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Trimebutine maleate treatment of diarrhea-predominant irritable bowel syndrome analysis

Time:2015/9/30 7:19:26

    Abstract: Objective trimebutine maleate joint Bacillus clinical efficacy of diarrhea-predominant irritable bowel syndrome (IBS) treatment. Methods 125 cases of diarrhea-predominant IBS patients were randomly divided into three groups, A group given trimebutine and Bacillus, Group B alone Trimebutine, Group C single land Bacillus licheniformis 4 weeks, observed in all groups clinical efficacy. Results A group clinical total effective rate of 96.2%, total effective rate of group B was 60.0% in group C clinical total effective rate 48.5%, the efficacy of the three groups, P <0.05, the difference was statistically significant. Conclusion trimebutine maleate joint Bacillus treatment of diarrhea-predominant IBS have significant synergistic effects, clinical efficacy, could be applied.

    Key words: maleic acid Trimebutine Bacillus diarrhea-type irritable bowel syndrome

    Irritable bowel syndrome (IBS) is a kind of abdominal pain or discomfort associated with altered bowel habits characterized by functional bowel disorder, accounting for 20% to 50% the amount of gastrointestinal clinic for gastroenterology outpatient common, clinical type constipation, diarrhea, and mixed. Where diarrhea-predominant IBS mainly as abdominal pain, diarrhea, poor stool, fecal urgency flu. Many ways to treat diarrhea-predominant IBS is clinically observed here trimebutine maleate joint Bacillus treatment of diarrhea-type IBS, compared with the single use of trimebutine and Bacillus, and achieved satisfactory results, are as follows.

    Materials and Methods

    1.1 General Information The group of 125 cases of diarrhea-predominant IBS patients in our hospital in March 2005 ~ June 2006 gastroenterology outpatients, which are in line with the Rome Ⅱ diagnostic criteria. Selected cases above exclude the following circumstances: (1) pregnant and lactating women. (2) heart, lung, liver and kidney dysfunction. (3) diabetes, hyperthyroidism and other endocrine diseases. In which 56 males and 69 females, aged 18 to 68 years, mean 38.2 years, duration was more than three months. 125 patients with IBS were randomly divided into three groups, A group of 52 cases, group B 40 cases, 33 cases of group C. More than three groups in age, gender and the duration of the difference was not statistically significant, comparable.

    1.2 Treatment drugs used trimebutine maleate tradename Nepal to Corfu (Zhejiang Angli Kang Pharmaceutical Co., approval number Zhunzi H20040882, 0.1 g per tablet), Bacillus capsule tradename Fishing Health (Shenyang First Pharmaceutical Factory, the approval number Zhunzi S10950019, each and 0.25 g, containing 250 million viable count). A group was treated with Nigeria to Corfu 0.2 g / time, 3 times / d, Zhengchangsheng 2 / time, 3 times / d; group B single-serving Nigeria as Corfu; group C single-serving Zhengchangsheng. B, C and A groups use the same set. More than 3 Group course of 4 weeks.

    1.3 The evaluation criteria markedly: abdominal pain, stool frequency and stool returned to normal; effective: abdominal pain, stool 2-3 times a day, a thin paste shapeless; invalid: abdominal pain and stool frequency and character has not changed. Significant efficiency increase over the total effective rate of efficiency.

    1.4 Χ2 test using statistical methods.

    2 Results

    A total effective rate was 96.2% in group B, the total effective rate was 60.0% in group C, the total effective rate was 48.5%. A group compared with B, C groups, P <0.05, the difference was statistically significant (Table 1).

    3 Discussion

    Irritable bowel syndrome (IBS) is a common chronic non-organic intestinal disorders, accounting for 20% to 50% of the amount of the gastrointestinal clinic. In the past it called irritable bowel, spastic colon, irritable colon, now unified named IBS, diarrhea-divided, constipation and mixed type. Etiology and pathogenesis is not completely Table 1. Table 1 Comparison of the therapeutic effect NOTE: A group and B, C between the two groups, P <0.05

    All-clear, generally considered IBS is a multifactorial pathophysiological basis with special physiological and psychological diseases. Because the etiology and pathogenesis of IBS has not been clarified, so the treatment is more difficult, a lot of clinical methods, including medication and psychotherapy. Wherein the drug treatment includes drugs regulate gastrointestinal function, visceral feel of drugs, antidepressants and anti-anxiety drugs, probiotics and Chinese medicine. As used herein, the drugs of choice that is falling within the above gastrointestinal function and regulation of pharmaceutical probiotics.

    According to the literature, the treatment of IBS Trimebutine mechanism that trimebutine inhibited potassium channel, resulting in depolarization, improve gastrointestinal smooth muscle cell excitability; on the other hand can block calcium channels, inhibition of calcium within the ion flow, inhibit gastrointestinal smooth muscle cell excitability. At the same effect on smooth muscle nerve receptors in the low state of motion, acting on adrenergic receptors, inhibiting the release of adrenaline, increased exercise adjustment; when hyperactivity, acting on Μ Κ- receptor and opioid receptor, inhibition of acetylcholine release, inhibit smooth muscle movement, which play a therapeutic effect of IBS. This group alone Trimebutine treatment of diarrhea-predominant IBS total effective rate of 60% corroborated Trimebutine treatment status in IBS. Since Trimebutine can act directly on the gastrointestinal smooth muscle, strengthen or inhibit gastrointestinal motility of the gastrointestinal tract has a two-way adjustment, therefore Trimebutine treating constipation-type IBS also found in the positive reports.

    The main symptoms are diarrhea-predominant IBS, abdominal pain and diarrhea. Studies have shown that, IBS patients have intestinal flora, mainly for Enterobacteriaceae increased bifidobacteria and anaerobic reduction. Intestinal microbial colonization resistance decreased, which obligate anaerobes intestinal barrier damage. And probiotics can enhance the biological barrier in the intestinal tract, adjust the intestinal flora, improve human immunity, reduce the source of endotoxin. This provides theoretical support for probiotics treat IBS. Bacillus into the intestine, Enterobacteriaceae, which are antagonistic to, but to promote the growth of Bifidobacterium and other effects, and also won the oxygen through the biological effects of the intestinal hypoxia, is conducive to the growth of a large number of anaerobic bacteria to adjust intestinal flora, play a therapeutic role. Our data show that, for the treatment of patients with diarrhea-predominant IBS, in Trimebutine based on the increase of land Bacillus clothes, to consolidate and enhance the efficacy of each other, have a good synergy, worthy of clinical application.

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