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| 1 | 针刺治疗腹泻型肠易激综合征肝郁脾虚证临床观察及其对Th1/Th2的影响显示文摘目的:观察针刺治疗腹泻型肠易激综合征肝郁脾虚证患者的临床疗效及其对细胞因子的影响。方法:纳入40例患者,随机分为两组。针刺组21例,予针刺治疗,穴取天枢、足三里、上巨虚等,每日1次;药物组19例,予口服得舒特及双岐杆菌乳杆菌三联活菌胶囊治疗。分别在治疗1周、2周、4周后比较两组治疗前后症状评分、血清Th1型细胞因子[γ型干扰素(IFN-γ)、白介素2(IL-2)]和Th2型细胞因子(IL-4、IL-10)含量以及IFN-γ/IL-4的比值等。结果:针刺组治疗1周后临床症状即有改善(P<0.05),较药物组临床起效快(P<0.05);针刺组总有效率为90.48%(19/21),优于药物组的78.95%(15/19,P<0.05);与药物相比较,患者Th1/Th2失衡状态经针刺后明显向Th2方向转化,有恢复平衡趋势。结论:针刺对D-IBS的临床疗效与其能有效促进D-IBS肝郁脾虚证患者Th1/Th2平衡密切相关。 | 吴晓亮 王烨林 孙建华 束彦页 裴丽霞 周俊灵 陈栋 张佶玮 占道伟 | 2013 | 中国针灸2013，33，12： | 36 |
| 2 | 肠易激综合征临床症状学及分型研究显示文摘目的调查肠易激综合征(irritablebowelsyndrome,IBS)患者腹部症状、排便症状、大便性状的特点及分型。方法收集2010年1月~2013年1月海军总医院消化内科诊断明确的IBS患者,并指导患者填写自行设计的调查问卷及Bristol粪便分型问卷,对患者的一般情况、腹部症状、排便症状、大便性状及分型进行统计分析。结果共调查IBS患者3242例,男女比例1:1.58;41~50岁年龄段患病率最高(29.73%)。腹痛、腹部不适比率分别为89.02%、86.92%,75.94%的患者有腹痛并腹部不适症状。92.20%的患者大便性状异常,其中排软片便或糊状便、干球样便者比率较高(51.33%、40.72%)。腹泻型IBS比率最高(40.83%)。结论IBS在41~50岁女性人群中高发,腹痛、腹部不适为常见症状,排便性状异常患者较多,最常见亚型为腹泻型。 | 崔立红 李超 王晓辉 闫志辉 贺星 弓三东 | 2014 | 解放军医药杂志2014，26，2： | 35 |
| 3 | Irritable bowel syndrome: a disease still searching for pathogenesis, diagnosis and therapy显示文摘Irritable bowel syndrome(IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient's quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain(gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome Ⅲ criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities.Nevertheless, the severity of the patient's symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms(fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge. | Massimo Bellini Dario Gambaccini Cristina Stasi Maria Teresa Urbano Santino Marchi Paolo Usai-Satta | 2014 | World Journal of Gastroenterology2014，20，27： | 37 |
| 4 | Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work?显示文摘Irritable bowel syndrome(IBS)is a functional intestinal disease characterized by abdominal pain or discomfort and altered bowel habits.It has drawn great attention because of its high prevalence,reoccurring symptoms,and severe influence on patients’lives.Many clinical studies have demonstrated the efficacy of acupuncturemoxibustion in treating IBS.Increasing attention has been paid to research regarding the action mechanisms of acupuncture-moxibustion for IBS,and the adoption of modern techniques has achieved some progress.This article reviews the latest advances among actionmechanism studies from the perspectives of gastrointestinal motility,visceral hypersensitivity,the braingut axis,the neuroendocrine system,and the immune system.It