阿米替林对肠易激综合征大鼠结肠和下丘脑促肾上腺皮质激素释放因子表达的影响

目的探讨阿米替林对肠易激综合征(IBS)大鼠结肠和下丘脑促肾上腺皮质激素释放因子(CRF)表达的影响。方法将30只成年Wistar大鼠随机分为3组:正常对照组、IBS模型组、阿米替林组。采用体重、排便粒数、敞箱实验评分和糖水偏嗜度,评价阿米替林对IBS的作用,采用RT-PCR和Western印迹检测大鼠结肠和下丘脑中CRF表达水平的变化。结果 IBS模型大鼠体重下降、排便增加、运动减少和兴趣缺失,同时下丘脑和结肠CRF的表达均显著高于正常对照组(P<0.05),阿米替林预防应用可改善IBS模型大鼠的症状,同时可减少IBS模型大鼠下丘脑和结肠CRF的表达(P<0.05)。结论预防应用阿米替林可改善IBS大鼠的症状,其机制可能与结肠和下丘脑CRF的表达下降有关。     

拮抗或激活促肾上腺皮质激素释放因子受体对肠易激综合征大鼠内脏敏感性及结肠动力的影响

目的 探讨促肾上腺皮质激素释放因子(CRF)及其受体对肠易激综合征大鼠内脏敏感性及结肠动力的影响.方法 SD大鼠60只,随机平均分入空白组(不做处理)、模型组(特殊气味条件刺激和肢体束缚直肠刺激非条件刺激轮替致敏)、干预对照组(造模前侧脑室注射0.9%NaC1)、干预一组(造模前侧脑室注射CRF-R1拮抗剂)和干预二组(造模前侧腑室注射CRF-R2激动剂).采用腹部收缩反射(AWR)评分标准评估各组大鼠肠道敏感性,记录各组大鼠结肠快、慢波波动率、最大振幅、收缩波数及振幅指数等电生理活动改变.采用SPSS16.0统计软件分析,计量资料采用方差分析,等级资料采用秩和检验.结果 以AWR=3分时所需的直肠注水量作为评价指标,模型组大鼠[(0.90±0.11)ml]较空白组[(1.23±0.07)ml]内脏敏感性增高(F＝82.586,P＜0.01);结肠电生理活动增强,造模成功.干预对照组直肠注水量为(0.81±0.11)ml,与模型组[(0.90±0.11)ml]差异无统计学意义(F＝3.734,P＞0.05),干预一组[(1.28±0.07)ml,F＝161.878,P＜0.01]和干预二组[(1.22±0.05)ml,F＝121.564,P＜0.01]较干预对照组内脏敏感性降低.干预对照组大鼠结肠快、慢波波动率、最大振幅、收缩波数及振幅指数等电生理活动与模型组无明显差异(P均＞0.05);干预一组和干预二组大鼠结肠电生理活动均较干预对照组明显减弱(均P＜0.05).结论 CRF在IBS发病中起重要作用,抑制CRF-R1或激活CRF-R2可降低1BS大鼠内脏敏感性并抑制结肠运动.

Abstract：

Objective To explore the effect of corticotropin releasing factor (CRF) and its receptor on visceral sensitivity and colon motility of irritable bowel syndrome (IBS) rats. Methods sixty SD rats were divided randomly and equally into control group (without treatment),model group (sensitized in turn with camphor odor as conditional stimulation and physical restraint in combination with rectal distention pressure as non-conditional stimulation),treatment control group (injected physiological saline into lateral ventricles before treatment),treatment group 1 (injected CRF-R1antagonist into lateral ventricles before treatment),treatment group 2 (injected CRF-R2 agonist into lateral ventricles before treatment). Then the rats' visceral sensitivity were assessed by AWR,and colonic electricity activities such as volatility,maximum amplitude of fast wave and slow wave,interdigestive number of contraction wave and index of contraction were recorded. The data was analyzed with SPSS 16. 0 software. Results By the amount of ractal water injection to reach AWR=3 as the evaluation index,model group [(0. 90±0. 11) ml] showed higher visceral sensitivity than that of control group [(1. 23±0. 07) ml,F=82. 586,P＜0. 01],and colonic electricity activity increased (P＜0. 05),model was successfully set up. There was no significant difference of the amount of ractal water injection between model group [(0. 90±0. 11) ml] and treatment control group [(0. 81±0. 11) ml,F=3. 734,P＞0. 05]. Compared with treatment control group,the visceral sensitivity decreased in treatment group 1 [(1. 28±0. 07) ml,F=161. 878,P＜0. 01] and treatment group 2 [(1. 22±0.05) ml,F=121. 564,P＜0. 01]. There was no significant difference between treatment control group and model group in electricity activities such as volatility,maximum amplitude of fast wave and slow wave,interdigestive number of contraction wave and index of contraction (all P＞0. 05). While the electricity activities was weakened in treatment group 1 and 2 compared with the treatment control group (all P＜0. 05). Conclusions CRF plays an important role in the pathogenesis of IBS. Inhibition of CRF-R1 or activation of CRF-R2 may lower visceral hypersensitivity and decrease colon motility of rats.     

