健脾法对腹泻型肠易激综合征食物不耐受患者肠黏膜CD3、MBP表达的影响

目的:探讨腹泻型肠易激综合征(IBS-D)食物不耐受与肠黏膜嗜酸细胞炎性介质CD3及MBP表达的关系及健脾药物的作用机制。方法:选择60例IBS-D食物不耐受患者随机分为治疗组30例和对照组30例,治疗组口服健脾中药,每日1剂,对照组口服匹维溴铵片,50mg,日3次,治疗4周后进行疗效评价,免疫组化法检测十二指肠黏膜CD3、MBP表达。结果:两组治疗后主要症状评分均显著低于治疗前(P<0.01),中药组治疗后大便次数、腹痛或腹部不适、大便性状及排便急迫感评分明显低于西药组治疗后(P<0.05),其中腹痛或腹部不适疗效显著优于西药对照组(P<0.01)。IBS-D食物不耐受患者十二指肠黏膜MBP、CD3阳性表达较健康组增强(P<0.01),而匹维溴铵片或健脾药物治疗4周后其表达明显减弱(P<0.01),且健脾药物的作用优于匹维溴铵片(P<0.05或P<0.01)。结论:IBS-D与食物不耐受所致肠道免疫机制紊乱关系密切,健脾中药通过对肠黏膜免疫功能的调整而改善其临床症状。

EFFECTS OF STRENGTHENING SPLEEN METHOD ON CD3 AND MBP EXPRESSIONS IN INTESTINAL MUCOSA OF PATIENTS WITH DIARRHEA TYPE OF IRRITABLE BOWEL SYNDROME AND FOOD INTOLERANCE

Objective:To explore the relationship between CD3 and MBP expressions in intestinal mucosa and diarrhea type of irritable bowel syndrome and food intolerance,observe the intervention effects of strengthening spleen method.Methods:60 patients with diarrhea type of irritable bowel syndrome and food intolerance were divided into treatment and control groups at random,each group contained 30 cases.Treatment group was given strengthening spleen herbs,control group was given pinaverium bromide,4 weeks was one treatment course.Observing and recording the changes of main symptoms and signs before and after treated 4 weeks,CD3 and MBP expressions in duodenal mucosa were determined by immunohistochemical method.Results:The main symptoms and signs in the two groups were improved significantly,the effects of treatment group were obvious better than those in control group.The CD3 and MBP positive expressions in duodenal mucosa of patients with diarrhea type of irritable bowel syndrome and food intolerance were significant more than those in health people,the CD3 and MBP positive expressions in duodenal mucosa of patients were reduced after treated with strengthening spleen herbs or pinaverium bromide,the CD3 and MBP positive expressions in duodenal mucosa of patients in treatment group were obviously less than those of control group.Conclusion:Diarrhea type of irritable bowel syndrome and food intolerance was related to disorder of intestinal immune mechanism,strengthening spleen herbs could regulate the disorder of intestinal immune function to improve clinical symptoms.