is shown that acupuncture-moxibustion can effectively regulate the above items,and thus,this treatment should have a high efficacy in the treatment of IBS.This article also identifies existing problems in current mechanism research and raises several ideas for future studies.Further revelations regarding these action mechanisms will promote the application of acupuncture-moxibustion in treating IBS. | Xiao-Peng Ma Jue Hong Cai-Ping An Dan Zhang Yan Huang Huan-Gan Wu Cui-Hong Zhang Sian Meeuwsen | 2014 | World Journal of Gastroenterology2014，20，20： | 30 |
| 5 | Irritable bowel syndrome:Emerging paradigm in pathophysiology显示文摘Irritable bowel syndrome(IBS)is one of the most common gastrointestinal disorders,characterized by abdominal pain,bloating,and changes in bowel habits.These symptoms cannot be explained by structural abnormalities and there is no specific laboratory test or biomarker for IBS.Therefore,IBS is classified as a functional disorder with diagnosis dependent on the history taking about manifested symptoms and careful physical examination.Although a great deal of research has been carried out in this area,the pathophysiology of IBS is complex and not completely understood.Multiple factors are thought to contribute to the symptoms in IBS patients;altered gastrointestinal motility,visceral hypersensitivity,and the brain-gut interaction are important classical concepts in IBS pathophysiology.New areas of research in this arena include inflammation,postinfectious low-grade inflammation,genetic and immunologic factors,an altered microbiota,dietary factors,and enteroendocrine cells.These emerging studies have not shown consistent results,provoking controversy in the IBS field.However,certain lines of evidence suggest that these mechanisms are important at least a subset of IBS patients,confirming that IBS symptoms cannot be explained by a single etiological mechanism.Therefore,it is important to keep in mind that IBS requires a more holistic approach to determining effective treatment and understanding the underlying mechanisms. | Yoo Jin Lee Kyung Sik Park | 2014 | World Journal of Gastroenterology2014，20，10： | 27 |
| 6 | 肠易激综合征发病机制的研究进展显示文摘肠易激综合征(IBS)是一种常见的功能性胃肠道疾病,临床表现主要为腹痛、腹胀以及排便习惯改变。目前,IBS的发病机制尚未完全明确。研究认为IBS是多因素共同作用的结果,相关因素包括生活方式、基因多态性、食物过敏、心理因素、脑-肠轴异常以及肠道菌群失调等。本文就IBS发病机制的研究进展作一综述。 | 郑洁 党彤 | 2015 | 胃肠病学2015，20，9： | 26 |