肠易激综合征的表观遗传学研究进展

肠易激综合征(IBS)是一种以腹痛和排便习惯改变为特征的功能性肠病.IBS是一种多因素、压力敏感的疾病.表观遗传学改变包括DNA甲基化改变、组蛋白修饰、微RNA和长链非编码RNA的差异表达.从表观遗传学角度解释IBS的变化可为了解其发病机制和疾病的治疗带来新的观点.本文就IBS的表观遗传学研究进展作一综述.     

双歧杆菌对应激大鼠肠道菌群及促肾上腺皮质激素释放激素的影响

目的:探讨应激对大鼠肠道菌群及血清促肾上腺皮质激素释放激素(CRF)的影响及双歧杆菌对应激大鼠肠道功能的调节作用.方法:50只SD大鼠随机分为5组:正常对照组、压力实验组、双歧杆菌干预组、思密达干预组、双歧杆菌+思密达共同干预组.采用WAS(water avoidance stress)避水实验构建大鼠应激模型,以三糖为探针,衍生化毛细管气相色谱法测定大鼠尿液中三种糖的浓度,以三氯蔗糖/甘露醇(S/M)评价大鼠肠道通透性;取大鼠新鲜粪便,用选择性培养基平皿计数法检测大鼠粪便菌群中几种代表性菌种的数量;取肠系膜淋巴结(MLN)培养后测定细菌移位率;用酶联免疫法测定大鼠血清中CRF和促肾上腺皮质激素(ACTH)的含量.结果:与正常对照组相比,压力实验组大鼠粪便中以大肠杆菌杆菌为主的条件致病菌数量增多(7.347±0.277 vs 7.078±0.229,P<0.05);24 h尿液中甘露醇量升高(5.097%±0.453% vs 4.718%±0.399%,P<0.05),MLN细菌移位率升高(40% vs 10%,P<0.05);CRH(300.8 ng/L ±34.3 ng/L vs 267.0 ng/L±32.3 ng/L,P<0.05),ACTH (6.79 ng/L±0.65 1 ng/L vs 5.68 ng/L±0.799 ng/L,P<0.05)水平升高.与压力实验组相比,双歧杆菌干预组大肠杆菌(7.044±0.281vs 7.347±0.277,P<0.05)、类杆菌(9.075±0.393 vs 9.485±0.306,P<0.05)数量显著下降,细菌移位率下降(10% vs 40%,P<0.05);ACTH水平下降(5.92 ng/L±0.477 ng/L vs 6.79 ng/L±0.651 ng/L,P<0.05).结论:在慢性应激条件下,大鼠出现肠道菌群失调、肠道通透性升高、神经内分泌处于应激状态的现象,双歧杆菌能够缓解慢性应激所导致的上述现象.     

肠易激综合征内脏高敏感性机制的研究进展

肠易激综合征(irritable bowel syndrome,IBS)是一种以腹部不适和排便习惯改变为特征的胃肠功能性疾病.其发病机制复杂,尚未被人类充分认识,可能与包括心理因素、胃肠道异常运动与分泌、内脏高敏感性在内的中枢和外周因素有关.但有的因子既能够调节胃肠道的运动,又能够调节内脏的敏感性,使IBS患者的胃肠道对应激及食物的敏感性增强.目前认为内脏敏感性增高是其特征性的病理生理基础,但IBS内脏高敏感性确切的神经生物学机制尚不清楚,脑-肠轴上有多种机制单独或共同作用形成内脏感觉的异常.本文综述近年来有关IBS患者肠道神经丛、脊髓及中枢神经系统存在结构或功能的异常.     

