莫沙必利治疗便秘型肠易激综合征重叠功能性消化不良临床研究

目的探讨莫沙必利对便秘型肠易激综合征重叠功能性消化不良患者治疗的临床疗效。方法选取商丘市第一人民医院在2011年12月至2012年12月期间收治的80例便秘型肠易激综合征重叠功能性消化不良患者,随机分为对照组和观察组,对照组采用肠激宁治疗,观察组采用莫沙必利进行治疗,治疗4周后比较两组患者的临床疗效及临床症状积分。结果治疗后,观察组总有效率(90%)明显高于对照组总有效率(72.5%),两组间差异有统计学意义(χ2=4.114 2,P<0.05);且观察组各临床症状积分均明显低于对照组,差异具有统计学意义(t=2.021 7,P<0.05;t=1.992 8,P<0.05;t=2.007 2,P<0.05;t=2.050 5,P<0.05);观察组治疗后各临床症状积分均较治疗前明显降低,差异有统计学意义(t=3.783 4,P<0.01;t=2.859 2,P<0.01;t=3.018 0,P<0.01;t=3.292 4,P<0.01)。结论莫沙必利对便秘型肠易激综合征重叠功能性消化不良治疗的临床疗效明显,具有一定的临床意义。     

复方阿嗪咪特治疗功能性消化不良重叠腹泻型肠易激综合征的研究

目的 研究复方阿嗪咪特联合多潘立酮和谷维素治疗功能性消化不良(FD)重叠腹泻型肠易激综合征(IBS-D)的疗效.方法 采用数字随机、病例对照的前瞻性研究.97例患者按数字随机方法分为治疗组(A组)49例(复方阿嗪咪特联合多潘立酮和谷维素)、对照组(B组)48例(多潘立酮和谷维素).两组治疗4周前后症状采用分级记分进行描述,疗效评价参照症状积分的变化.结果 A组治疗后患者症状总积分较治疗前明显下降(P＜0.01),且积分下降幅度与B组比较差异有统计学意义(P＜0.01).A组治疗各种症状及总症状的有效率,均显著优于B组(P＜0.01).结论 复方阿嗪米特肠溶片联合多潘立酮和谷维素治疗功能性消化不良重叠腹泻型肠易激综合征,疗效高,无明显副作用.     

肠易激综合征临床分析

目的 探讨肠易激综合征（IBS）的病因、发病情况及其相关临床特征。方法连续收集问卷普通内科门诊及消化专科门诊IBS 826例。结果IBS患者女性显著多于男性。发病高峰年龄段为25～55岁；中等文化水平者（60.2％）惠病就医比例最高。结论IBS患者的高峰年龄段较国外报道提前，IBS患病率高低与患者受教育程度不成正比例关系，不同于国外报道。     

肠易激综合征的中医护理

肠易激综合征是临床上常见的消化系统功能性疾病，与肠道动力学异常有关。其发病机制目前不详。作者试图根据中医的病因病机特点及其中医临床护理特点，对肠易激综合征的护理疗法及预后调护进行系统的阐述，以提高临床疗效及护理水平。     

腹泻型、便秘型肠易激综合征和功能性便秘患者的直肠肛管测压比较

目的研究腹泻型、便秘型IBS和功能性便秘患者直肠肛管测压参数的不同，并评价性别和年龄对各项参数的影响，方法腹泻型IBS(n=18)、便秘型IBS(n=14)、功能性便秘(n=30)和健康对照组(n=18)，通过定点牵拉法进行直肠肛管测压。结果腹泻型IBS、便秘型IBS、功能性便秘以及健康对照组直肠肛管测压各项压力参数基本无差异，但三组患者的诱发RAIR所需的最小气体容量均显著高于健康对照组，便秘型IBS和功能性便秘模拟排便时发生矛盾运动的百分比显著高于腹泻型IBS和健康对照组；便秘型IBS和功能性便秘组中，肛管上部和下部最大紧缩压力，以及模拟排便发生矛盾运动的百分比男性均高于女性；腹泻型IBS组内男性模拟排便发生矛盾运动的百分比高于女性；健康对照组内男性肛管下部静息压力和最大紧缩压力高于女性；各组20-50岁人群和50-80岁人群的各项压力参数无显著性差异，但功能性便秘组青年组诱发RAIR所需的最小气体容量低于老年组。结论腹泻型IBS、便秘型IBS和功能性便秘患者的直肠肛管测压各项压力参数无助于这三型功能性肠病的鉴别诊断。男性的直肠肛管测压的多项压力参数显著高于女性，男性更易出现模拟排便矛盾运动，年龄对直肠肛管测压各项参数无明显影响。     