| 7 | 腹泻型肠易激综合征“肝郁脾虚证”病证结合大鼠模型的动态评估显示文摘目的:通过检测Thl型细胞因子IL-12和Th2型细胞因子IL-10的含量,来评价慢性束缚(S)联合番泻叶(F)灌胃法复制的D-IBS肝郁脾虚型病证结合模型。方法:将40只SPF级Wistar大鼠(雌雄各半),随机平均分为空白组及D-IBS"肝郁脾虚证"模型Ⅰ(造模7 d)组、Ⅱ(造模14d)组、Ⅲ(造模21 d)组。除空白组灌服等体积的纯净水外,其余各模型组采用S+F复制D-IBS肝郁脾虚型病证结合大鼠,分别于造模第7、14、21天采用酶联免疫吸附测定法(ELISA)检测血清1L-12、1L-10含量。结果:与空白组比较,D-IBS肝郁脾虚证模模型Ⅰ、Ⅱ、Ⅲ组Th1促炎因子IL-12的含量显著升高(P〈0.05,P〈0.01),模型Ⅰ、Ⅱ、Ⅲ组Th2抑炎因子IL-10的含量显著降低(P〈0.01)。结论:S+F灌胃法复建的D-IBS"肝郁脾虚证"模型可能存在Th1/Th2平衡漂移,是一种较好的研究中医药治疗D-IBS疗效机制的动物模型。 | 郭军雄 许小敏 刘雨娟 马丽 汪斌 | 2018 | 中华中医药学刊2018，36，11： | 25 |
| 8 | 电针对便秘型肠易激综合征大鼠结肠组织5-HT、5-HT_4受体的调节作用显示文摘目的通过观察电针对便秘型肠易激综合征大鼠结肠组织5HT、5-HL受体的调节作用,探讨电针治疗便秘型肠易激综合征的效应机制。方法将40只SD大鼠随机分为正常组、模型组、电针组和西药组,采用0~4℃生理盐水灌胃方法建立便秘型肠易激综合征大鼠模型:模型制备成功后电针组和西药组均连续治疗7d。治疗结束后,对大鼠直肠扩张刺激诱导的腹部撤回反射(AWR)进行半定量评分,采用酶联免疫技术检测结肠黏膜5-HT含量,采用免疫组化法观察结肠黏膜5-HT。受体的表达。结果与正常组相比较,模型组大鼠在肠道压力为20mmHg时腹部撤回反射评分降低(P〈0.01):与模型组相比较,电针组和西药组在肠道压力为20mmHg时腹部撤回反射评分增高(P〈0.05)。与正常组相比较,模型组大鼠结肠5-HT含量增高(P〈0.05),5HTa受体平均光密度降低(P〈0.05):与模型组比较,电针组和西药组结肠5-HT含量降低(P〈0.01,P〈0.05),电针组5-HT。受体平均光密度增加(P〈0.05):电针组与西药组5-HT浓度降低之间的差异无统计学意义(P〉0.05)。结论电针能够抑制5-HT在便秘型肠易激综合征大鼠肠道的异常表达,增加5-HT4R表达。 | 杨玲 施征 王晓梅 江岩 刘晓旭 吴璐一 马晓芃 刘慧荣 吴焕淦 | 2014 | 上海针灸杂志2014，33，3： | 21 |
| 9 | Irritable bowel syndrome:A clinical review显示文摘Irritable bowel syndrome(IBS)remains a clinical challenge in the 21st century.It’s the most commonly diagnosed gastrointestinal condition and also the most common reason for referral to gastroenterology clinics.Its can affect up to one in five people at some point in their lives,and has a significantly impact of life quality and health care utilization.The prevalence varies according to country and criteria used to define IBS.Various mechanisms and theories have been proposed about its etiology,but the biopsychosocial model is the most currently accepted for IBS.The complex of symptoms would be the result of the interaction between psychological,behavioral,psychosocial and environmental factors.The diagnosis of IBS is not confirmed by a specific test or structural abnormality.It is made using criteria based on clinical symptoms such as Rome criteria,unless the symptoms are thought to be atypical.Today the Rome CriteriaⅢis the current goldstandard for the diagnoses of IBS.Secure positive evidence of IBS by means of specific disease marker is currently not possible and cannot be currently recommended for routine diagnosis.There is still no clinical evidence to recommend the use of biomarkers in blood to diagnose IBS.However,a number of different changes in IBS patients were demonstrated in recent years,some of which can be used in the future as a diagnostic support.IBS has no definitive treatment but could be controlled by non-pharmacologic management eliminating of some exacerbating factors such