Ucn3及其受体CRFR2在肠易激综合征大鼠模型肠神经系统中的表达

目的:探讨尿皮质素3(Urocotin3,Ucn3)及其受体促肾上腺皮质释放因子受体2(corticotrophin releasing factor receptor2,CRFR2)在肠易激综合征中的表达.方法:将36只180-220g的Wistar大鼠随机分为对照组(N)、急性应激组(A,急性束缚1h)、慢性应激组(C,28d不可预知轻度应激)、急慢性联合应激组(AC,在慢性应激基础上给予急性束缚)4组建模.采用排便粒数、敞箱行为评分和蔗糖水偏嗜度评价动物模型.建成后留取大鼠结肠组织,采用Real-timePCR方法检测各组大鼠结肠中Ucn3及其受体CRFR2表达水平的变化.结果:Ucn3在各组大鼠结肠中的表达:N组1.108±0.293,A组3.594±1.839,C组1.852±0.674,AC组3.989±1.591,各应激组Ucn3的表达均高于对照组(P<0.05),各应激组间A组vsC组(P<0.017),C组vsAC组(P<0.002),表达有统计学差异.CRFR2在各组大鼠结肠中的表达:N组1.042±0.217,A组2.119±0.468,C组1.568±0.507,AC组2.392±0.840,各应激组CRFR2的表达均高于对照组(P<0.05).各应激组之间没有统计学差异.结论:慢性应激、慢急性联合应激建立肠易激综合征大鼠模型重复性好.Ucn3及其受体CRFR2在肠易激综合征中表达升高,且Ucn3在急性应激后升高比慢性应激后更明显.     

缰核损毁降低外源性抑郁症大鼠室旁核促肾上腺皮质激素释放激素的表达

目的探讨缰核与下丘脑-垂体-肾上腺皮质轴及抑郁症之间的关系。方法应用慢性温和性刺激诱导抑郁症大鼠模型,观察缰核损毁对抑郁症大鼠行为、血清皮质醇及下丘脑室旁核内促肾上腺皮质激素释放激素(CRH)表达的影响。结果经历慢性不可预知性刺激后,大鼠在开野实验中的水平活动次数及直立次数明显减少(P<0.01);在强迫游泳实验中的不动时间延长,上窜时间缩短(P<0.01);放射免疫学结果显示血清皮质醇水平显著升高(P<0.01),免疫组织化学结果显示下丘脑室旁核内CRH表达增加。损毁缰核后,抑郁症大鼠在开野实验中的水平及直立次数明显增加(P<0.01);强迫游泳实验中不动时间明显缩短,上窜时间明显延长(P<0.01);血清皮质醇水平下降(P<0.05);下丘脑室旁核内CRH表达减少。结论缰核损毁可改善抑郁症大鼠的抑郁行为,对下丘脑-垂体-肾上腺皮质轴功能的调节可能是实现这一作用的机制之一。     

肠康方对肠易激综合征内脏高敏感模型大鼠的作用

[目的]探讨肠康方对肠易激综合征(IBS)内脏高敏感模型大鼠的作用.[方法]制备肠易激综合征内脏高敏感模型,将72只Sprague-Dawley大鼠随机分为6组,即模型组,空白对照组,阳性药物对照组,肠康方高、中、低剂量组.在造模第60天开始灌胃给药或0.9％氯化钠溶液共10d,干预后通过腹肌回缩反射(AWR)半定量评分测定大鼠内脏敏感性.[结果]不同压力下模型组AWR评分显著高于空白对照组,肠康方高、中、低剂量组治疗后AWR评分均显著低于模型组(P＜0.05或P＜0.01).[结论]肠康方可通过改善内脏高敏感治疗IBS.     

