脑-肠轴在肠易激综合征发病中的作用

肠易激综合征(IBS)的发病可能与肠道动力异常、内脏高敏感、感染、精神心理等有关。脑-肠轴在IBS发病中的作用引起普遍关注,上述的发病因素均可整合到脑-肠互动框架中进行阐述,脑-肠轴成为研究IBS发病机制的切入点。本文从脑-肠轴的概念、作用机制、脑-肠轴功能异常与IBS发病、靶向治疗等方面对脑-肠轴在IBS发病中的作用作一综述。     

肠黏膜分泌物调节肠易激综合征发病机制的研究进展

肠易激综合征(IBS)是一种以腹部不适或腹痛伴排便习惯改变为主要特征的功能性胃肠病。IBS的发病机制与胃肠动力学异常,内脏感觉异常、感染、精神心理因素等有关。其病理生理学机制尚不清楚,现认为脑肠轴神经免疫内分泌功能紊乱参与其中。近年来,研究发现肠黏膜的免疫炎性反应、内分泌功能紊乱以及神经营养因子分泌异常参与调节IBS脑肠轴功能紊乱并且导致肠黏膜异常分泌多种物质。此文主要阐述这些异常分泌的肠黏膜分泌物在IBS发病机制中的重要作用,并为IBS治疗提供一个广阔的前景。     

幽门螺杆菌在肠易激综合征中对脑-肠轴的作用机制

肠易激综合征(IBS)是一种常见的功能性肠道疾病,其病因和发病机制目前尚不完全明确,可能与脑-肠轴功能紊乱、遗传、肠道感染、精神心理因素等多个因素相关。近年来的研究结果表明,脑-肠轴功能紊乱是IBS发生的重要病理生理学基础之一。目前对于幽门螺杆菌(Hp)是否参与了IBS的发生仍存在争议。有些研究提示Hp可能通过影响脑-肠轴的功能而导致IBS的发生。此文就Hp对IBS患者脑-肠轴的作用机制作一综述。     

雌激素及其受体对肠易激综合征影响的研究进展

肠易激综合征（IBS）是临床常见的功能性肠病,其发病机制为多种因素共同作用而引起的脑-肠互动异常。研究表明女性的IBS发病率高于男性,雌激素及其受体可通过多种中枢及外周途径参与脑-肠互动,从而导致IBS患者的性别差异。该文就雌激素及其受体对IBS影响的研究进展作一综述,以期为IBS患者的诊断和个体化治疗提供新的思路。     

肠上皮细胞紧密连接在肠易激综合征发病中的作用

肠易激综合征(IBS)是常见的功能性胃肠病,其病因和发病机制尚未完全明确。近年肠黏膜屏障在IBS发病中的作用备受关注。肠上皮细胞是肠黏膜屏障的重要组成部分,其功能与细胞间紧密连接(TJ)密切相关。研究证实IBS患者肠黏膜TJ结构异常,可能与IBS发病相关。本文就肠上皮细胞TJ在IBS发病中的作用作一综述。     

肠易激综合征肠道菌群失调与脑-肠轴调节紊乱的相关性

肠易激综合征(IBS)是一种临床较为常见的功能性胃肠病。目前针对IBS发病机制的研究多集中于遗传易感性、社会心理应激、内脏高敏感、脑-肠轴调节紊乱、肠道菌群失调、肠道黏膜免疫异常等方面。本文就IBS肠道菌群失调与脑-肠轴调节紊乱的关系作一综述。     

炎症免疫与肠易激综合征关系的研究进展

肠易激综合征(irritable bowel syndrome,IBS)是一组以腹痛、腹胀以及排便习惯改变为主要症状的慢性功能性肠道疾病.近些年大量研究表明肠黏膜炎症免疫在IBS的发病机制中起了重要的作用,本文综述了肠黏膜炎症免疫与IBS关系的研究进展.     

迷走神经参与肠易激综合征中肠-脑互动紊乱的研究进展

迷走神经是肠-脑轴的重要组成部分,参与调节肠道运动和分泌,人体情绪反应和免疫应答,以及肠易激综合征（IBS）患者的肠-脑互动紊乱。本文就迷走神经及其功能,肠-脑轴中迷走神经功能异常与IBS发病的关系,以及迷走神经在IBS治疗中的应用等方面作一综述,以期提高对迷走神经功能与IBS中肠-脑互动紊乱关系的认识,了解其潜在治疗方法。     

肠易激综合征发病机制的研究进展

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。     

匹维溴铵联合谷参肠安治疗腹泻型肠易激综合征的临床观察

肠易激综合征(IBS)是一种具有特殊病理生理基础，独立的肠功能紊乱性疾病。本文观察匹维溴铵联合谷参肠安，与分别单独应用匹维溴铵、谷参肠安治疗腹泻型IBS的临床疗效。     