certain drugs,stressor conditions and changes in dietary habits.The traditional pharmacologic management of IBS has been symptom based and several drugs have been used.However,the cornerstone of its therapy is a solid patient physician relationship.This review will provide a summary of pathophysiology,diagnostic criteria and current and emerging therapies for IBS. | Rosa LS Soares | 2014 | World Journal of Gastroenterology2014，20，34： | 16 |
| 10 | 布拉酵母菌治疗腹泻型肠易激综合征的效果及机制分析显示文摘目的探讨布拉酵母菌对腹泻型肠易激综合征(IBS-D)患者的临床症状的改善及炎性反应的影响。方法选取2013年1月—2014年12月在海军总医院消化内科就诊的IBS-D患者112例,随机分为观察组和对照组各56例。对照组予以饮食、生活方式指导及常规对症治疗,观察组在对照组治疗的基础上给予布拉酵母菌治疗,疗程8周。观察两组治疗前后IBS-D相关症状和血清炎性因子白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及核因子-κB(NF-κB)的变化。结果观察组和对照组治疗后症状改善方面均取得明显效果,观察组总体有效率明显高于对照组(P<0.01);两组治疗后症状评分均较前降低(P<0.05),观察组下降更加明显(P<0.05);观察组治疗后血清IL-6、TNF-α及NF-κB明显下降(P<0.05),对照组上述指标亦有下降,但与治疗前比较差异无统计学意义(P>0.05),两组治疗后IL-6、TNF-α及NF-κB差异有统计学意义(P<0.05)。结论布拉酵母菌可以通过抑制NF-κB活性进而调节IBS-D患者肠道的异常炎性反应改善临床症状,是一种治疗IBS-D的有效药物。 | 李超 崔立红 贺星 王晓辉 闫志辉 弓三东 | 2015 | 解放军医药杂志2015，27，8： | 16 |
| 11 | 金荞麦片对脾虚湿热证腹泻型肠易激综合征大鼠免疫炎症和内脏高敏感性的影响显示文摘目的:研究金荞麦片对脾虚湿热证肠易激综合征腹泻型(diarrhea-predominant irritable bowel syndrome,IBS-D)大鼠免疫炎症和内脏高敏感性的影响.方法:选取SPF级新生SD大鼠,采用高乳糖饲料+慢性束缚+夹尾刺激诱导IBS-D大鼠模型.造模成功后,将实验动将物随机分为正常对照组(A组)、模型对照组(B组)、金荞麦片高剂量组(C组)、中剂量组(D组)、低剂量组(E组)、谷参肠安组(F组),金荞麦片组分别给予高剂量[6 g/(kg·d)]、中剂量[3 g/(kg·d)]和低剂量[1.5 g/(kg·d)]中药灌胃,谷参肠安组给予谷参肠安2 g/(kg·d),正常组和模型组分别给予等容积生理盐水灌胃,1次/d.灌胃4 wk后,行直肠内球囊扩张实验(colorectal distention,CRD),观察腹肌收缩反射(abdominal withdrawal reflex,AWR),评估大鼠结肠转运和感觉功能,放射免疫法检测血清肿瘤坏死因子-(tumor necrosis factor-,TNF-)、白介素-17(interleukin 17,IL-17)、IL-10、P物质(substance P,SP)和降钙素基因相关肽(calcitonin gene-related peptide,CGRP)含量,荧光定量PCR检测肠组织5-羟色胺(5-hydroxytryptamine,5-HT)、5-羟色胺3受体(5-hydroxytryptamine 3 receptor,5-HT3R)、神经激肽受体-1(neurokinin receptor 1,NK1R)和细胞间黏附分子(intracellular adhesion molecule-1,ICAM-1)mRNA表达水平.结果:与模型组比较,金荞麦片各剂量组大鼠结肠转运功能及内脏高敏感性明显降低(P<0.05或0.01),大鼠血清TNF-(2.81 ng/L±0.67 ng/L,2.76 ng/L±0.31 ng/L,2.91 ng/L±0.77 ng/L vs 3.77 ng/L±0.44 ng/L)、IL-17(2.01 ng/L±0.76 ng/L,2.14 ng/L±0.29ng/L,1.98 ng/L±0.11 ng/L vs 2.47 ng/L±0.33 ng/L)及SP(38.22 pg/mL±3.15 pg/mL,37.55 pg/mL±2.63 pg/mL,42.01 pg/mL±3.79pg/mL vs 43.19 pg/mL±4.28 pg/mL)含量均较模型组降低.IL-10(137.25 ng/L±6.2 ng/L,135.90 ng/L±4.4 ng/L,121.70 ng/L±5.11 ng/L vs 82.09 ng/L±5.33 ng/L)和CGRP(155.09 ng/L±4.38 ng/L,142.02 ng/L±2.44 ng/L,158.25ng/L±4.02 ng/L vs 107.31 ng/L±3.96 ng/L)明显升高(P<0.05或0.01).肠组织5-HT(0.74±0.43,0.97±0.91,0.66±0.29 vs 1.27±0.45)、5-HT3R(1.01±0.35,1.14±0.76,1.47±0.65 vs1.61±0.03)、NK1R(1.07±0.58,0.98±0.67,0.88±0.79 vs 1.47±0.94)和ICAM-1(0.81±0.55,0.96±0.19,0.72±0.93 vs 1.33±0.26)mRNA表达水平下调(P<0.05或0.01),尤以金荞麦片高剂量组为优.结论:金荞麦片可降低IBS-D大鼠内脏高敏感性,有效抑制免疫炎症反应,多靶点、多层次地参与调节胃肠动力.金荞麦片对实验性IBS-D具有量效依赖作用. | 牛晓玲 周英豪 孙书焰 庄璘 | 2013 | 世界华人消化杂志2013，21，32： | 14 |