肠易激综合征患者生活质量对照研究

目的了解肠易激综合征(IBS)患者生活质量状况.方法应用SF-36健康普适量表对25例符合罗马Ⅱ诊断标准的IBS患者及性别、年龄相匹配的健康对照者进行调查,作生活质量比较研究.结果 IBS患者除了生理功能(PF)外,其它7个维度的生活质量平均积分均比健康对照组低(生理职能P＜0.05,余6个维度均P＜0.01);IBS患者生活质量下降和肠道症状并不相关.结论 IBS患者生活质量普遍低下,但并非肠道症状直接影响所致.     

心身障碍可致肠易激综合征

肠易激综合征是一种以腹痛,腹部不适,伴排便习惯改变为特征的功能性肠病。是一种与心身障碍有关的肠道紊乱疾病。     

肠易激综合征患者胆囊排空功能研究

目的:研究肠易激综合征(IBS)患者胆囊排空功能.方法:用二维B超测量47例肠易激综合征(腹泻型25例,便秘型22例)患者胆囊排空功能,并与对照组比较.结果:空腹时腹泻型IBS患者胆囊平均体积大于对照组和便秘组(P＜0.01),脂肪餐后其排空率明显下降(P＜0.05),而便秘型IBS与对照组无显著性差异(P＞0.05).结论:腹泻型IBS患者存在胆囊排空功能障碍.     

肠易激综合征患者疾病认知情况调查

目的调查肠易激综合征（IBS）患者对疾病的认知情况。方法收集86例IBS患者进行问卷调查，然后根据各个调查问题进行患者数据汇总统计，并计算其占总例数的百分率。结果仅47．7％的患者听说过IBS，44．2％的患者认为IBS为肠道细菌感染性疾病。26．7％的患者认为IBS起源于急性胃肠炎。半数以上的患者认为IBS与心理因素．工作或生活压力、睡眠质量和食品有关。26．7％的患者认为诊断IBS需要长期反复进行结肠镜等检查，33．7％的患者认为仅使用药物就能治愈IBS。69．8％的患者认为IBS随着年龄增长会恶化，15．1％的患者认为IBS会发展为结肠癌。结论患者对IBS的知识了解有限，部分患者甚至观念错误。应加强对IBS患者的卫生知识宣教以提高IBS患者的生活质量。     

The prevalence of irritable bowel syndrome in outpatients with bulimia nervosa

Objective:

This study examined the prevalence of irritable bowel syndrome (IBS) in patients with bulimia nervosa (BN), and the relationship between these disorders.

Method:

Sixty‐four participants with a diagnosis of BN or a related condition were recruited from an outpatient eating disorders service. Questionnaire and interview measures were used to assess bulimic symptoms and attitudes, IBS symptoms, anxiety and depression. Cases of IBS were identified using the Manning criteria.

Results:

There was a high prevalence of IBS in the patient group (68.8%), but IBS status was not predicted by any of the other variables measured. Patients who met criteria for IBS reported more frequent self‐induced vomiting than those who did not (U = 256.0, p = 0.038).

Discussion:

There is evidence of an high incidence of IBS in outpatients with BN, but the relationship between these conditions remains unclear. Future research should consider possible common risk factors. © 2011 by Wiley Periodicals, Inc.     

肠易激综合征患者生命质量测定量表研制及评价

目的 研制与评价慢性病患者生命质量测定量表体系之肠易激综合征量表(QLICD-IBS).方法 采用程序化决策方式,结合中国人群背景,进行量表开发和研制;对99例肠易激综合征患者住院治疗前后的生命质量进行测评,评价量表效度、信度、反应度.结果 肠易激综合征患者生命质量测定量表(QLICD-IBS)包括慢性病共性模块30个条目和肠易激综合征特异模块15个条目,量表各领域及维度的内部一致性信度(α)基本>0.6以上、重测信度(r)>0.9;各条目与所属维度及其领域的相关均大于与其他维度及领域的相关,相关系数(r)值大多>0.6;量表能够反映出患者治疗前后生命质量的变化.结论 量表(QLICD-IBS)具有较好的信度、效度、反应度和临床可行性,可作为适合中国人群的生命质量测评工具.     

