目的观察及评估凝结芽孢杆菌活菌片联合米氮平治疗腹泻型肠易激综合征(diarrhea irritable bowel syndrome,IBS-D)的临床疗效。方法将67例腹泻型肠易激综合征患者随机分成3组,A组服用凝结芽孢杆菌活菌片联合米氮平片治疗;B组单用米氮平片治疗;C组单用凝结芽孢杆菌活菌片治疗。连续用药4周,观察疗效和安全性。结果 A组患者总有效率为95.5%,明显高于B组的63.6%和C组的65.2%(P<0.01),B组共有3例患者治疗后出现轻微头晕、嗜睡、乏力症状,A组和C组患者未见任何不良反应。结论凝结芽孢杆菌活菌片联合米氮平治疗腹泻型肠易激综合征能显著改善患者临床症状及生活质量,效果显著,安全可靠,值得进一步临床推广使用。 Objective To observe and evaluate the clinical efficacy of Bacillus coagulans combined with mirtazapine in the treatment of diarrhea irritable bowel syndrome (IBS-D). Methods Sixty-seven patients with diarrhea-predominant irritable bowel syndrome were randomly divided into three groups: group A was treated with Bacillus coagulans viable combination with mirtazapine; group B with mirtazapine alone; group C with B. coagulans alone Live bacteria treatment. Continuous medication for 4 weeks to observe the efficacy and safety. Results The total effective rate was 95.5% in group A, significantly higher than 63.6% in group B and 65.2% in group C (P <0.01). A total of 3 patients in group B developed mild dizziness, drowsiness and fatigue after treatment, and group A And group C patients did not see any adverse reactions. Conclusion Bacillus coagulans combined with mirtazapine treatment of diarrhea-predominant irritable bowel syndrome can significantly improve clinical symptoms and quality of life in patients with significant effect, safe, reliable and worth further clinical use.