| 12 | 综合护理干预在肠易激综合征治疗中效果分析显示文摘目的分析综合护理干预在治疗肠易激综合征中的临床效果。方法选择2012年4月-2014年12月在我院住院的120例肠易激综合征患者作为研究对象,随机分为观察组和对照组各60例,在给予药物治疗同时,分别实施综合护理干预和常规护理。治疗前及治疗8周后所有患者分别完善肠易激综合征知识问卷、焦虑、抑郁自评量表,并分别采集患者临床症状资料,观察疗效。结果观察组治疗效果明显优于对照组(86.67%vs 61.67%,P<0.05),治疗后观察组焦虑、抑郁评分较对照组显著降低(42.54±6.04 vs 52.92±6.09,45.42±5.84 vs 54.88±5.91,P<0.05),肠易激综合征知识问卷得分较对照组显著升高(23.15±3.82 vs 16.76±4.73,P<0.05)。结论综合护理干预较常规护理干预可提高肠易激综合征患者的治疗效果。 | 荣加 崔立红 | 2015 | 解放军医学院学报2015，36，10： | 11 |
| 13 | Is irritable bowel syndrome an organic disorder?显示文摘Irritable bowel syndrome(IBS)is a common gastrointestinal disorder that is generally considered to be functional because there appears to be no associated anatomical defect.Stress and psychological factors are thought to play an important role in IBS.The gut neuroendocrine system(NES),which regulates all functions of the gastrointestinal tract,consists of endocrine cells that are scattered among the epithelial cells of the mucosa,and the enteric nervous system.Although it is capable of operating independently from the centra nervous system(CNS),the gut NES is connected to and modulated by the CNS.This review presents evidence for the presence of an anatomical defect in IBS patients,namely in the gastrointestinal endocrine cells.These cells have specialized microvilli that project into the lumen and function as sensors for the luminal content and respond to luminal stimuli by releasing hormones into the lamina propria,which starts a chain reaction that progresses throughout the entire NES.The changes in the gastrointestinal endocrine cells observed in IBS patients are highly consistent with the other abnormalities reported in IBS patients,such as visceral hypersensitivity,dysmotility,and abnormal secretion. | Magdy El-Salhy Doris Gundersen Odd Helge Gilja Jan Gunnar Hatlebakk Trygve Hausken | 2014 | World Journal of Gastroenterology2014，20，2： | 11 |
| 14 | Methodological issues in the study of intestinal microbiota in irritable bowel syndrome显示文摘Irritable bowel syndrome(IBS) is an intestinal functional disorder with the highest prevalence in the industrialized world. The intestinal microbiota(IM) plays a role in the pathogenesis of IBS and is not merely a consequence of this disorder. Previous research efforts have not revealed unequivocal microbiological signatures of IBS, and