肠易激综合征药物治疗进展

肠易激综合征 (ｉｒｒｉｔａｂｌｅｂｏｗｅｌｓｙｎｄｒｏｍｅ ,ＩＢＳ)属胃肠功能紊乱性疾病 ,表现为腹痛、腹胀、排便习惯改变及大便性状异常等症状 ,但缺乏形态学和实验室异常的依据。长期以来 ,其病理生理机制一直未被阐明 ,因此药物治疗发展缓慢。但近年来随着各种内脏感觉、消化道运动功能检查手段的发展 ,ＩＢＳ病理生理研究的不断的深入以及药理学的进展 ,出现了一批具有希望的药物 ,其中部分已在临床应用中取得了较为满意的疗效。目前 ,除了纤维素制剂外 ,ＩＢＳ的药物治疗主要针对调节肠道转运功能、纠正内脏感觉过敏和改善中枢…     

肠易激综合征中西医研究的若干进展

肠易激综合征(IBS)是与肠道动力学异常有关的功能性疾病，是一组包括腹痛、腹胀伴排便习惯改变(腹泻／便秘)，粪便性状异常(稀便、粘液便／干便)等临床表现的症候群，持续存在或间歇发作，但无器质性疾病(形态学、细菌学及生化代谢指标等异常)的证据。目前仍被认为是功能性疾病，但近年来许多研究已显示出该病有胃肠动力异常和内脏感觉异常的病理现象。     

5-羟色胺与肠易激综合征关系的研究进展

肠易激综合征(IBS)是一种由胃肠功能紊乱引起的疾病,国内外研究表明IBS与5-羟色胺(5-HT)关系密切,5-HT能使IBS患者的肠道运动增加、对液体的吸收减少和内脏敏感性增高,调控胃肠运动、分泌、吸收及感觉等复杂功能,故5-HT与IBS患者腹痛、腹泻和内脏感觉异常等症状密切相关。     

肠易激综合征动物模型研制现状和进展

肠易激综合征(IBS)是一种常见的肠功能紊乱性疾病,特点是慢性反复发作的腹痛、腹部不适及排便习惯的改变。发病机制目前尚未阐明。研究显示IBS可能与肠道动力、内脏感觉过敏和肠道感染等因素有关。此文对IBS动物模型研制现状及展望作一综述。     

肠易激综合征与心理因素及睡眠障碍的关系

肠易激综合征（IBS）是一种多因素引发的疾病,该病的病因及发病机制尚不清楚,多种因素均可诱发该病发作,如胃肠动力异常,内脏感觉过敏,肠道炎性反应及免疫功能改变,饮食及生活方式的改变,心理因素等。研究发现,IBS患者存在明显的精神心理异常及睡眠障碍。此文就IBS和精神心理因素及睡眠障碍的关系作一综述。     

5羟色胺在肠易激综合征中的作用

肠易激综合征(IBS)是一个复杂的胃肠功能失调性疾病,包括胃肠动力、内分泌及内脏感觉等的异常.其临床特点为慢性的、或复发性的腹部疼痛或不适,包括排便习惯和大便性状异常,症状从轻到重.5羟色胺(5-HT)是一种广泛存在于中枢神经系统和胃肠道的神经递质,具有多种生物学功能.近年来其在调节胃肠道运动方面的作用逐渐受到重视,尤其在IBS发病机制及治疗中的作用受到越来越多的关注.     

辣椒素及其受体与肠易激综合征的相关研究

肠易激综合征(irritable bowel syndrome,IBS)是一种常见的肠功能紊乱性疾病,特点是慢性反复发作的腹痛、腹部不适及排便习惯的改变.发病机制目前尚未阐明.研究显示IBS可能与肠道动力、内脏感觉过敏和肠道感染等因素有关,同时辣椒素及辣椒素受体对内脏痛觉的影响也受到越来越多的关注,其表达异常与IBS究竟有无关系目前尚不清楚.本文就辣椒素及其受体在理化性质、药理作用及与内脏痛觉方面的联系,以及辣椒素及其受体在IBS中的调节作用作一简要综述.     

