王氏保赤丸临床应用近况

王氏保赤丸系清代通州名医王胪卿祖传几世的秘方 ,由北京中医药大学王绵之教授监制的纯中药制剂。其成分主要是由大黄、黄连、川贝、制南星、生姜、巴豆霜等药物组成 ,具有清热泻火、泻积导滞、化痰平喘等功效。现代药理试验亦表明具有抑菌、消炎、解热、镇静、化痰和排出毒素等作用。临床用于小儿消化系统和呼吸系统的治疗 ,是儿科疾病的良药。近年来也在临床应用于成人 ,可开发成类似胃肠动力药[1] 。现将其近年来临床应用近况概述如下。1　小儿高热惊厥症　　董氏[2 ] 报道用王氏保赤丸治疗小儿高热惊厥症 60例 ,其中男 2 6例 ,女 3 6例 …     

肠易激综合征的治疗

肠易激综合征（Ｉｒｒｉｔａｂｌｅ ｂｏｗｅｌ ｓｙｎｄｒｏｍｅ, ＩＢＳ）是最常见的肠道运动障碍性疾病,其紊乱不仅限于结肠,且可累及小肠乃至胃、胆囊等,临床表现为腹痛和排便习惯的改变。文献上它有过许多名称,如神经性结肠炎、过敏性结肠炎、结肠痉挛、粘液性结肠炎、结肠过敏、结肠功能紊乱等等。本病的确切病因尚不清楚。很可能是包含多种疾病的“混合体”,正因为如此,对本病的治疗并无统一的“规格”。 治疗肠易激综合征的前提 治疗 ＩＢＳ应在以下前提下进行：（１）确诊;（ ２）病人诊疗程序的考虑;（３）药物与安慰剂…     

肠易激综合征的动力学实验研究

肠易激综合征(IBS)是最常见的肠道运动异常性疾病,表现为腹痛、腹胀,排便习惯改变及大便性状异常等,缺乏形态学的生物学标志.其发病机制不很明确,可能与胃肠动力学、内脏高敏感性、脑肠轴的改变、肠道过敏、肠道菌群失调和精神行为的异常有关,其中动力异常是重要表现形式之一.动力异常可表现为结肠、小肠、其他消化道、甚至消化道外动力异常,例如胆道.IBS一般据其症状分为便秘型(IBS-C)、腹泻型(IBS-D)、交替型(IBS-A).此外,Cole等[1]根据动力异常的形式分为痉挛性结肠综合征(SCS)、功能性腹泻(FD)、腹泻为主的痉挛性结肠综合征(DPSCS)和小肠动力异常(MGD)4种.现就IBS的动力学实验研究作一综述.     

肠易激综合征的药物治疗进展

肠易激综合征(IBS)是常见消化系统疾病,其治疗主张包括心理治疗在内的综合措施[1]。患者易出现焦虚、忧郁等精神或心理学异常,因此,心理治疗占有重要位置,针对本病常见症状,其主要治疗药物有以下几种。1　镇痛药[3,4]对于顽固性腹痛的患者可用小剂量镇痛药。不透血脑屏障的鸦片类药,理论上对IBS有效,主要作用于肠道鸦片受体,不产生欣快和药物依赖性,如dextromethorphan可减轻疼痛,trimebutine为外周性脑腓肽类似物,对控制下腹痛发作次数和时间较美贝维林(mebeverine)为优。苯二氮　类(benzodi-azepine)及麻醉性镇痛剂因有成瘾可能,不推荐…     

肠易激综合征的认知治疗

肠易激综合征 (ｉｒｒｉｔａｂｌｅｂｏｗｅｌｓｙｎｄｒｏｍｅ ,ＩＢＳ)是一种常见的以腹痛 /腹部不适伴排便习惯改变 (包括粪便性状、排便频率、排便不净感、便急、排便费力以及腹胀 )为特征的功能性肠病 (ｆｕｎｃｔｉｏｎａｌｂｏｗｅｌｄｉｓｅａｓｅ ,ＦＢＤ) ,缺乏形态学和生化学改变的生物学标志[1] 。其病因和发病机制复杂 ,迄今尚无定论[2 ,3] 。因此 ,目前诊断主要是根据临床症状的积分 ,并通过一定的实验室检查排除器质性病变后诊断的 ,常用的诊断标准是Ｍａｎｎｉｎｇ标准和罗马标准Ⅰ[1,4 ] ,新近修订的罗马标准Ⅱ已公布 ,但…     