Management of patients with food intolerance in irritable bowel syndrome: the development and use of an exclusion diet

Food intolerance is an important cause of abdominal symptoms. As no objective tests are available to identify the foods concerned, diets are essential for the management of these patients. The fewer foods allowed in the diet, the greater is die chance of success. Our original studies of 182 patients between 1979 and 1982, using a diet of lamb, rice and pears, had resulted in a 67% success rate. The foods most commonly involved were wheat (60%), cows' milk (44%) and corn (44%). A less restrictive exclusion diet was developed from the results of this work, avoiding all those foods to which 20% or more of the patients had been intolerant. Of 253 patients (79%), 200 were able to complete 2 weeks on this diet and 100 (50%) were successful in controlling their symptoms. The exclusion diet was modified in the light of this experience and in a subsequent study of 129 patients, 96 (75%) were able to comply for 2 weeks, but only 39 (41%) improved on the basic diet. However, examination of the food diaries of these patients enabled the identification of less frequent food intolerances in 21 (22%) giving an overall success rate of 60 (63%). In this way, equally good results can be obtained using a nutritionally adequate exclusion diet and avoiding the difficulties of following a more rigorous elimination regime.     

某校大学生饮食习惯对肠易激综合征的影响

目的 了解饮食对肠易激综合征的影响。方法 对2018年10月—2019年4月来校医院就诊的1 207名在校本科生进行问卷调查,问卷依据罗马Ⅳ诊断标准,数据分析采用SPSS 22.0卡方检验、单因素分析、Logistic多因素回归分析。结果 来校医院就诊的在校大学生中,肠易激综合征的患病率为5.1%(60/1207)。在单因素分析中,进食生冷(P=0.070)、高纤维(P=0.367)、乳制品(P=0.414)、果蔬(P=0.784)与肠易激综合征的患病差异无统计学意义。进食辛辣(P=0.002)、高脂饮食(P<0.001)与肠易激综合征的患病差异有统计学意义。进一步Logistic多因素回归分析显示,高频率进食高脂食物比低频率(≤1次/周)进食高脂食物更容易引起肠易激综合征。P值为0.003,OR:1.545。结论 本调查样本中,肠易激综合征的患病率为5.1%。肠易激综合征的患病与进食辛辣、高脂饮食有关。高频率的进食高脂食物是肠易激综合征患病的危险因素。基层医生应着重做好相关病人的饮食指导,尽量减少肠易激综合征被诱发。     

Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome

Background: Emerging evidence indicates that the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may result in symptoms in some patients with irritable bowel syndrome (IBS). The present study aimed to determine whether a low FODMAP diet is effective for symptom control in patients with IBS and to compare its effects with those of standard dietary advice based on the UK National Institute for Health and Clinical Excellence (NICE) guidelines. Methods: Consecutive patients with IBS who attended a follow‐up dietetic outpatient visit for dietary management of their symptoms were included. Questionnaires were completed for patients who received standard (n = 39) or low FODMAP dietary advice (n = 43). Data were recorded on symptom change and comparisons were made between groups. Results: In total, more patients in the low FODMAP group reported satisfaction with their symptom response (76%) compared to the standard group (54%, P = 0.038). Composite symptom score data showed better overall symptom response in the low FODMAP group (86%) compared to the standard group (49%, P < 0.001). Significantly more patients in the low FODMAP group compared to the standard group reported improvements in bloating (low FODMAP 82% versus standard 49%, P = 0.002), abdominal pain (low FODMAP 85% versus standard 61%, P = 0.023) and flatulence (low FODMAP 87% versus standard 50%, P = 0.001). Conclusions: A low FODMAP diet appears to be more effective than standard dietary advice for symptom control in IBS.     

4～5岁肠易激综合征儿童心理行为特点及家庭环境研究

【目的】探讨肠易激综合征儿童的心理行为及家庭环境特点,为其心理干预提供依据。【方法】应用问卷调查与专科随访相结合的方式选定肠易激综合征儿童352例,采用病例对照研究的方法探讨肠易激综合征儿童的气质、行为和家庭环境特征。【结果】肠易激综合征儿童气质维度方面活动水平和反应强度得分高于对照组(P0.01),规律性、趋避性、情绪本质及注意分散度得分低于对照组(P0.01)。肠易激综合征儿童发生行为问题的风险大(OR=1.793);肠易激综合征是男童发生体诉、抑郁、不成熟、攻击、违纪和行为总分异常的危险因素(OR=3.93,2.84,4.99,30.86,3.03,4.22),是女童发生体诉、强迫性和行为总分异常的危险因素(OR=5.11,2.00,1.55)。家庭环境方面病例组亲密度、独立性、道德宗教观及控制性得分低于对照组(P0.05),娱乐性与组织性得分低于对照组(P0.01),矛盾性和成功性得分高于对照组(P0.01)。【结论】肠易激综合征儿童有独特的气质特点,其家庭环境不良,发生行为问题的风险大。     

