肠易激综合征患者直肠肛门动力学研究

为了研究肠易激综合征患者肛门运动功能，我们测定了５０例ＩＢＳ患者在１１例正常人直肠肛门压力衣排便功能；发现：（１）直肠静息压，肛门括约肌静息压及其最大缩窄压在ＩＢＳ腹泻组，便秘组及正常对照组组均无显著差异。（２）肛管高压带长度在ＩＢＳ腹泻组及便秘组均显著高于正常对照组。（３）直肠壶腹部的感觉阈值，最大耐受量等，在ＩＢＳ腹泻组均显著低于正常对照组。（４）ＩＢＳ便秘组感觉阈值与正常对照组差异，但其最大     

肠易激综合征血浆及乙状结肠粘膜中生长抑素的变化

应用放射免疫分析法检测正常组２４例及肠易激综合征组２６例受检者血浆及乙状结肠粘膜中生长抑素的含量，旨在探讨ＩＢＳ患者历浆及乙状结肠粘膜中ＳＳ的含量有无变化，以及它在ＩＢＳ疾病过程中的可能作用和临床意义。结果；ＩＢＳ组血浆中ＳＳ的浓度明显高于正常组；乙状结肠粘膜中的ＳＳ的含量痛秘型ＩＢＳ显著高于痛泻型，痛泻型ＩＢＳ显著高于正常组。     

惠州地区胃食管反流病与肠易激综合征重叠的特征

目的 探讨惠州地区胃食管反流病（GERD）重叠肠易激综合征（IBS）的症状特征.方法 采用整群、分层、随机抽样的方法,收集到61例GERD症状人群,其中12例（19.7％） GERD重叠IBS患者、49例单纯GERD患者,记录其人口统计学资料以及症状严重程度,对结果进行统计分析.结果 GERD重叠IBS组男女比例为1：1.4,其症状较单纯GERD组严重（P＜0.05）.结论 GERD与IBS的重叠现象多见,患者多为女性,且症状更严重.     

肠易激综合征患者的胃排空

应用锝＾９０标记的固体试餐对３０例健康者及５６例肠是铁激综合征患者的胃排空功能进行了观察。５６例肠易激合征患乾按临床症状分为２组，第１组为腹泻为主者，共２０例，第２组３６例系以腹痛及便秘为主要表现者。     

得舒特治疗肠易激综合征的临床疗效观察

目的:评价得舒特对肠易激综合征(IBS)的疗效。方法:56例根据罗马标准诊断为IBS的患者进入本研究。所有患者在服用得舒特治疗前一周服用安慰剂6天。安慰剂治疗无效的47例患者随后进入得舒特治疗,50mg,每日3次口服,疗程4周。结果:得舒特对肠易激综合征患者腹痛、腹泻和便秘单项症状的有效率分别为85.1％(40/47)、89.2％(33/37)和93.3％(14/15),对肠易激综合征的总有效率为85.1％(40/47)。治疗期间除2例诉头晕外,无其他不良反应。结论:得舒特治疗1BS疗效确切、副反应率低,临床上可作为治疗IBS的首选药物之一。     

血浆及乙状结肠粘膜中CCK、MOT的含量与肠易激综合征的关系

应用放射免疫分析法检测正常对照组２４例及肠易综合征组（ＩＢＳ）２６例受检者血浆及乙状结肠粘膜中胆囊收缩素（ＣＣＫ）和胃动素（ＭＯＴ）的含量，旨在探讨ＩＢＳ患者血浆及乙状结肠粘膜中ＣＣＫ和ＭＯＴ有无变化，以及它们在ＩＢＳ疾病过程中的可能作用和临床意义。结果：ＩＢＳ组血浆中ＣＣＫ、ＭＯＴ的含量明显高于正常对照组（Ｐ＜０．０５）；乙状结肠粘膜中ＣＣＫ的含量两组无显著差别（Ｐ＞０．２），ＭＯＴ的含量两组均为零。提示血浆中ＣＣＫ和ＭＯＴ可能在ＩＢＳ的疾病过程中起有一定作用，建议在临床实验诊断中验证它们作为ＩＢＳ诊断标志的可能性。     

A Survey about Irritable Bowel Syndrome in South Korea

The aims of the present study were: (1) to assess the prevalence of symptom-based irritable bowel syndrome (IBS) in Korean adults, (2) to assess several organic abnormalities which can be found in IBS patients, and (3) to analyze the risk or associated factors that influence the presence of IBS. Adult health examinees were requested to fill out a questionnaire. The prevalence of IBS was calculated using Rome II criteria. Using several tests, several organic abnormalities were identified in the IBS group. Risk factors were analyzed by comparing the IBS and normal groups. The prevalence value for IBS according to Rome II criteria was 16.8%. Mucosal hyperplasia, lymphocyte aggregation, and increased eosinophil counts were relatively common microscopic findings in IBS group. Female gender, self-consciousness of IBS, and irregular defecation were expressed as significantly independent risk or associated factors for IBS. Several colonic microscopic findings mentioned above may be helpful in accurate diagnosis of IBS. Therefore a more-precise and large population study about these findings is necessary to reach a definitive conclusion.     