早期生活应激所致功能性慢性内脏痛对成年后大鼠抑郁样行为和下丘脑室旁核促肾上腺皮质激素释放激素表达的影响

目的:观察大鼠新生期经历直结肠扩张所致功能性慢性内脏痛对成年后大鼠抑郁样行为及下丘脑室旁核(corticotropin releasing hormone,PVN)内促肾上腺皮质激素释放激素(corticotropin releasing hormone,CRH)表达的影响,探讨早期生活应激所致的功能性慢性内脏痛大鼠伴发抑郁样行为的可能作用机制.方法:将新生期♂SD大鼠20只,随机分成2组(n=10):假手术(Sham)组,新生期结直肠扩张(colorectal distension,CRD)组.CRD组大鼠出生后第8、10、12天,每天给予两次结直肠扩张,成年后即出生后第8-10周,检测腹壁撤退反射(abdominal withdrawal reflex,AWR)评分、痛阈以及腹外斜肌放电幅度,出生后第10-12周检测旷场实验、糖水偏好及强迫游泳等抑郁样行为变化,行为学检测后取结肠进行HE染色观察组织病理变化,取血浆检测皮质酮(cortisol,CORT)水平,取脑PVN进行荧光检测CRH表达水平.结果:(1)大鼠新生期经历直结肠扩张,成年后痛阈值下降,AWR评分、腹外斜肌放电幅度增高(P<0.05,P<0.05),结直肠组织均未见明显病理改变;(2)与Sham组相比,CRD组大鼠在5 min旷场实验中的穿格子线数、直立次数和总运动距离明显减少(均P<0.05),总休息时间明显增多(P<0.05),糖水消耗率下降(P<0.05)强迫游泳过程中不动时间增加(P<0.05);(3)与Sham组相比较,CRD组大鼠血浆中CORT的水平增高(P<0.05),PVN内CRH表达也增加(P<0.05).结论:早期生活应激致功能性慢性内脏痛大鼠有抑郁样行为改变,其机制可能与PVN内CRH表达增加,HPA轴功能失调有关.     

肠易激综合征内脏高敏感性发生机制中相关受体的作用

内脏高敏感性(VHL)被认为是肠易激综合征(IBS)重要的病理生理学改变之一,IBS患者肠道低度炎症产生的炎性介质通过相关受体参与了IBS患者VHL的发生,此文结合相关文献探讨IBS患者VHL发生机制中相关受体的作用.     

Activation of corticotropin-releasing hormone system in the locus ceruleus induces the visceral sensitivity of irritable bowel syndrome rats

正Objective To study the role of corticotropin-releasing hormone (CRH) system in locus ceruleus (LC) in irritable bowel syndrome (IBS) and to explore its molecular mechanism.Methods The IBS rat was established by maternal separation following postnatal stress.The tissues sample of LC was obtained by micropunched nuclei.The expression of c-Fos,CRH and its receptors including corticotropin-releasing hormone receptor (CRHR) 1 and CRHR2 of rats’ LC tissues of control group and IBS group     

Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome

AIM: To investigate the effect and mechanism of electro-acupuncture (EA) at ST25 and ST37 on irritable bowel syndrome (IBS) of rats. METHODS: A total of 21 male Sprague-Dawley rats were randomly divided into normal group, model group and EA group. A rat model of IBS was established by constraining the limbs and distending the colorectum of rats. Rats in EA group received bilateral EA at ST25 and ST37 with a sparse and intense waveform at a frequency of 2/50 Hz for 15 min, once a day for 7 d as a course. Rats in normal and model groups were stimulated by distending colorectum (CR). An abdominal withdrawal reflex (AWR) scoring system was used to evaluate improvements in visceral hypersensitivity. Toluidine blue-improved method, immunohistochemistry and radioimmunoassay were used to observe mucosal mast cells (MC), changes of substance P (SP) and substance P receptor (SPR) in colon and change of corticotropin-releasing hormone (CRH) in hypothalamus. RESULTS: The threshold of visceral sense was significantly lower in model group than in normal group, and significantly higher in EA group than in model group. The number of mucosal MC was greater in model group than in normal group and significantly smaller in EA group than in model group. The CRH level in hypothalamus of rats was significantly higher in model group than in normal group, which was remarkably decreased after electro-acupuncture treatment. The SP and SPR expression in colon of rats in model group was decreased after electro-acupuncture treatment.CONCLUSION:EA at ST25 and ST37 can decrease the number of mucosal MC and down-regulate the expression of CRH in hypothalamus,and the expression of SP and SPR in colon of rats with IBS.     

