摘要目的:探讨胃肠宁颗粒联合复方嗜酸乳杆菌片对腹泻型肠易激综合征(D-IBS)的疗效及其对患者炎性因子、胃肠激素和肠黏膜屏障的影响。方法:选择杭州市富阳区第一人民医院2017年1月至2019年12月收治的D-IBS患者80例，按照随机数字表法分为对照组和观察组，每组40例。对照组给予复方嗜酸乳杆菌片治疗，观察组在对照组基础上结合胃肠宁颗粒治疗。两组疗程均为2周。比较两组治疗疗效，治疗前后炎性因子、胃肠激素和肠黏膜屏障的变化。结果:观察组治疗总有效率为92.50%(37/40)，高于对照组的70.00%(28/40)，差异有统计学意义(χ 2＝6.646， P<0.05)。观察组治疗后血清肿瘤坏死因子α[(36.15±10.12)ng/L]、白细胞介素1β[(0.43±0.08)μg/L]和白细胞介素6[(12.18±3.06)ng/L]均低于对照组[(54.36±15.73)ng/L、(0.79±0.12)μg/L和(18.53±2.19)ng/L]( t＝6.157、15.787、10.673，均 P<0.05)。观察组治疗后血清生长抑素[(28.91±11.02)μg/L]和血管活性肠肽[(185.46±17.34)ng/L]均低于对照组[(45.63±12.54)μg/L和(235.12±18.29)ng/L]( t＝6.334、12.462，均 P<0.05)。观察组治疗后血清二胺氧化酶活性[(1.05±0.19)U/L]、内毒素[(0.62±0.19)U/L]和D-乳酸[(38.97±6.39)mg/L]均低于对照组[(1.53±0.28)U/L、(1.16±0.23)U/L和(49.81±4.25)mg/L]( t＝8.972、11.448、8.934，均 P<0.05)。 结论:胃肠宁颗粒联合复方嗜酸乳杆菌片对D-IBS患者疗效明显，可减轻炎性反应，改善胃肠激素和肠黏膜屏障功能。

abstractsObjective:To investigate the therapeutic effect of Weichangning granule combined with compound Lactobacillus acidophilus tablet on diarrhea type irritable bowel syndrome and its effect on inflammatory factors, gastrointestinal hormones and intestinal mucosal barrier.Methods:From January 2017 to December 2019, 80 patients with diarrhea type irritable bowel syndrome admitted in the First People's Hospital of Fuyang District were selected, and they were divided into observation group and control group according to the random digital table method, with 40 cases in each group.The control group was treated with relapsed Lactobacillus acidophilus tablets, and the observation group was treated with Weichangning granules on the basis of the control group.The course of treatment in both two groups was 2 weeks.The changes of inflammatory factors, gastrointestinal hormones and intestinal mucosal barrier were compared before and after treatment.Results:The total effective rate of the observation group[92.50%(37/40)] was higher than that of the control group[70.00%(28/40)], the difference was significant (χ 2=6.646, P<0.05). The levels of TNF-α[(36.15±10.12)ng/L], IL-1β[(0.43±0.08)μg/L] and IL-6[(12.18±3.06)ng/L] in the observation group were lower than those in the control group[(54.36±15.73)ng/L, (0.79±0.12)μg/L and (18.53±2.19)ng/L]( t=6.157, 15.787, 10.673, all P<0.05). The serum levels of SS[(28.91±11.02)μg/L] and VIP[(185.46±17.34)ng/L] in the observation group were lower than those in the control group[(45.63±12.54)μg/L and (235.12±18.29)ng/L]( t=6.334, 12.462, all P<0.05). The levels of DAO[(1.05±0.19)U/L], endotoxin[(0.62±0.19)U/L] and D-lactate[(38.97±6.39)mg/L] in the observation group were lower than those in the control group[(1.53±0.28)U/L, (1.16±0.23)U/L and (49.81±4.25)mg/L]( t=8.972, 11.448, 8.934, all P<0.05). Conclusion:Weichangning granule combined with compound Lactobacillus acidophilus tablet has obviously curative effect on diarrhea type irritable bowel syndrome, which can reduce inflammatory reaction, improve gastrointestinal hormone and intestinal mucosal barrier function.