肠易激综合征诊断和治疗规范

肠易激综合征（Irritable bowel syndrome,IBS）是一常见的功能性胃肠病,其临床特点是持续或反复发作的腹痛或不适,伴有排便习惯改变或排便异常,目前认为多种因素包括胃肠运动改变、内脏感觉异常和社会心理因素相互作用导致其症状,但缺乏可识别的生理、生化或形态等方面的器质性病变。其病因和发病机制不明,被认为是了解得最差的疾病之一。自1978年Manning提出IBS的症状学诊断标准以来,国际上的专业工作小组在达成共识的基础上,     

中西医结合治疗肠易激综合征疗效观察

肠易激综合征（IBS）主要临床表现是慢性腹泻，或腹泻与便秘交替，伴腹胀腹痛。现代医学对IBS的治疗方法主要是止泻与对症治疗为主，但疗效欠满意，而单用中药治疗，疗程较长，又易复发。笔者自1994年至今．用中医辨证用药加服洛赛克治疗40例IBS患者，疗效满意，现总结报道如下。1临床资料1．1一股资料：40例IBS患者来自我科门诊和住院病例，均符合1986年11月全国慢性腹泻学术会制定《肠易激综合征》临床诊断标准、并全部经X光或结肠镜检排除肠道内器质性病变。其中男28例，女12例，年龄19～68岁，病程6个月～4年，发病1年以上者36例…     

规范化肠易激综合征治疗

功能性胃肠病是非常常见的消化系统疾病,肠易激综合征(irritable bowel syndrome,IBS)则是最常见的功能性肠病,且常与其他功能性胃肠病重叠.IBS是一种高度异质性疾病,不同患者表现的症状不同,涉及的病因和发病机制不同,加之目前对.IBS的发病机制尚未完全阐明.     

福松治疗便秘型肠易激综合征的研究

目的研究观察福松对便秘型肠易激综合征（IBS）的治疗效果。方法根据罗马Ⅱ标准80例病人诊断为IBS，随机分出40例设为治疗组，予以福松治疗；另40例设为对照组，：产以安慰剂治疗，观察疗效。结果经1个月的治疗后，治疗组显效26例（65％），有效10例（25％），无效4例（10％），总有效率为90％。结论福松对便秘型肠易激综合征具有满意的疗效。     

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.     

百忧解治疗肠易激综合征的临床研究

目的　评价百忧解对肠易激综合征 (ISB)的疗效 ,以供临床用药参考。方法　随机选取 65例伴有明显抑郁症状的IBS患者 ,3 4例治疗组对症治疗的同时给予百忧解 2 0mg ,每日清晨 1次顿服 ,共 8周 ,疗程结束后随诊 4～ 6个月。 3 1例对照组只采用对症治疗。结果　治疗组 3 4例中有效者 2 9例 ,有效率为 83 5 %。对照组有效者 19例 ,有效率为 61 3 %。两组之间差别极显著 (P<0 0 1)。结论　百忧解治疗伴有抑郁症状的IBS疗效显著 ,值得推广应用     

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。     

褪黑激素与肠易激综合征

肠易激综合征是一种原因不明的慢性肠功能紊乱性疾病，其发病机制尚不清楚。其治疗方法也在不断改进中，褪黑激素对肠易激综合征的治疗有着积极的作用。     

青少年儿童肠易激综合征的流行病学调查

目的分析青少年儿童肠易激综合征(IBS)的患病率、分布特征(包括区域、学龄段、性别分布等)及其致病的相关危险因素。方法采用多级整群随机抽样方法,对黑龙江省与上海市共9所学校中5403名中小学生进行流行病学问卷调查,估算符合罗马Ⅱ诊断标准IBS的期间患病率,对其致病的相关危险因素进行单因素与多因素分析。结果推测被调查的两地中小学生符合罗马Ⅱ诊断标准的IBS患病率为13.25%,男女患病率差异无统计学意义(P>0.05)。区域性分层研究表明,患病率在黑龙江省(14.02%)和上海市(11.72%)之间差异有统计学意义(P<0.05)。学龄段分层研究表明,高中生患病率(17.80%)明显高于其他学龄段(P<0.01)。多因素回归分析表明,饮酒、吸烟、辛辣食物、痢疾史、腹部手术史、服用大量抗生素史、受凉、疲劳、心情焦虑、心情压抑及内向性格11个因素为最具可能性的危险因素,其OR值分别为1.25、1.44、1.13、1.37、1.63、1.93、2.83、1.10、1.07、1.13及1.05。结论IBS是青少年儿童人群的常见病和多发病。青少年儿童IBS患病率存在区域性与学龄段差异。心理因素、食物、不良外界环境因素及家庭环境因素等可能是诱发青少年儿童IBS致病的相关危险因素。     