Effects of electroacupuncture on corticotropin-releasing hormone in rats with chronic visceral hypersensitivity

AIM: To investigate the effect of electroacupuncture on corticotropin-releasing hormone (CRH) in the colon, spinal cord, and hypothalamus of rats with chronic visceral hypersensitivity.METHODS: A rat model of chronic visceral hypersensitivity was generated according to the internationally accepted method of colorectal balloon dilatation. In the 7^th week after the procedure, rats were randomly divided into a model group (MG), electroacupuncture group (EA), and sham electroacupuncture group (S-EA). After treatment, the abdominal withdrawal reflex (AWR) score was used to assess the behavioral response of visceral hyperalgesia. Immunohistochemistry (EnVision method), ELISA, and fluorescence quantitative PCR methods were applied to detect the expression of CRH protein and mRNA in the colon, spinal cord, and hypothalamus.RESULTS: The sensitivity of the rats to the colorectal distension stimulus applied at different strengths (20-80 mmHg) increased with increasing stimulus strength, resulting in increasing AWR scores in each group. Compared with NG, the AWR score of MG was significantly increased (P < 0.01). After conducting EA, the AWR scores of the rats were decreased compared with MG rats. The relative expression of CRH mRNA in the colon, spinal cord, and hypothalamus of MG rats was significantly increased compared with NG rats (P < 0.01). CRH mRNA in the colon and spinal cord of EA and S-EA rats was decreased to varying degrees (P > 0.05) compared with normal rats (NG). However, the decrease in EA compared with MG rats was statistically significant (P < 0.01). The average optical density of CRH expression in the colon of the MG rats was significantly enhanced compared with NG (P < 0.05), while the average optical density of CRH expression in the EA and S-EA rats was significantly decreased compared with MG rats (P < 0.01, P < 0.05, respectively). Compared with MG rats, the CRH concentration in the spinal cord of EA rats was significantly reduced (P < 0.01), but there was no significant change in S-EA rats (P > 0.05).CONCLUSION: Electroacupuncture at the Shangjuxu acupoint was able to significantly reduce the visceral hypersensitivity in rats, and regulated the expression of CRH protein and mRNA in the colon, spinal cord and hypothalamus at different levels, playing a therapeutic role in this model of irritable bowel syndrome.     

Suspended moxibustion relieves chronic visceral hyperalgesia and decreases hypothalamic corticotropin-releasing hormone levels

AIM:To evaluate the effect of suspended moxibustion(SM) on rectal sensory thresholds and to analyze the possible mechanisms involved in SM treatment of chronic visceral hypersensitivity(CVH) in rats.METHODS:SM was administered once daily to 37-dold CVH rats for 7 d.The two pairs of acupoints(ST25 and ST37,bilateral) were simultaneously treated with SM.Each treatment lasted for 30 min.Rats undergoing treatment with SM were not anesthetized.Untreated CVH rats and normal rats were used as controls.The abdomina...     

Molecular basis of the irritable bowel syndrome

Irritable bowel syndrome(IBS)is a functional disorder characterized by abdominal pain,discomfort and bloating.The pathophysiology of IBS is poorly understood,but the presence of psychosocial basis is now known.There is an increasing number of publications supporting the role of genetics in IBS.Most of the variations are found in genes associated with the brain-gut axis,revealing the strong correlation of brain-gut axis and IBS.miRNAs,which play critical roles in physiological processes,are not well studied in IBS.However,so far there is found an involvement of alterations in miRNA expression or sequence,in IBS symptoms.IBS phenotype is affected by epigenetic alteration and environment.Changes in DNA and histone methylation are observed in patients who suffered childhood trauma or abuse,resulting in altered gene expression,such as the glucocorticoid receptor gene.Finally,diet is another factor associated with IBS,which may contribute to symptom onset.Certain foods may affect on bacterial metabolism and epigenetic modifications,predisposing to IBS.     

Recent advances in pharmacological treatment of irritable bowel syndrome

Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient’s most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS.     

