Gao Yu, Gong Xiangping, Qi Juanjuan, Guo Ping
Department of Gastroenterology, Baoji High Tech Hospital No. 19 Harmony Road, Baoji 721300, Shaanxi, China.
Am J Transl Res. 2025 May 15;17(5):3333-3344. doi: 10.62347/GNSB4367. eCollection 2025.
OBJECTIVE: To evaluate the effects of combining linaclotide with Bifid Triple Viable Capsules on clinical outcomes and quality of life (QoL) in patients with constipation-predominant irritable bowel syndrome (IBS-C). METHODS: A retrospective analysis was performed on data from 189 IBS-C patients treated between April 2021 and January 2024. The control group (91 patients) received linaclotide, while the combined group (98 patients) received linaclotide plus Bifid Triple Viable Capsules. Outcomes assessed included bowel movement frequency, stool consistency scores, constipation severity, anxiety (Self-Rating Anxiety Scale, SAS), depression (Self-Rating Depression Scale, SDS), QoL (Irritable Bowel Syndrome Quality of Life, IBS-QoL), and symptom severity (Irritable Bowel Syndrome Severity Scoring System, IBS-SSS). Logistic regression identified independent risk factors for QoL improvement. RESULTS: Both groups showed significant increases in bowel movement frequency after treatment (P < 0.001). The combined group experienced a significantly greater improvement compared to the control group (P < 0.001). Stool consistency scores improved significantly in both groups (P < 0.001), but no significant difference was observed between groups (P > 0.05). Both groups showed significant reductions in constipation severity, with the combined group showing greater improvement (P < 0.001). SAS and SDS scores decreased significantly in both groups (P < 0.001). The combined group showed greater reductions in SAS (P < 0.05) and SDS (P < 0.001). IBS-QoL scores improved significantly in both groups, with the combined group achieving greater improvement (P < 0.001). IBS-SSS scores decreased significantly, with the combined group experiencing a greater reduction (P < 0.001). IBS-QoL scores were positively correlated with bowel movement frequency (r = 0.289, P < 0.001) and negatively correlated with stool consistency scores (r = -0.154, P = 0.036), constipation severity (r = -0.386, P < 0.001), SDS scores (r = -0.150, P = 0.040), and IBS-SSS scores (r = -0.347, P < 0.001). Logistic regression identified treatment regimen (OR = 0.163, P = 0.017), age (OR = 4.666, P = 0.002), monthly income (OR = 0.065, P < 0.001), post-treatment bowel movement frequency (OR = 0.055, P < 0.001), and post-treatment constipation severity (OR = 5.545, P = 0.007) as independent factors influencing QoL improvement. CONCLUSION: The combined use of linaclotide and Bifid Triple Viable Capsules significantly enhances bowel movement frequency, reduces constipation severity, and improves QoL and psychological well-being in IBS-C patients. This approach offers a promising strategy for the comprehensive management of IBS-C.
目的：评估利那洛肽联合双歧三联活菌胶囊对便秘型肠易激综合征（IBS-C）患者临床结局和生活质量（QoL）的影响。 方法：对2021年4月至2024年1月期间接受治疗的189例IBS-C患者的数据进行回顾性分析。对照组（91例患者）接受利那洛肽治疗，联合组（98例患者）接受利那洛肽加双歧三联活菌胶囊治疗。评估的结局包括排便频率、大便性状评分、便秘严重程度、焦虑（自评焦虑量表，SAS）、抑郁（自评抑郁量表，SDS）、生活质量（肠易激综合征生活质量量表，IBS-QoL）和症状严重程度（肠易激综合征严重程度评分系统，IBS-SSS）。逻辑回归分析确定了生活质量改善的独立危险因素。 结果：两组治疗后排便频率均显著增加（P < 0.001）。联合组与对照组相比改善更为显著（P < 0.001）。两组大便性状评分均显著改善（P < 0.001），但组间差异无统计学意义（P > 0.05）。两组便秘严重程度均显著降低，联合组改善更明显（P < 0.001）。两组SAS和SDS评分均显著降低（P < 0.001）。联合组SAS（P < 0.05）和SDS（P < 0.001）降低幅度更大。两组IBS-QoL评分均显著改善，联合组改善更显著（P < 0.001）。IBS-SSS评分显著降低，联合组降低幅度更大（P < 0.001）。IBS-QoL评分与排便频率呈正相关（r = 0.289，P < 0.001），与大便性状评分（r = -0.154，P = 0.036）、便秘严重程度（r = -0.386，P < 0.001）、SDS评分（r = -0.150，P = 0.040）和IBS-SSS评分（r = -0.347，P < 0.001）呈负相关。逻辑回归分析确定治疗方案（OR = 0.163，P = 0.017）、年龄（OR = 4.666，P = 0.00）、月收入（OR = 0.065，P < 0.001）、治疗后排便频率（OR = 0.055，P < 0.001）和治疗后便秘严重程度（OR = 5.545，P = 0.007）为影响生活质量改善的独立因素。 结论：利那洛肽与双歧三联活菌胶囊联合使用可显著提高排便频率，降低便秘严重程度，改善IBS-C患者的生活质量和心理健康。该方法为IBS-C的综合管理提供了一种有前景的策略。
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