奥替溴胺联合洛哌丁胺治疗腹泻型肠易激综合征的疗效及机制分析

摘要

Objective To investigate the efficacy of otilonium bromide combined with loperamide in the treatment of diarrhea type irri-table bowel syndrome(IBS-D)and the influence on serum levels of water channel protein 3(AQP-3)andAQP-8.Methods Onehun-dred and ten patients with IBS-D were randomly divided into control group and observation group with 55 cases in each group according to random number table.Both groups were treated with non-drug therapy according to"treatment plan of integrated Chinese and western medicine of irritable bowel syndrome".Control group orally received otilonium bromide(40 mg,tid).Based on control group,observa-tion group was treated with loperamide(2~4 mg,bid).Treatment course was 6 weeks for all cases.Scores of abdominal pain,diarrhea, and abdominal distension and efficacy were compared between two groups.IBS-QOL scale was used to evaluate life quality.Serum levels of AQP-3 and AQP-8 were detected in both groups.Results Scores of abdominalpain,diarrhea,and abdominal distension were obvi-ously lower than those of control group after treatment(P<0.01).Clinical efficacy of treatment group was 96.36 %,which was higher than that of control groups 83.02 %(P<0.05).After treatment,scores of IBS-QOL and serum levels of AQP-3 and AQP-8 of observa-tion group were remarkably higher than that of control group(P<0.01).Conclusion Efficacy of otilonium bromide combined with loperamide in the treatment of diarrhea type irritable bowel syndrome is obvious,and can up-regulate serum levels of AQP-3 and AQP-8.%目的 观察奥替溴胺联合洛哌丁胺治疗腹泻型肠易激综合征(IBS-D)的疗效及对血清水通道蛋白-3(AQP-3)和水通道蛋白-8(AQP-8)水平的影响.方法 选择符合纳入标准的IBS-D病人共110例,按数字表法随机分为对照组和观察组,两组均55例;两组参照《肠易激综合征诊断和治疗的共识意见》给予非药物治疗;对照组给予奥替溴胺片,每次40 mg,每天3次,口服;观察组在对照组基础上给予洛哌丁胺,初始剂量2~4 mg,每天2次;两组病人均连续观察6周.比较两组腹痛、腹泻、腹胀评分及临床疗效;应用IBS生活质量问卷(IBS-QOL)量表评价两组生活质量;检测两组血清AQP-3和AQP-8水平.结果 治疗后,观察组病人的腹胀、腹泻、腹痛评分均明显低于对照组(P<0.01);观察组病人治疗后总有效率为96.36%,显著高于对照组(83.02%)(P<0.05);观察组治疗后IBS-QOL量表评分均明显高于对照组(P<0.01);治疗后,观察组治疗后AQP-3和AQP-8水平明显高于对照组,差异有统计学意义(P<0.01).结论 奥替溴胺联合洛哌丁胺治疗IBS-D疗效明显,上调血清AQP-3和AQP-8水平可能是该疗法作用机制之一.