肠易激综合征患者直肠气囊扩张时的功能脑显像研究

目的:肠易激综合征(IBS)是一类以腹痛及排便习惯改 变为特征的胃肠功能性疾病,内脏痛觉过敏可能是其重要的病理生理基础之一。本研究的目的在于应用血氧水平依赖性功能磁共振成像(BOLD—fMRI)技术,探讨直肠气囊扩张刺激下大脑内脏痛觉中枢的兴奋情况,并比较IBS患者在不同容量刺激下兴奋区分布、范围及强度与正常人群的差异性。方     

电针足三里对胃肠功能性疾病作用的研究进展

电针人体穴位对胃肠动力产生重要影响,足三里是最常用穴位之一,其是足阳明胃经的合穴.在特定频率下电针足三里对胃肠功能性疾病发挥了重要的调节作用,如能改善胃食管反流、功能性消化不良和肠易激综合征等.尽管临床研究中未有定论,但更多证据支持电针足三里对胃肠功能性疾病的发挥重要的调节作用.本文就最近电针足三里对胃肠功能性疾病的调...     

胃肠起搏在胃肠功能性疾病中的应用

胃肠功能性疾病是临床上常见的消化道疾病,其病理生理复杂,病因及发病机理尚未明确,还没有一个确切有效的治疗方案。近年来,胃肠起搏应用于糖尿病胃轻瘫、胃食管反流、功能性消化不良等胃肠功能性疾病的治疗中,已取得了良好的疗效。     

胃肠电生理起搏治疗胃肠动力障碍性疾病的临床疗效

目的　探讨胃肠电生理起搏对胃肠动力障碍性疾病的疗效 ,并探索其可能的作用机制。方法　 82例胃肠动力障碍性疾病患者 ,随机分为 2组 ,低频和高频起搏组分别为 5 0和 32例 ,分别采用1 .1～ 1 .2倍内源性胃慢波频率 (IGF)叠加 1 0Hz的双极脉冲方波和 4 .0倍IGF叠加 30Hz双极脉冲方波进行起搏。胃起搏 1次 /d ,每次 4 5min ,共 1 5d。采用 8导联胃电图仪 (EGG)记录患者空腹状态和进食试餐后的胃电活动各 1h。分别于治疗前、治疗 1 5d后对胃电图和各种症状的改善情况进行评估。结果　治疗 1 5d后 ,除高频起搏组反酸外 ,患者各症状评分均有改善 ,差异有显著性 (P <0 .0 4 )。高频起搏组治疗后恶心、呕吐的改善较低频起搏组更为明显 (P <0 .0 5 ) ,而低频起搏组早饱、嗳气的缓解则较高频起搏组更显著 (P <0 .0 5 ) ,但两组间症状总积分的比较差异无显著性 (P >0 .0 5 )。治疗后低频起搏组餐后过速频率较治疗前显著降低 [(3.4 3± 0 .2 5 )次 /min比 (3.0 1± 0 .2 0 )次 /min ,P <0 .0 5 ],餐后过缓频率则显著增加 [(2 .4 1± 0 .4 3)次 /min比 (2 .6 7± 0 .2 6 )次 /min ,P <0 .0 5 ]。但无论在空腹状态或餐后 ,高频起搏组治疗前后其胃电主频率无明显改变 (P >0 .0 5 )。两组患者治疗后正常胃电节律百分比     

胃肠功能和动力障碍研究进展

近年提出的功能性胃肠病(FGID)的罗马Ⅱ诊断标准和胃肠动力障碍(DGIM)的新分类已为国内外普遍接受，并有助于国内外的交流。这里将讨论FGID和DGIM的研究热点、方法学及诊治的进展。     

Effects of gastrointestinal peptides on gastrointestinal cancer growth

The trophic effect of gut hormones may have important clinical applications for treatment of gut and pancreatic cancers. We now have developed methods by which we can quantitate gut hormone receptors in normal and neoplastic gut mucosa and pancreas. Analysis of gut and pancreatic tumors for gut hormone receptors may thus allow us to select patients with these cancers who would respond to treatment with hormones, antihormones, or hormone ablation in a manner similar to current strategies that are employed successfully for treatment of patients with breast cancer.     

胃肠电刺激和胃肠动力紊乱研究进展

胃肠电刺激治疗消化道运动障碍性疾病方面的研究已经取得可喜的成果.此文就胃肠电刺激的分类和作用机制及其在胃轻瘫、肥胖、大便失禁、便秘及慢性假性肠梗阻中临床应用的研究成果进行综述.     

