西兰司琼治疗肠易激综合征的疗效观察及机制探讨

Clinical observation and mechanism discussion on treating irritable bowel syndrome by Cilansetron

摘要:

目的研究西兰司琼对肠易激综合征（IBS）的临床治疗效果，探讨西兰司琼治疗IBS 的机制。方法选取2014 年7 月-2015 年10 月在该院就诊的IBS 患者80 例，随机分为两组：观察组46 例（口服西兰司琼8 mg，3 次/d，连续服用6 d）、对照组34 例（口服维生素C 片50 mg，3 次/d，连续服用6 d）。运用罗马Ⅲ标准对治疗结果进行评价，并运用免疫组织化学法分别测定回盲部黏膜肥大细胞（MC）数目、脱颗粒比率及高效液相电化学法测定5-HT 浓度，记录治疗过程中的不良反应及不良反应率。结果治疗后，观察组显效率和总有效率与对照组比较，差异均有统计学意义（p <0.05），观察组患者的MC 数目和MC 脱颗粒比率较对照组均减少，差异有统计学意义（p <0.05），观察组患者5-HT浓度恢复正常，且高于对照组（p <0.05）；治疗前后治疗组患者MC 数目，MC 脱颗粒比率以及5-HT 浓度下降值均高于对照组（p <0.05）。结论西兰司琼对IBS 症状具有治疗作用，可降低回盲部黏膜MC 数目及脱颗粒比例，并可能通过与调节5-HT 信号通路，来调节肠道运动有关。

Abstract:

Objective To study the clinical effect of Cilansetron on treating irritable bowel syndrome (IBS),and investigate its mechanism. Methods Eighty patients with irritable bowel syndrome were randomly divided into two groups: observation group (46 cases, oral Cilansetron 8 mg tid for 6 days) and control group (34 cases, oral vitamin C tablets 50 mg tid for 6 days) between July 2014 and October 2015. The results of treatment were evaluated using the Rome Ⅲcriteria, and the number and degranulation rate of MC in blind back mucosa were measured by immunohistochemical method, and the concentration of 5-HT was measured with the HPLC electrochemical method. The incidences of adverse side effects and the response rates were recorded during the process. Results The value of the efficiency and total efficiency in the observation group were significantly different from those in the control group (p < 0.05). The number of MC and the MC degranulation rate in the observation group were significant lower than those in the control group (p < 0.05), and the concentration of 5-HT in the observation group was also significant higher than that in the control group (p < 0.05). The changes of number of MC, MC degranaulation rate and the concentration of 5-HT in the observation group were more obvious than those in the control group (p < 0.05). Conclusions Cilansetron has significant therapeutic effect on IBS, with reducing the number of ileocecal mucosa MC and the degranulation rate, and regulating the 5-HT signaling pathway to regulate bowel movements.