Ambulatory 24-Hour Jejunal Motility in Diarrhea-Predominant Irritable Bowel Syndrome

Background: Whether small-bowel motility is abnormal in the irritable bowel syndrome (IBS) is a controversy at present. The aim of our study was to compare ambulatory long-term jejunal motility in 35 IBS patients with predominant diarrhea to normal values obtained in 50 healthy controls. Methods: Twenty-four-hour motility was recorded in the proximal jejunum with a portable datalogger and tubemounted miniature pressure sensors. Fasting motility in the waking (W) and sleeping (S) state and the motor response to a standardized evening meal of 600 kcal underwent visual and computer-aided analysis. Results: Fasting motility in patients showed migrating motor complex (MMC) cycles of normal length and composition. Uninterrupted runs of discrete clustered contractions during phase II (W) occurred in 57% of patients and 52% of controls but had a significantly longer duration in patients (33 ± 5 versus 19 ± 7 min; p < 0.005). During phase II (W) IBS patients had an increase in aborally propagated contractions (41 ± 2% versus 35 ± 2%; p < 0.01) and higher contraction amplitudes (26.3 ± 0.8 versus 23.0 ± 0.5 mm Hg; p < 0.01). Similar differences were obtained during postprandial motility (47 ± 3% versus 39 ± 3%; p < 0.01, and 25.9 ± 0.9 versus 23.8 ± 0.05 mm Hg; p < 0.02). In three patients (8.6%) disturbed aboral migration of phase III and irregular burst activity, manometric features of chronic idiopathic intestinal pseudo-obstruction, were identified. Whereas 57% of patients had an entirely normal 24-h manometry, 43% had at least one finding not present in any healthy control. Conclusion: Small-intestinal motility is frequently but not universally abnormal in diarrhea-predominant IBS. The abnormal manometric findings are heterogeneous and range from subtle quantitative changes to severe qualitative abnormalities resembling chronic idiopathic intestinal pseudo-obstruction in a small subset of patients.     

腹泻型肠易激综合征患者肠黏膜肥大细胞的变化

目的探讨腹泻型肠易激综合征(IBS)与肠黏膜肥大细胞(MC)及脱颗粒之间的关系。方法正常人10例和腹泻型IBS患者11例。每例于结肠镜下取盲肠、横结肠和直肠黏膜组织各2块,用免疫组化方法行MC染色,计算每高倍视野下MC的数量及脱颗粒MC所占MC总数的比例。结果腹泻组IBS患者盲肠、横结肠黏膜MC数量显著高于正常对照组(P<0·01及P<0·05);直肠黏膜MC数量与正常对照组无显著差异(P>0·05)。腹泻型IBS患者盲肠、横结肠、直肠黏膜脱颗粒MC比率显著高于正常对照组(P<0·05或P<0·01)。结论肠黏膜肥大细胞在腹泻型IBS的发病过程中起着重要作用。     

肠易激综合征血浆及乙状结肠粘膜中VIP及SS的含量

目的 :探讨肠易激综合征 (IBS)患者血浆及乙状结肠粘膜中血管活性肠肽 (VIP)、生长抑素 (SS)有无变化 ,以及它们在IBS发病过程中的可能作用和临床意义。方法 :应用放射免疫分析法 (RIA)测定IBS患者血浆及乙状结肠粘膜内VIP、SS的含量 ,并与正常组比较。结果 :便秘型IBS血浆及乙状结肠粘膜中VIP含量显著高于正常组 (P <0 .0 1 ) ,腹泻型显著低于正常组 (P <0 .0 5) ;SS在IBS各组均显著高于正常组 (P <0 .0 5) ,而便秘型又显著高于腹泻型 (P <0 .0 5)。结论 :IBS患者存在VIP、SS含量异常 ,且这些异常可能在IBS发病中起一定的作用 ;不同类型IBS患者VIP及SS含量有显著差异 ,说明不同类型IBS在发病机制上有其不同的病理生理学基础     

Association between Diet and Lifestyle Habits and Irritable Bowel Syndrome: A Case-Control Study