Management of irritable bowel syndrome

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. The prevalence rate is 10-20% and women have a higher prevalence. IBS adversely affects quality of life and is associated with health care use and costs. IBS comprises a group of functional bowel disorders in which abdominal discomfort or pain is associated with defecation or a change in bowel habit, and with features of disordered defecation. The consensus definition and criteria for IBS have been formalized in the "Rome II criteria". Food, psychiatric disorders, and gastroenteritis are risk factors for developing IBS. The mechanism in IBS involves biopsychosocial disorders; psychosocial factors, altered motility, and heightened sensory function. Brain-gut interaction is the most important in understanding the pathophysiology of IBS. Effective management requires an effective physician-patient relationship. Dietary treatment, lifestyle therapy, behavioral therapy, and pharmacologic therapy play a major role in treating IBS. Calcium polycarbophil can benefit IBS patients with constipation or alternating diarrhea and constipation.     

肠易激综合征内脏高敏感的研究进展

肠易激综合征(IBS)是以腹痛或腹部不适并伴有排便习惯改变但无器质性病变的功能性胃肠疾病,其发病与多种因素有关。近年来,内脏高敏感(包括内脏痛觉过敏和痛觉异常)作为IBS的生物学标记受到广泛关注。本文就IBS内脏高敏感的的研究进展作一综述。     

Emerging pharmacological therapies for the irritable bowel syndrome

The irritable bowel syndrome (IBS) is a symptom-based disorder defined by the presence of abdominal pain and altered bowel habits. Clinical presentations of IBS are diverse, with some patients reporting diarrhea, some constipation, and others a mixture of both. Like the varied clinical phenotypes, the pathogenesis of IBS is also diverse. IBS is not a single disease entity, but rather likely consists of several different disease states. This fact has important implications for the choices and efficacy of IBS treatment. This article reviews the IBS drugs that have reached phase II or III clinical trials.     

Genetic epidemiology of irritable bowel syndrome

Irritable bowel syndrome(IBS) is the most common functional gastrointestinal disorder characterized by presence of abdominal pain or discomfort associated with altered bowel habits. It has three main subtypes- constipation predominant IBS(C-IBS),diarrhea predominant IBS(D-IBS) and IBS with mixed featuresof both diarrhea as well as constipation(M-IBS). Its pathophysiology and underlying mechanisms remain elusive. It is traditionally believed that IBS is a result of multiple factors including hypersensitivity of the bowel,altered bowel motility,inflammation and stress. Initial studies have shown familial aggregation of IBS suggesting shared genetic or environmental factors. Twin studies of IBS from different parts of world have shown higher concordance rates among monozygotic twins than dizygotic twins,and thus suggesting a genetic component to this disorder. Multiple studies have tried to link single-nucleotide polymorphisms(SNPs) to IBS but there is little evidence that these SNPs are functional. Various molecules have been studied and investigated by the researchers. Serotonin,a known neurotransmitter and a local hormone in the enteric nervous system,has been most extensively explored. At this time,the underlying gene pathways,genes and functional variants linked with IBS remain unknown and the promise of genetically-determined risk prediction and personalize medicine remain unfulfilled. However,molecular biological technologies continue to evolve rapidly and genetic investigations offer much promise in the intervention,treatment and prevention of IBS.     

肠易激综合征与精神神经免疫内分泌网络调控异常

肠易激综合征(IBS)是一组包括腹痛、腹胀、排便习惯和大便性状异常,持续或间歇发作,而又缺乏明显形态学和生化异常改变的症候群。该病发病率高,影响范围广,但病理生理机制尚未完全阐明。以往提出的肠道运动异常、内脏感觉过敏、脑肠作用、免疫异常等难以全面解释IBS的发病机制。目前认为肠道神经、免疫、内分泌等是一个网络调控的整体,IBS的发生与该网络调控异常关系密切。本文就IBS与精神神经免疫内分泌网络调控异常的关系作一综述。     

Travel and Travelers�� Diarrhea in Patients with Irritable Bowel Syndrome

This study evaluated occurrence of travel and travelers’ diarrhea in patients with irritable bowel syndrome (IBS). A survey was mailed to 591 patients of a clinical practice who had IBS. Based on survey responses, patients were categorized as having IBS, post-infectious IBS (PI-IBS), unclassified functional bowel disorder (UFBD), or post-infectious UFBD (PI-UFBD). Of 201 persons who returned questionnaires meeting inclusion criteria, 57.7%, 11.4%, 24.9%, and 6.0% had IBS, UFBD, PI-IBS, and PI-UFBD, respectively. Travel during six months before illness onset was more common in patients with PI-IBS or PI-UFBD than in persons with idiopathic IBS or UFBD (P = 0.006). Survey results demonstrated that 16.1% of post-infectious bowel disorder cases and 7.5% of overall IBS cases in a general medical population developed chronic disease within six months of an international trip. Symptoms of established functional bowel disorder in each clinical category were shown to worsen after travel-related acute diarrhea.     