Effects of linseeds on the symptoms of irritable bowel syndrome: a pilot randomised controlled trial

Background: Manipulation of dietary fibre intake represents a longstanding treatment for patients with irritable bowel syndrome (IBS), particularly for those with constipation. Linseeds are often recommended by both clinicians and dietitians as a source of dietary fibre to alleviate symptoms. Recent guidance on the management of irritable bowel syndrome (IBS) advises that linseeds may reduce wind and bloating, although there is limited clinical evidence to support this recommendation. The present pilot study aimed to compare the clinical effectiveness of: (i) whole linseeds versus ground linseeds; (ii) whole linseeds versus no linseeds; and (iii) ground linseeds versus no linseeds in the management of IBS symptoms. Methods: In an open randomised controlled trial, subjects with IBS (n = 40) were allocated to one of three intervention groups: two tablespoons of whole linseeds per day (n = 14), two tablespoons of ground linseeds per day (n = 13) and no linseeds as controls (n = 13). Symptom severity (primary outcome) and bowel habit were assessed before and after a 4‐week intervention and statistical differences between the groups were compared. Results: Thirty‐one subjects completed the present study. Between‐group analysis comparing the improvement in symptom severity did not reach statistical significance for whole linseeds (n = 11) versus ground linseeds (n = 11; P = 0.62), whole linseeds versus controls (n = 9; P = 0.12) and ground linseeds versus controls (P = 0.10). There were no significant changes in stool frequency or stool consistency for any of the groups. Conclusions: Linseeds may be useful in relief of IBS symptoms. Further research is needed to detect clear differences between the effects of whole and ground linseeds.     

An epidemiologic study of irritable bowel syndrome in adolescents and children in South China: a school‐based study

Background To explore the prevalence of irritable bowel syndrome (IBS) among school‐aged children in South China, and identify distribution characteristics and contributing factors. Methods Primary, middle and high school students (n= 2013) were recruited from schools in Shanghai. Students completed two questionnaires, one for IBS in adolescents and children and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Results (1) The prevalence of IBS among students was 20.72% and the incidence increased with age. (2) Several physical factors and overuse of analgesics were significantly associated with IBS. (3) The prevalence of anxiety disorder was higher in older students, and in females vs. males. Students with IBS tended towards anxiety‐related emotional disorders (38.14% vs. 18.96%). (4) IBS students scored higher in all SCARED categories. Within IBS students, those who frequently sought medical care reported higher scores in the somatization/panic category. Conclusion (1) Irritable bowel syndrome is a common disorder among adolescents in South China and prevalence increases with age. (2) Gastrointestinal infection, abuse of analgesics and psychological factors might be related to the incidence of IBS. (3) The tendency towards anxiety‐related emotional disorders also increases with age, suggesting a possible correlation with IBS and underlining the importance of positive family and school environments. Although the prevalence of anxiety‐related emotional disorders was higher in females than males, this trend was not correlated with the occurrence of IBS.     

肠易激综合征回盲部肥大细胞的实验观察

目的观察肠易激综合征(IBS)患者肠黏膜回盲部肥大细胞的分布及变化,探讨其在IBS中的可能作用。方法符合入选标准IBS患者30例,按临床症状分为腹泻型、便秘型。与15例正常人经结肠镜钳取回盲部结肠黏膜,检测肥大细胞及脱颗粒肥大细胞的数目,进行比较。结果IBS患者回盲部肥大细胞的数目增多,与正常对照组比较,有高度统计学意义,腹泻型与便秘型之间差异无统计学意义;腹泻型、便秘型患者回盲部脱颗粒肥大细胞数明显多于正常组,差异有统计学意义;便秘型与腹泻型之间比较P<0.01,有高度统计学意义。结论肠易激综合征患者回盲部肥大细胞增多,提示与IBS临床症状有相关性;腹泻型肠易激综合征回盲部脱颗粒肥大细胞增多,提示肥大细胞活化是产生IBS腹泻的原因。