目的 探討痛瀉寧顆粒聯(lián)合奧替溴銨片治療腹瀉型腸易激綜合征的治療效果。方法 選取2021年6月—2023年5月秦皇島市北戴河醫(yī)院收治80例腹瀉型腸易激綜合征患者，按隨機數(shù)字表將患者分為對照組和治療組組，每組40例。對照組口服奧替溴銨片，1片/次，3次/d。治療組在對照組治療的基礎上口服痛瀉寧顆粒，1袋/次，3次/d。兩組患者連續(xù)治療4周。比較兩組的臨床療效、癥狀消失時間、腹瀉癥狀、血清指標。結果 治療后，治療組總有效率為95.00%，對照組總有效率為75.00%，組間比較差異顯著（P＜0.05）。治療后，治療組患者腹痛、腹瀉、腹脹消失時間均短于對照組（P＜0.05）。治療后，兩組排便頻率評分、大便性狀評分均比治療前?。?i>P＜0.05）；治療組患者排便頻率評分、大便性狀評分比對照組?。?i>P＜0.05）。治療后，兩組的血清趨化因子C-C-基元配體16（CCL-16）、白細胞介素-17A（IL-17A）水平均低于治療前，血清白細胞介素-12（IL-12）水平高于治療前（P＜0.05）；治療組的血清CCL-16、IL-17A水平低于對照組，血清IL-12水平高于對照組（P＜0.05）。治療后，兩組血清二胺氧化酶（DAO）、D-乳酸（D-LAC）水平低于治療前（P＜0.05）；治療組血清DAO、D-LAC水平低于對照組（P＜0.05）。結論 腹瀉型腸易激綜合征患者經痛瀉寧顆粒聯(lián)合奧替溴銨片治療，療效和癥狀改善效率明顯提高，進一步減輕炎癥反應，降低腸道屏障功能損傷。

Objective To investigate the therapeutic effect of Tongxiening Granules combined with Otilonium Bromide Tablets in treatment of diarrheal irritable bowel syndrome. Methods Patients (80 cases) with diarrheal irritable bowel syndrome in Qinhuangdao Beidaihe Hospital from June 2021 to May 2023 were divided into control and treatment groups according to the random number table, and each group had 40 cases. Patients in the control group were po administered with Otilonium Bromide Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tongxiening Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. The clinical efficacies, the symptom disappearance time, diarrhea symptoms, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.00%, while the total effective rate of the control group was 75.00%, with a significant difference between the groups (P< 0.05). After treatment, the disappearance time of abdominal pain, diarrhea, and abdominal distension in the treatment group was shorter than that in the control group (Pv < 0.05). After treatment, the scores of defecation frequency and stool trait in two groups were lower than those before treatment (P < 0.05), and the scores of defecation frequency and stool trait of the treatment group were lower than those of the control group (P < 0.05). After treatment, the serum levels of CCL-16 and IL-17A were lower than before treatment, but the serum levels of IL-12 were higher than before treatment (P < 0.05). The serum levels of CCL-16 and IL-17A in the treatment group were lower than those in the control group, but the serum levels of IL-12 were higher than those in the control group (P < 0.05). After treatment, the serum levels of DAO and D-LAC were lower than those before treatment (P < 0.05), and the serum levels of DAO and D-LAC in the treatment group were lower than those in the control group (P < 0.05). Conclusion Tongxiening Granules combined with Otilonium Bromide Tablets can significantly improve the therapeutic effect in patients with diarrheal irritable bowel syndrome, further reduce the inflammatory response and intestinal barrier function damage.