the experimental results are contradictory. The experimental methodologies adopted to investigate the complex intestinal ecosystem drastically impact the quality and significance of the results. Therefore, to consider the methodological aspects of the research on IM in IBS, we reviewed 29 relevant original research articles identified through a PubMed search using three combinations of keywords: 'irritable bowel syndrome + microflora', 'irritable bowel syndrome + microbiota' and 'irritable bowel syndrome + microbiome'. For each study, we reviewed the quality and significance of the scientific evidence obtained with respect to the experimental method adopted. The data obtained from each study were compared with all considered publications to identify potential inconsistencies and explain contradictory results. The analytical revision of the studies referenced in the present review has contributed to the identification of microbial groups whose relative abundance significantly alters IBS, suggesting that these microbial groups could be IM signatures for this syndrome. The identification of microbial biomarkers in the IM can be advantageous for the development of new diagnostic tools and novel therapeutic strategies for the treatment of different subtypes of IBS. | Valentina Taverniti Simone Guglielmetti | 2014 | World Journal of Gastroenterology2014，20，27： | 10 |
| 15 | 乌灵胶囊联合匹维溴铵治疗肠易激综合征的临床研究显示文摘目的观察乌灵胶囊联合匹维溴铵治疗肠易激综合征(irritable bowel syndrome,IBS)的疗效和安全性。方法 64例IBS患者按随机数字表法分为治疗组(32例)和对照组(32例)。治疗组给予口服乌灵胶囊(0.33 g/粒),1次3粒,每日3次,并联合口服匹维溴铵片(50 mg/片),1次1片,每日3次;对照组仅口服匹维溴铵片(50 mg/片),1次1片,每日3次;两组疗程均为6周。观察两组治疗前后各项IBS症状评分和IBS生活质量评价量表(IBS-Quality of Life,IBS-QOL)评分的变化,应用抑郁自评量表(Self-Rating Depression Scale,SDS)和焦虑自评量表(Self-Rating Anxiety Scale,SAS)进行心理评估,观察患者不良反应发生的情况。结果与对照组比较,治疗组腹痛、大便次数、大便性状症状改善,积分变化率高于对照组,差异有统计学意义(P<0.05);治疗组IBS-QOL烦躁不安、身体意象、健康忧虑、饮食限制的评分改善,评分变化率高于对照组,差异有统计学意义(P<0.05);治疗组SDS和SAS的评分改善,评分变化率高于对照组,差异有统计学意义(P<0.05)。两组患者均未发现严重不良反应。结论乌灵胶囊联合匹维溴铵治疗IBS,能够进一步改善IBS患者腹痛及排便症状,减轻抑郁焦虑,且安全性高。 | 吴晓尉 侯煜 季洪赞 梁铭铭 许莲娥 汪芳裕 | 2015 | 中国中西医结合杂志2015，35，4： | 9 |
| 16 | 中性粒细胞与淋巴细胞比值对初发溃疡性结肠炎鉴别诊断及其严重程度判断的临床意义显示文摘目的评估中性粒细胞与淋巴细胞比值(NLR)对溃疡性结肠炎诊断的临床意义。方法选取2009年6月~2016年6月就诊于上海长海医院的192例患者,其中溃疡性结肠炎患者97例,肠易激综合征患者95例。通过研究血常规中中性粒细胞与淋巴细胞比值(NLR),分析两组疾病NLR差异,并评价NLR对溃疡性结肠炎诊断的敏感度及特异度;通过改良的Mayo评分系统评估溃疡性结肠炎疾病严重程度,并分别分析NLR在溃疡性结肠炎不同严重程度及不同病变部位之间的差异。结果与肠易激综合征组相比,溃疡性结肠炎患者NLR显著增高,差异具有统计学意义(t=2.327,P<0.021);诊断溃疡性结肠炎敏感度和特异度分别为69.1%和75.8%;NLR在溃疡性结肠炎严重程度之间差异有统计学意义(F=8.221,P=0.001);NLR在不同病变部位之间差异无统计学意义(F=0.737,P=0.483)。结论 NLR在溃疡性结肠炎与肠易激综合征鉴别诊断中具有一定价值和临床意义,并且可以判断溃疡性结肠炎的严重程度。 | 周正宇 高谦 景丽玲 岳展伊 孟洁 刘善荣 | 2018 | 现代检验医学杂志2018，33，1： | 9 |