Meta-analysis of probiotics for the treatment of irritable bowel syndrome

Irritable bowel syndrome （IBS） is a chronic condition affecting 3%-25% of the general population. As no curative treatment is available, therapy is aimed at reducing symptoms, often with little success. Because alteration of the normal intestinal microflora has been observed in IBS, probiotics （beneficial microbes taken to improve health） may be useful in reducing symptoms. This paper systematically reviews randomized, controlled, blinded bials of probiotics for the treatment of IBS and synthesizes data on efficacy across trials of adequate quality. Pubr4ed, Medline, Google Scholar, NIH registry of clinical trials, metaRegister, and the Cochrane Central Register of Controlled Trials were searched from 1982-2007. We also conducted secondary searches of reference lists, reviews, commentaries, relevant articles on associated diseases, books and meeting abstracts. Twenty trials with 23 probiotic treatment arms and a total of 1404 subjects met inclusion criteria. Probiotic use was associated with improvement in global IBS symptoms compared to placebo [pooled relative risk （RRpooled） 0.77, 95% confidence interval （95% CI） 0.62-0.94]. Probiotics were also associated with less abdominal pain compared to placebo [RRpooled = 0.78 （0.69-0.88）]. Too few studies reported data on other IBS symptoms or on specific probiotic strains to allow estimation of a pooled RR. While our analyses suggest that probiotic use may be associated with improvement in IBS symptoms compared to placebo, these results should be interpreted with caution, given the methodological limitations of contributing studies. Probiotics warrant further study as a potential therapy for IBS.     

肠易激综合征流行病学研究现状与进展

肠易激综合征(irritable bowel syndrome,IBS)是一种以慢性或者反复发作的腹痛伴排便习惯改变为特征的功能性肠病,并缺乏形态学和生化标志的异常。IBS是一种全球性疾病,人群患病率较高,其症状可反复发作,严重影响患者的生活质量,并占用了大量的医疗资源。IBS的病因和发病机制尚未明了,随着对IBS认识的不断深入和发展,国内外在不同时期,采用不同的标准和方法,对IBS的流行病学进行了较深入的研究,但不同国家和地区、不同人群的IBS患病率及其分布特征研究结果不尽相同,影响IBS的危险因素主要包括社会心理因素及遗传、感染、食物、药物因素等,现就近年来国内外IBS流行病学的研究情况作一综述。     

State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008

Irritable bowel syndrome （IBS） and inflammatory bowel disease （IBD） are two of the leading causes of chronic intestinal conditions in the world. This issue of World Journal of Gastroenterology （ WJG） presents a series of papers from world experts who discuss the current knowledge and opinions on these important conditions. Although great strides have been made in the diagnosis, treatment and pathology of IBS and IBD; much has yet to be explained. The etiologies and risk factors of these multifactorial conditions remain elusive. Specific diagnostic biomarkers need to be developed and safer treatments developed. The burden of IBS and IBD on the healthcare system is felt with repeated medical care visits and high costs. IBS and IBD patients can account for 30%-50% of office visits at gastroenterology services/clinics. Over one million people have IBD in the United States, with 30000 new cases being diagnosed every year. One-quarter million people in the UK are afflicted with IBD. The cost of medical care in the United States for IBD is estimated to be $1.8 billion/year.     

Updates on treatment of irritable bowel syndrome

Irritable bowel syndrome （IBS） is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated tD affect 10%-15% of the Western population, and has a large impact on quality of life and （in）direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and postinfectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications （alosetron and tegaserod） because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologicallybased overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.     

肠易激综合征发病机理的研究进展

肠易激综合征的发病机制至今仍不明确，目前比较一致的观点认为IBS是胃肠动力异常、内脏感觉敏感性增高、肠道感染、炎症、心理社会精神因素、神经免疫内分泌及基因遗传等多种发病机制共同参与共同作用的结果，本文就近年来有关IBS发病机制的研究进展作一综述。