内科

目的探讨二甲硅油联合枯草杆菌肠球菌治疗腹泻型肠易激综合征患者的临床疗效及对患者血清炎症因子、5-羟色胺和活性肠肽的影响。方法选择2015年12月至2017年6月我院收治的腹泻型肠易激综合征患者102例，依据随机数字表法分为观察组与对照组，每组51例。对照组患者口服枯草杆菌肠球菌肠溶胶囊治疗；观察组患者在对照组治疗的基础上加用二甲硅油治疗，疗程均14 d。比较两组患者的疗效，治疗前后大便泄泻和腹胀腹痛评分、血清IL-18、TNF-α和IL-23水平及血浆5-羟色胺和活性肠肽水平的变化。结果治疗14 d后，观察组患者的治疗总有效率（94.12%）显著高于对照组（76.47%），临床疗效优于对照组，差异有统计学意义（P＜0.05）。治疗前两组患者大便泄泻、腹胀腹痛评分以及血清IL-18、TNF-α、IL-23、血浆5-羟色胺和活性肠肽水平比较差异无统计学意义（P＞0.05）；治疗后两组患者大便泄泻、腹胀腹痛评分以及血清IL-18、TNF-α、IL-23、血浆5-羟色胺和活性肠肽水平均显著低于治疗前（P＜0.01），观察组患者的大便泄泻等评分及血清IL-18等水平均低于对照组（P＜0.01）。结论二甲硅油联合枯草杆菌肠球菌治疗腹泻型肠易激综合征患者临床疗效显著，可显著减轻患者炎症反应，降低血浆5-羟色胺和活性肠肽水平，具有重要的临床应用价值。

ObjectiveTo investigate the clinical efficacy of dimethicone combined with bacillus subtilis enterococcus in the treatment of patients with diarrhea predominant irritable bowel syndrome(IBS-D) and its influence on serum inflammatory factors, 5-HT and vasoactive intestinal peptide. Methods102 patients with IBS-D treated in our hospital from December 2015 to June 2017 were randomly divided into the observation group and the control group according to the random digital table method, with 51 cases in each group. The control group treated with bacillus subtilis and enterococcus faecium enteric-coated capsules. The observation group were treated with dimethicone on the basis of the control group. The two groups were treated with 14d. The therapeutic effects were compared between the two groups. Diarrhea score, abdominal distension and pain score, serum IL-18, TNF-alpha and IL-23 level and plasma 5-activity of serotonin and intestinal peptide levels were compared before and after treatment. ResultsAfter 14 d treatment, the total effective rate of treatment in the observation group (94.12%) was significantly higher than that of the control group (76.47%). The difference was statistically significant (P＜0.05). Before treatment, Comparing the two groups of diarrhea score, abdominal pain score, serum IL-18, TNF-α, IL-23, 5-alpha plasma serotonin and vasoactive intestinal peptide level, the difference was not statistically significant (P＞0.05). After treatment, two groups of diarrhea score, abdominal pain score and serum IL-18, TNF-α, IL-23, 5-alpha plasma serotonin and vasoactive intestinal peptide levels were significantly lower than those before treatment (P＜0.01). The observation group diarrhea score and serum IL-18 water were lower than those in control group (P＜0.01). ConclusionThe clinical efficacy of dimethicone combined with bacillus subtilis enterococcus in the treatment of diarrhea induced irritable bowel syndrome is significant, which can significantly alleviated the inflammatory response in patients, decrease the level of 5-serotonin and active intestinal peptide in plasma. It has important clinical value.