中药"神曲"对肠易激综合征患者肠道菌群的调节和临床疗效的研究

目的探讨中药"神曲"对肠易激综合征(IBS)病人肠道微生态环境的调节及临床治疗作用.方法(1)健康人17例,IBS(以腹泻为主型)患者34例(按ROMEⅡ诊断标准),取粪便做双歧杆菌、类杆菌、乳杆菌、肠球菌及肠杆菌的培养,对比2组菌数量的差别;(2)随机将34例患者分为3组,分别给予思密达、思密达加丽珠肠乐及思密达加神曲水煎液口服,治疗2周后,复查粪便菌培养,对比各组治疗前后的细菌数量变化,并观察临床疗效;(3)菌群的定性定量检测,采用厌氧菌及需氧菌培养法;(4)统计学处理,用SPSS 11.0软件,一般情况的比较用t检验;各菌群数量的比较用F检验;治疗有效率的比较用x2检验.结果(1)健康人组与治疗前患者组各菌群的对比IBS患者粪便中类杆菌、双歧杆菌与乳杆菌数量较健康人组增加(P＜0.05),肠球菌、肠杆菌数量较正常人组下降(P＜0.05).(2)治疗后思密达组患者粪便中厌氧菌种有所增加,需氧菌种有所减少,但差异无显著性(P＞0.05).(3)神曲组患者经治疗后,粪便中乳杆菌明显增多(P＜0.01),双歧杆菌增加(P＜0.05),肠杆菌减少(P＜0.05);与丽珠肠乐组治疗后乳杆菌、双歧杆菌及肠杆菌菌群数量比较,差异无显著性(P＞0.05);与治疗后思密达组各菌群比较,差异有显著性(P＜0.05).(4)神曲组与丽珠肠乐组,临床治疗总有效率明显高于思密达组(P＜0.05).结论中药"神曲"有调节IBS患者肠道菌群的作用,能增加肠道有益菌的数量,改善临床症状.

Study on the microecological changes and curetive effects of irritable bowel syndrom by Chinese drug "Shenqu"

Objective To study the microecological changes and the curetive effects to irritable bowel syndrom(IBS) by Chinese drug "Shenqu". Methods (1)The counts of Bacteroides,Bifidobacterium,Lactobacillus,Intestine coccus and Enterobacteriaceae were determined in the feces of 17 normal adults and 34 patients of IBS and the difference were compared.(2)34 patients were randomly divided into three groups and respectively treated by oral Simida or Simida and Li Zhu Chang Le or Simida and Shenqu for two weeks.Then the bacteria were cultured repeatedly and the flora's counts were compared with that before teatment.(3)To determine the flora's qualities and quantities with the method of aerobic and anaerobic culture.Results (1)The counts of fecal anaerobia such as Bifidobacterium and Lactobacillus and Bacteroids of the IBS patients were higher than that of normal adults(P<0.05);The counts of fecal aerobia such as Intestine coccus and Enterobacteriaceae were lower(P<0.05).(3)After treatment the counts of Bifidobacterium were increased (P<0.05) and Lactobacillus increased remarkly (P<0.01) in the patients of Shenqu group.While the counts of Bacteroids were decreased (P>0.05) .(4)The clinical symptoms were significantly improved in the Shenqu and Li Zhu Chang Le groups compared with the Simida group(P<0.05).Conclusions Chinese drug "Shenqu" could adjustmented the amount of intestinal tract microflora in the patients of IBS and improved the clinical symptoms.That was worth to observe the curetive effects and the mechanism further.