食物因素在肠易激综合征中的研究进展

肠易激综合征（IBS）是一种以腹痛或腹部不适伴排便习惯改变为特征的功能性胃肠病,缺乏可解释症状的形态学和生化学异常,其病理生理学机制尚未完全明确。作为胃肠道与外界的直接联系,近年来食物在IBS中的作用受到广泛关注,为IBS的诊断和治疗提供了一条新思路。本文就食物因素在IBS中的研究进展作一综述。     

Psychologic considerations in the irritable bowel syndrome

Among medical clinic patients consulting for IBS, symptoms of psychologic distress are common, and more than half of these patients are found to have a psychiatric diagnosis in addition to bowel dysfunction. Many investigators have therefore concluded that IBS is a psychophysiologic disorder and proposed that patients with IBS be treated with psychologic techniques. However, recent studies suggest that this association may be spurious; persons in the community who have symptoms of IBS but do not consult a doctor have no more psychologic symptoms than persons without bowel symptoms. This indicates that psychologic symptoms do not cause bowel symptoms, but, instead, influence which persons with bowel symptoms will consult a physician. The bowel symptoms and the psychologic symptoms that coexist in most patients with IBS may be best thought of as comorbid conditions. Neither causes the other, but both may be serious enough to warrant treatment. Moreover, in some patients whose bowel symptoms consist of vague complaints of abdominal pain not specifically related to defecation or to changes in the frequency or consistency of bowel habits, the psychologic disorder may be primary. Psychologic stress may exacerbate IBS whether or not the patient has a psychiatric disorder, and psychologic stress may trigger acute episodes of symptoms similar to those of IBS even in persons without IBS. However, the magnitude of this correlation is modest, suggesting that only about 10% of the variation in bowel symptoms is attributable to stress. Psychologically oriented treatments have a role in the management of IBS. Most patients who consult internists about bowel symptoms have significant levels of depression and anxiety, and they tend to notice and to worry about somatic complaints more when they experience these dysphoric affects. Psychologic treatments that reduce the level of their psychologic distress also frequently reduce the frequency and severity of complaints about bowel symptoms. Tricyclic antidepressants may be tried as a first line of treatment; they have been shown to be superior to placebo for the management of abdominal pain and diarrhea but not constipation. In patients who do not show an adequate response to antidepressants, brief psychotherapy focusing on better ways of coping with current problems, hypnosis, or behavior therapy emphasizing methods of controlling reactions to stress are recommended. Controlled trials show these treatment approaches to be superior to medical management alone. It may appear paradoxical that psychologic treatments aimed at the management of emotions are so frequently found to reduce bowel symptoms, because the motility disorder responsible for the bowel symptoms may be unrelated to the psychologic symptoms that influence the patient to seek treatment.+4     

Motility of isolated bowel segment Iowa model III

The isolated bowel segment (IBS) is an amesenteric segment of bowel that is devoid of extrinsic nerves and yet is viable with motility and absorption preserved after its mesentery is completely severed. The IBS is created by initial coaptation of a loop of bowel to a host organ, such as muscle (Iowa model I), liver (Iowa model II), or intestine, and secondary severance of its mesentery several weeks later. In previous studies using Iowa models I and II, the viability, motility, and absorption of the IBS were preserved by vascular collaterals, which form across the coaptation. In rats, an IBS was created in the jejunum by initial enteroenteropexy (Iowa model III), followed by its mesenteric division five weeks later. At the second laparotomy, bipolar electrodes were implanted in the IBS and the adjacent jejunum. One week later, myoelectrical recording was performed during a fasting state. Coordinated aborad propagation of migrating motor complex (MMC) was observed in the IBS. The MMC period was 16.9 ± 1.7 and 19.3 ± 0.8 min in the intact bowel, and 22.8 ± 0.8 min in the IBS (P=0.1). After feeding, the MMC in the IBS was replaced by irregular spike burst activity similar to that observed in the intact bowel. This study concludes that the IBS Iowa model III can be used for studies of bowel physiology.Presented at the poster session of the 57th Annual Meeting of the American College of Gastroenterology, Miami Beach, Florida, October 1992     

肠易激综合征发病机制研究进展

肠易激综合征（irritable bowel syndrome,IBS）是常见的功能性肠病,以腹痛伴有大便性状和排便习惯改变为主 要表现。IBS 发病机制复杂,包括了增加IBS易感性的因素及与症状发作相关的因素,多种因素相互作用导致了相应 的病理生理变化,从而产生IBS症状,文章就已有的研究结果对IBS的发病机制进行总结。