| 17 | 小肠细菌过度生长与肠易激综合征的关系显示文摘目的探讨小肠细菌过度生长与肠易激综合征的关系,为肠易激综合征的发病和治疗寻找新思路。方法选择2013年1月-2015年1月在我院就诊的120例肠易激综合征(irritable bowel syndrome,IBS)患者作为观察组,选取同期我院体检中心60例健康查体者作为对照组。两组均行乳糖甲烷-氢呼吸试验检查、炎性细胞因子检测及完善IBS症状积分调查问卷。小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)阳性的IBS患者接受利福昔明治疗2周后复查甲烷-氢呼吸试验,根据氢呼吸试验结果将SIBO阳性的IBS患者分为转阴组和未转阴组,观察IBS的治疗有效率。结果观察组与对照组SIBO阳性率(68.33%vs 18.33%)存在统计学差异(P<0.05);利福昔明治疗SIBO的转阴率为70.73%;转阴组(症状积分:3.96±1.42 vs 12.45±3.78,IL-6:97.32±13.83 vs 158.84±15.51,TNF-α:29.67±6.19 vs 42.67±7.65)及未转阴组(症状积分:7.89±2.37 vs 12.39±3.69,IL-6:126.79±14.29 vs 156.43±15.49,TNF-α:35.12±6.67 vs 43.27±7.64)治疗后IBS症状积分及炎性细胞因子均明显低于治疗前(P<0.05);转阴组治疗后IBS治疗有效率(82.75%vs 62.50%)、IBS症状积分(3.96±1.42 vs 7.89±2.37)及炎性细胞因子(IL-6:97.32±13.83 vs 126.79±14.29,TNF-α:29.67±6.19 vs35.12±6.67)均优于未转阴组(P<0.05)。结论 SIBO在IBS患者中有较高的发病率,治疗SIBO可以改善IBS患者的临床症状。 | 崔立红 王晓辉 闫志辉 李超 贺星 弓三东 | 2015 | 解放军医学院学报2015，36，10： | 9 |
| 18 | 针刺对腹泻型肠易激综合征脑肠神经肽NPY及PAR4的影响显示文摘目的探讨针刺对肠易激综合征(D-IBS)脑肠神经肽NPY及PAR4的影响,为中医药治疗肠易激综合征(IBS)提供可靠科学数据。方法50只SPF级SD大鼠,通过随机数字表法筛选8只作为正常组,其余42只参照D-IBS模型进行复制,将复制成功的18只模型大鼠再随机分成模型组和针刺组,针刺组针刺天枢、中脘、关元、足三里四穴,观察各组大鼠的体重、粪便含水量、胃排空率、小肠推进率的差异变化;应用酶联免疫吸附法(ELISA)检测肠派式小体及脑扣带回组织中的NPY含量差异;应用免疫组织化学法(IHC)检测肠派式小体及脑扣带回组织中PAR4的差异变化。结果模型组的体重显著低于正常组,在针刺治疗后有明显增加;模型组的粪便含水量、肠推进率及脑肠神经肽NPY含量均显著高于正常组,针刺组明显低于模型组;IHC检测PAR4显示模型组脑扣带回及肠派式小体组织中的平均光密度显著低于正常组,针刺组明显高于模型组。结论针刺显著改善D-IBS的腹泻指证,通过调控脑肠神经肽NPY和PAR4等关键因子达到缓解治疗的目的。 | 司原成 任晨晨 李青青 陈波 | 2020 | 时珍国医国药2020，31，7： | 9 |
| 19 | 肠易激综合征的可能相关致病因素和机制显示文摘肠易激综合征(irritable bowel syndrome,IBS)是一种常见的功能性胃肠病。在世界范围内,有大量关于IBS的研究和报道,但目前其具体病因和机制尚不十分清楚。可能涉及到遗传、肠道感染、精神心理因素、肠道高敏性、食物不耐受、激素水平改变、睡眠障碍、压力等因素。本文对其可能的相关致病因素和机制作一概述。 | 刘亮 姚树坤 | 2013 | 胃肠病学和肝病学杂志2013，22，10： | 9 |
| 20 | 针刺联合参苓健脾胃颗粒治疗肠易激综合征腹泻型的近远期疗效观察显示文摘目的:观察针刺联合参苓健脾胃颗粒治疗IBSD的近期和远期疗效。方法:来自2011年5月—2014年3月新乡医学院第一附属医院消化科门诊和住院病房的640例确诊的IBSD病人采用随机方法分为4组:针刺组、参苓健脾胃颗粒(Shen ling jian pi wei Granules,SLJPWG)组、联合治疗组及对照组,每组160例。针刺组针刺足三里、肝俞、脾俞、太冲及脐中四边穴,每日2次,共4周;SLJPWG组予SLJPWG 10g口服,每日2次;联合治疗组则予上述针刺及SLJPWG治疗;对照组口服复方地芬诺酯1片,每日2次,蒙脱石散3 g,每日3次,阿米替林25mg,每日两次。评价4组患者治疗前、治疗结束时及治疗结束后60周排便次数、大便性状、伴随症状评分、生活质量评分及不良反应。结果:治疗过程中SLJPWG组剔除3例,脱落2例;联合组和对照组各脱落3例。与治疗前比较,治疗结束时各组排便次数、大便性状和伴随症状评分均明显下降(P<0.01),生活质量评分明显上升(P<0.01),联合治疗组上述指标优于其他组(P<0.05);与治疗结束时比较,治疗后60周上述指标在针刺组和联合治疗组无明显反复(P>0.05),在SLJPWG组和对照组则明显反复(P<0.05),联合治疗组近期和远期疗效率均显著高于其他组的总有效率(P<0.05或P<0.01),各组均无严重不良反应发生。结论:针刺和SLJPWG均能显著减少IBSD患者排便次数,改善大便性状,缓解伴随症状,提高生活质量,但联合用药效果更好,并具有较好的安全性和近远期疗效。 | 张超贤 郭李柯 秦咏梅 | 2016 | 中华中医药学刊2016，34，4： | 8 |
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