Background/AimsRecent papers have highlighted the role of diet and lifestyle habits in irritable bowel syndrome (IBS), but very few population-based studies have evaluated this association in developing countries. The aim of this study was to evaluate the association between diet and lifestyle habits and IBS.MethodsA food frequency and lifestyle habits questionnaire was used to record the diet and lifestyle habits of 78 IBS subjects and 79 healthy subjects. Cross-tabulation analysis and logistic regression were used to reveal any association among lifestyle habits, eating habits, food consumption frequency, and other associated conditions.ResultsThe results from logistic regression analysis indicated that IBS was associated with irregular eating (odds ratio [OR], 3.257), physical inactivity (OR, 3.588), and good quality sleep (OR, 0.132). IBS subjects ate fruit (OR, 3.082) vegetables (OR, 3.778), and legumes (OR, 2.111) and drank tea (OR, 2.221) significantly more frequently than the control subjects. After adjusting for age and sex, irregular eating (OR, 3.963), physical inactivity (OR, 6.297), eating vegetables (OR, 7.904), legumes (OR, 2.674), drinking tea (OR, 3.421) and good quality sleep (OR, 0.054) were independent predictors of IBS.ConclusionsThis study reveals a possible association between diet and lifestyle habits and IBS.     

肠易激综合征患者心血管自主神经功能变化与心率变异性的关系

目的 :探讨肠易激综合征 (1BS)患者心血管自主神经功能变化与心率变异性 (HRV)的关系。方法 :对IBS患者 50例进行标准心血管自主神经功能测试 ,将其结果分成阳性组 (DNA+ )及阴性组 (DNA- ) ,健康人 30名为对照组。 2 4h动态心电图进行HRV分析。结果 :IBS患者自主神经功能异常的发生率为 58% ,主要表现为迷走神经功能异常 ;HRV时域分析中DNA+ 组SDNN、SDANN、SDNNindex明显减少 ;DNA+ 及DNA- 组中反映副交感神经张力的RMSSD、PNN50 、HF等指标明显增高 ,LF/HF比值明显减低 ,与对照组比较有显著性差异 (P <0 .0 5)。结论 :IBS患者存在副交感神经张力增加。HRV分析是发现IBS患者自主神经功能异常的较好方法     

肠易激综合征T淋巴细胞亚群变化及其意义

目的 :通过检测肠易激综合征 (IBS)患者外周血T淋巴细胞亚群水平的变化 ,探讨IBS细胞免疫调节的变化及其可能的发病机制。方法 :采取双色直接免疫荧光标记和流式细胞仪检测方法 ,对 30例临床诊断为IBS的患者外周血T细胞亚群进行测定。结果 :30例IBS患者外周血CD3 、CD4 及CD8细胞数分别是 5 7 15± 9 17、36 0 1± 9 12及16 34± 5 2 1,其中CD3 及CD8均较正常对照组显著下降 (P <0 0 0 1) ,并且IBS患者CD4 /CD8比值是 2 6 7± 0 6 9,较正常对照组显著升高 (P <0 0 0 1)。结论 :IBS患者存在T淋巴细胞功能减弱和调节紊乱 ,细胞免疫异常可能参与IBS的发病机制。     

Gut Microbiota as Potential Orchestrators of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a multifactorial functional disorder with no clearly defined etiology or pathophysiology. Modern culture-independent techniques have improved the understanding of the gut microbiota’s composition and demonstrated that an altered gut microbiota profile might be found in at least some subgroups of IBS patients. Research on IBS from a microbial perspective is gaining momentum and advancing. This review will therefore highlight potential links between the gut microbiota and IBS by discussing the current knowledge of the gut microbiota; it will also illustrate bacterial-host interactions and how alterations to these interactions could exacerbate, induce or even help alleviate IBS.     

Cross-Cultural Validation of Irritable Bowel Syndrome Quality of Life in Korea

Patients’ responses to quality-of-life questionnaires are dependent on the cultural milieu. The aims of this study were to translate the Irritable Bowel Syndrome Quality of Life questionnaire, which was developed in the West, into Korean and to validate the translated questionnaire in patients with irritable bowel syndrome. Translation of the original questionnaire was performed according to accepted linguistic validation guidelines. Korean patients had no difficulty understanding the questions. Data from the translated questionnaire were well correlated with results from the SF-36 questionnaire and reflected the stress status of the patients as measured on the Perceived Stress Scale. Some questionnaire items seemed, on first analysis, to be problematic in this subset of patients, but these results may relate, in part, to cultural differences between Korea and the West. We conclude that the translated questionnaire is reliable and offers an accurate measure of quality of life for Korean patients with irritable bowel syndrome.