control group (

0.05). The counts of

bifidus

and

acidi lactici

increased after 4 weeks of TCM treatment

and the count of

Enterobacteria

decreased (

0.05). However

no obvious change was observed in patients of control group before and after treatment. Compared with the control group

bifidus

increased

while

Enterobacteria

decreased in the TCM treatment group (

0.05). There was no significant regulatory effect of

Bacteroides

after treatment in each group.

Conclusion:

Jianpi Shugan decoction combined with acupuncture has a reliable curative effect on IBS-D patients with liver depression and spleen deficiency. The mechanism may be related to the regulation of intestinal flora imbalance.

关键词

Keywords

references

Chey W D , Maneerattaporn M , Saad R . Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome [J]. Gut Liver , 2011 , 5 ( 3 ): 253 - 266 .

吴蓉，陈淑洁，姒健敏．肠易激综合征与肠道微生态的研究现状分析 [J]．国际消化病杂志， 2007 ， 27 ( 5 )： 350-352，385 ．

Nellesen D , Yee K , Chawla A , et al . A systematic review of the economic and humanistic burden of illness in irritable bowel syndrome and chronic constipation [J]. J Managed Care Pharmacy , 2013 , 19 ( 9 ): 755 - 674 .

Niesler B . 5-HT3 receptors: potential of individual isoforms for personalised therapy [J]. Current Opinion Pharmacol , 2011 , 11 ( 1 ): 81 - 86 .

Kapeller J , Houghton L A , Mönnikes H , et al . First evidence for an association of a functional variant in the microRNA-510 target site of the serotonin receptor-type 3E gene with diarrhea predominant irritable bowel syndrome [J]. Human Mol Gen , 2008 , 17 ( 19 ): 2967 - 2977 .

Ohman L , Simrén M . Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions [J]. Nat Rev Gastroenterol Hepatol , 2010 , 7 ( 3 ): 163 - 173 .

张静之，包春辉，施征，等．肠道菌群参与炎症性肠病发病机制研究新进展 [J]．世界华人消化杂志， 2016 ， 24 ( 33 )： 4505 - 4513 ．

Khlevner J , Park Y , Margolis K G . Brain-gut axis: clinical implications [J]. Gastroenterol Clin North Am , 2018 , 47 ( 4 ): 727 - 739 .

Drossman D A ．罗马IV：功能性胃肠病 [M]． 4 版．北京：科学出版社， 2016 ： 20 - 50 ．

叶柏，陈静，宁丽琴，等．调肝运脾方治疗腹泻型肠易激综合征临床研究 [J]．南京中医药大学学报， 2013 ， 29 ( 4 )： 314 - 316 ．

宁丽琴，叶柏．叶柏教授治疗腹泻型肠易激综合征经验介绍 [J]．新中医， 2014 ， 46 ( 5 )： 17 - 19 ．

占道伟．疏肝健脾法针刺对腹泻型肠易激综合征患者血清5-HT、NPY和CGRP水平变化的影响 [D]．南京：南京中医药大学， 2013 ： 5 - 10 ．

吴晓亮，王烨林，孙建华，等．针刺治疗腹泻型肠易激综合征肝郁脾虚证临床观察及其对Th1/Th2的影响 [J]．中国针灸， 2013 ， 33 ( 12 )： 1057 - 1060 ．

Longstreth G F , Thompson W G , Chey W D , et al . Functional bowel disorders [J]. Astroenterology , 2006 , 130 ( 5 ): 1480 - 1491 .

中华医学会消化病学分会胃肠动力学组中华医学会消化病学分会胃肠功能性疾病协作组．中国肠易激综合征专家共识意见(2015年，上海) [J]．中华消化杂志， 2016 ， 36 ( 5 )： 299 - 312 ．

Design of Treatment Trials Committee , Irvine E J , Whitehead W E , et al . Design of treatment trials for functional gastrointestinal disorders [J]. Gastroenterology , 2006 , 130 ( 5 ): 1538 - 1551 .

Hahn B A , Kirchdoerfer L J , Fullerton S , et al . Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome [J]. Aliment Pharmacol Ther , 1997 , 11 ( 3 ): 547 - 552 .

中华人民共和国卫生部．中药新药临床研究指导原则 [M]．北京：中国医药科技出版社， 2002 ： 50 - 129 ．

Bijkerk C J , de Wit N J , Muris J W , et al . Outcome measures in irritable bowel syndrome: comparison of psychometric and methodological characteristics [J]. Am J Gastroenterol , 2003 , 98 ( 1 ): 122 - 127 .

沈定树，陈素云．肠道微生态与定植抗力 [J]．中国微生态学杂志， 2012 ， 24 ( 12 )： 1150 - 1152 ．

Giuseppe C , Marcella P , Alberto F , et al . Complementary and alternative treatment in functional dyspepsia [J]. United European Gastroenterol J , 2018 , 6 ( 1 ): 5 - 12 .

Lembo A J , Conboy L , Kelley J M , et al . A treatment trial of acupuncture in IBS patients [J]. Am J Gastroenterol , 2009 , 104 ( 6 ): 1489 - 1497 .

李帮洁，缪乐涛，芮俊乾，等．痛泻要方主要有效成分的多靶点网络构建与机制分析 [J]．中国实验方剂学杂志， 2018 ， 24 ( 8 )： 206 - 213 ．

裴丽霞，孙建华，夏晨，等．针灸治疗腹泻型肠易激综合征肝郁脾虚证临床研究 [J]．南京中医药大学学报， 2012 ， 28 ( 1 )： 27 - 29 ．

Sergio P , Claudia C , Tiziana D , et al . Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: experience with rifaximin [J]. World J Gastroenterol , 2009 , 15 ( 21 ): 2628 - 2631 .

朱青，温天燕，杨道炬，等．消脂汤对FFA诱导NASH细胞模型的影响及其相关机制 [J]．中国实验方剂学杂志， 2017 ， 23 ( 23 )： 109 - 115 ．

阎力君，洪涛，雒江菡，等．黄芪多糖对结肠癌SW620细胞增殖及凋亡作用的影响 [J]．中国实验方剂学杂志， 2017 ， 23 ( 22 )： 97 - 101 ．

LIN H C . Small intestinal bacterial overgrowth: a frame work for understanding irritable bowel syndrome [J]. JAMA , 2004 , 292 ( 7 ): 852 - 858 .

SI J M , YU Y C , FAN Y J , et al . Intestinal microecology and quality of life in irritable bowel syndrome patients [J]. World J Gastroenterol , 2004 , 10 ( 12 ): 1802 - 1805 .

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