Management of gastrointestinal bleeding induced by gastrointestinal endoscopy

Therapeutic gastrointestinal endoscopy has a much greater risk of inducing gastrointestinal hemorrhage than diagnostic endoscopy. For example, colonoscopic polypectomy has a risk of approximately 1.6% of inducing bleeding, compared with a risk of approximately 0.02% for diagnostic colonoscopy. Higher-risk procedures include colonoscopic polypectomy, endoscopic biliary sphincterotomy, endoscopic dilatation, endoscopic variceal therapy, percutaneous endoscopic gastrostomy, and endoscopic sharp foreign body retrieval. The risk of inducing hemorrhage is decreased by meticulous endoscopic technique. Hemorrhage from endoscopy may be immediate or delayed. Immediate hemorrhage should be immediately treated by endoscopic hemostatic therapy, including injection therapy, thermocoagulation, or electrocoagulation. Delayed hemorrhage generally requires repeat endoscopy for diagnosis and for therapy, using the same hemostatic techniques.     

Differential diagnosis of gastrointestinal leiomyoma versus gastrointestinal stromal tumor

Introduction Strategies for the diagnosis of tumors arising in the intestinal muscular wall are rapidly evolving. Immunoreactivity for CD117 (KIT) usually supports the diagnosis of gastrointestinal stromal tumor (GIST), but a small subset of GISTs lacks KIT expression. In these cases the differential diagnosis of KIT-negative GIST versus one of their morphological mimics is difficult and bears critical implications for therapeutic management.Case report Here, we report a case of a KIT-negative smooth muscle cell tumor of the colon in a 21-year-old man with the clinical appearance of GIST. Mutations of the KIT and platelet-derived growth factor receptor alpha (PDGFRA) gene could be ruled out. No chromosomal imbalances characteristic of GIST were found. However, cytogenetic analysis revealed losses at 7q, which has previously been reported in cases of uterine leiomyoma.Discussion We discuss current approaches to the differential diagnosis of true gastrointestinal smooth muscle cell tumor versus GIST.     

Carbonic anhydrases in normal gastrointestinal tract and gastrointestinal tumours

Carbonic anhydrases (CAs) catalyse the hydration of C02 to bicarbonate at physiological pH. This chemical interconversion is crucial since HCO3- is the substrate for several biosynthetic reactions. This review is focused on the distribution and role of CA isoenzymes in both normal and pathological gastrointestinal (GI) tract tissues. It has been known for many years that CAs are widely present in the GI tract and play important roles in several physiological functions such as production of saliva, gastric acid, bile, and pancreatic juice as well as in absorption of salt and water in intestine. New information suggests that these enzymes participate in several processes that were not envisioned earlier. Especially, the recent reports on plasma membrane-bound isoenzymes IX and XII have raised considerable interest since they were reported to participate in cancer invasion and spread. They are induced by tumour hypoxia and may also play a role in von Hippel-Lindau (VHL)-mediated carcinogenesis.     

Human interdigestive and postprandial gastrointestinal motor and gastrointestinal hormone patterns

Fasting gastrointestinal motor and hormone patterns were studied in 11 healthy volunteers. Cyclic motor activity was present in all subjects during fasting, but the duration and site of onset of each cycle were variable, even in the same subject. Fasting gastrin, GIP, and glucagon levels remained low and constant during the 8-hr study, while plasma motilin levels exhibited cyclic variation in 7 of the 11 subjects. Achlorhydria (induced with cimetidine in 5 of the 11 subjects) did not alter the pattern of fasting motor activity or plasma motilin. In the remaining six subjects, the effect of liquid nutrient meals was examined. Ingestion of a sodium chloride bolus failed to disrupt fasting cyclic activity, while all nutrient-containing solutions inhibited gastric phase-2 motor activity, the duration of inhibition being longest for the mixed and lipid meals. All nutrient meals released GIP, while only protein and mixed meals released gastrin, and the lipid meal released motilin. Our study confirms the rhythmicity of interdigestive motor cycles in man and demonstrates their lack of dependence on gastric acid secretion and some relationship to motilin cycles in certain individuals as determined by radioimmunoassay. Transition from fasting to fed pattern (after liquid meals) is characterized by the inhibition of phasic gastric pressure changes in the antrum and the development of irregular activity in the intestine, similar in pattern to fasting phase 2. Because the duration of interruption of the gastric interdigestive pattern by meals depends on their nutrient content, we conclude that dietary composition may be a major determinant of the fasting-fed motor balance in man.