肠易激综合征内脏感觉过敏动物模型的建立

目的 内脏感觉过敏是肠易激综合征(IBS)的主要发病机制之一，本文利用大鼠建立一种内脏感觉过敏的动物模型。方法8～21天雌雄Wistar大鼠每天接受不同压力的结肠机械刺激，成年后直肠扩张时记录大鼠腹肌收缩反应(AWR)评分，并进行降结肠的组织学检查。结果 ①新生儿时期接受不同压力结肠机械刺激的大鼠成年后直肠扩张时AWR评分明显高于对照组，不同压力机械刺激组间AWR评分无明显差异，雌性大鼠AWR评分明显高于雄性大鼠。②各组大鼠降结肠常规病理切片未见明显异常。结论 Wistar大鼠在新生儿时期接受的结肠刺激可造成无明显病理改变的慢性内脏感觉过敏模型，雌性大鼠更具有易感性。     

直肠内不同温度刺激对肠易激综合征患者内脏敏感性的影响

目的研究肠易激综合征（IBS）患者对直肠内冷、温两种不同温度扩张试验的反应，以探讨IBS的可能发病机制。方法门诊随机选择腹泻型IBS（D—IBS）21例，便秘型IBS（C—IBS）15例，对照者33例，随机应用冷刺激（3℃水）或温刺激（35℃水）进行球囊灌注扩张，记录诱发受试对象产生便意和腹痛时的球囊内容量及压力。结果①无论予以冷、温何种刺激，D—IBS患者及C—IBS患者便意容量阈值（DSVT）及腹痛容量阈值（APVT）较对照者均明显降低，其中在D—IBS患者又稍低于C—IBS患者，但两者之间无显著性差异；而两种刺激下虽然在D—IBS患者及C—IBS患者中便意压力阈值（DSPT）及腹痛压力阈值（APPT）均较对照者稍低，但三者之间无显著性差异。②在D—IBS患者中，予以冷刺激后患者便意容量阈值（DSVT）及便意压力阈值（DSPT）均较温刺激时明显升高，而对于腹痛容量阈值（APVT）及腹痛压力阈值（APPT）影响不明显；在C—IBS患者中，予以冷刺激后，患者便意容量阈值（DSVT）明显升高，但便意压力阈值（DSPT）无明显变化，而对于腹痛容量阈值（APVT）及腹痛压力阈值（APPT）影响不明显；在对照者中，虽然予以冷刺激后便意及腹痛容量及压力阈值均较温刺激时稍高，但均无统计学差异。③IBS患者较对照者的容量／压力比值普遍降低，但D-IBS组与C—IBS组两者之间无显著性差异；在IBS患者中，无论D—IBS还是C—IBS，予以冷刺激后。诱发患者产生便意所需的球囊内容量／压力比值明显升高，而对于腹痛的产生影响不明显；在对照者两种温度刺激诱发出受试对象产生便意及腹痛的球囊内容量／压力比值均无统计学差异。结论①IBS患者较对照者的内脏敏感性明显增高。②直肠内温度变化对IBS患者的非伤害性内脏感觉的产生有显著的影响，而对伤害性内脏感觉的产生影响不明显。③IBS患者的直肠顺应性减低。     

妊娠肠易激综合征86例临床分析

目的探讨妊娠对肠易激综合征（IBS）的影响以及妊娠期性激素对IBS发病的作用。方法按照罗马Ⅲ标准入选IBS患者86例,其中早、中、晚孕期分别为36例、28例和22例,根据腹部疼痛或不适的严重程度将症状分为轻度、中度和重度3级,根据粪便性状分为腹泻型（IBS—D）、便秘型（IBS—C）、混合型（IBS-M）和不定型（IBS-U）,根据有无重叠功能性消化不良（FD）症状分为重叠组和非重叠组,调查两组患者的性格特征、精神情绪、睡眠状况、焦虑抑郁等;对照组选择同期就诊的120例非妊娠女性患者。对妊娠各期与对照组患者的症状程度、IBS分型及重叠症状发生情况进行比较。结果随着孕期的增加,中度和重度发生率及发作频率有所减少,以肠道动力障碍为表现的IBS—C发生率有所增加（P〈0．05）;早、中孕期与对照组重叠症状的发生率比晚孕期患者有较明显增加。结论妊娠对IBS发病存在较为明显的影响,与妊娠密切有关的性激素水平对肠道动力和功能改变可能起着重要作用。     

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.