心痛定加消炎痛治疗肠道易激综合征疗效观察(附108例报告)

肠道易激综合征 (ＩＢＳ)是一种具有特殊的病理生理基础的独立的肠功能紊乱性疾病。临床上较常见。我们对 10 8例ＩＢＳ患者应用心痛定加消炎痛与谷维素进行了临床对比观察 ,现报告如下。1　资料与方法1·1　一般资料　 10 8例ＩＢＳ患者中 ,男 5 2例 ,女 5 6例 ,年龄 2 1～ 78岁 ,平均 (4 1 2± 5 1)岁 ,30～ 5 0岁占82 3% ,病程 6个月～ 15年。将 10 8例患者随机分成两组 :治疗组 5 6例 ,男 2 7例 ,女 2 9例 ,平均年龄 (4 0 8± 5 1)岁 ,病程 8月～ 15年 ,对照组 5 2例 ,男 2 5例 ,女2 7例 ,平均年龄 (4 1 3± 5 0 )岁 ,病程 6月～ 1…     

含有低浓度肠安Ⅰ号制作的安慰剂对腹泻型IBS大鼠内脏高敏感性的影响

目的研究低浓度肠安Ⅰ号制作的安慰剂对番泻叶灌胃联合传统束缚应激诱导腹泻型肠易激综合征（IBS）大鼠模型的影响。方法采用番泻叶灌胃联合传统束缚应激诱导腹泻型IBS大鼠模型,将实验动物分为8组：正常组、模型组、肠安Ⅰ号高、中、低剂量组、含有低浓度（5%、10%）肠安Ⅰ号的安慰剂两组和阳性药对照组。观察各组大鼠在20、40、60、80mmHg下行直肠扩张,采用腹壁撤退反射（AWR）评分测定各组大鼠在20、40、60、80mmHg直结肠扩张压力下疼痛反应,观察本安慰剂对IBS大鼠内脏高敏感的影响。结果番泻叶灌胃联合传统束缚应激诱导腹泻型IBS大鼠模型在造模后第1天各实验组和用药结束后模型组明显增高（P〈0.05）,显示造模成功。中药对照药肠安Ⅰ号能降低IBS大鼠内脏敏感性的AWR评分（P〈0.05,P〈0.01）,且有一定的量效关系。安慰剂组不能降低其AWR评分（P〉0.05）。结论肠安Ⅰ号高、中、低剂量组对番泻叶灌胃＋传统束缚应激诱导腹泻型IBS大鼠的内脏高敏感性有一定的调节作用,含有低浓度肠安Ⅰ号制作的安慰剂对IBS大鼠的内脏高敏感则没有调节作用。     

用CCD摄像机取代光导管摄像机的系统改进

目的：通过采用CCD摄像机取代老化的光导管摄像机，使影像增强电视系统继续发挥作用。方法：选择低照度高灵敏度的CCD摄像机，配制X射线剂量自动控制器。结果：经过改进后的CCD配套影像增强电视系统能够达到临床使用的要求。结论：用CCD摄像头取代已老化的光导管摄像机，能够达到临床使用要求。明确了将通用CCD摄像机配套为影像增强电视系统的可行性。     

Enteroendocrine,Musashi 1 and neurogenin 3 cells in the large intestine of Thai and Norwegian patients with irritable bowel syndrome

Objectives: The prevalence, gender distribution and clinical presentation of IBS differ between Asian and Western countries. This study aimed at studying and comparing enteroendocrine, Musashi 1 (Msi 1) and neurogenin 3 (neurog 3) cells in Thai and Norwegian IBS patients.

Material and methods: Thirty Thai and 61 Norwegian IBS patients as well as 20 Thai and 24 Norwegian controls were included. Biopsy samples were taken from each of the sigmoid colon and the rectum during a standard colonoscopy. The samples were immunostained for serotonin, peptide YY, oxyntomodulin, pancreatic polypeptide, somatostatin, Msi 1 and neurog 3. The densities of immunoreactive cells were determined with computerized image analysis.

Results: The densities of several enteroendocrine cell types were altered in both the colon and rectum of both Thai and Norwegian IBS patients. Some of these changes were similar in Thai and Norwegian IBS patients, while others differed.

Conclusions: The findings of abnormal densities of the enteroendocrine cells in Thai patients support the notion that enteroendocrine cells are involved in the pathophysiology of IBS. The present observations highlight that IBS differs in Asian and Western countries, and show that the changes in large-intestine enteroendocrine cells in Thai and Norwegian IBS patients might be caused by different mechanisms.     

The probiotic Bifidobacterium infantis 35624 displays visceral antinociceptive effects in the rat

Background Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain and altering bowel habit with a high percentage of patients displaying comorbid anxiety. Growing clinical and preclinical evidence suggests that probiotic agents may restore the altered brain–gut communication in IBS. In this study, we evaluated the efficacy of repeated treatment with three different probiotics in reducing visceral pain in visceral normosensitive (Sprague–Dawley [SD]) and visceral hypersensitive (Wistar–Kyoto [WKY]) rat strains. Methods Following 14 days oral gavage of Lactobacillus salivarius UCC118, Bifidobacterium infantis 35624, or Bifidobacterium breve UCC2003 both SD and WKY rats were exposed to a novel stress, the open field arena and their behavior was recorded. Subsequently, the effects of probiotics on visceral nociceptive responses were analyzed by recording pain behaviors during colorectal distension (CRD). Key Results It was found that there was a difference in the open field behavior between strains but none of the probiotic treatment altered behavior within each strain. Interestingly, the probiotic B. infantis 35624 but not others tested significantly reduced CRD‐induced visceral pain behaviors in both rat strains. It significantly increased the threshold pressure of the first pain behavior and also reduced the total number pain behaviors during CRD. Conclusions & Inferences These data confirm that probiotics such as B. infantis 35624 are effective in reducing visceral pain and may be effective in treating certain symptoms of IBS.     

One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders

Background

In order to clarify the classification of physical complaints not attributable to verifiable, conventionally defined diseases, a new diagnosis of bodily distress syndrome was introduced. The aim of this study was to test if patients diagnosed with one of six different functional somatic syndromes or a DSM-IV somatoform disorder characterized by physical symptoms were captured by the new diagnosis.

Method

A stratified sample of 978 consecutive patients from neurological (n=120) and medical (n=157) departments and from primary care (n=701) was examined applying post-hoc diagnoses based on the Schedules for Clinical Assessment in Neuropsychiatry diagnostic instrument. Diagnoses were assigned only to clinically relevant cases, i.e., patients with impairing illness.

Results

Bodily distress syndrome included all patients with fibromyalgia (n=58); chronic fatigue syndrome (n=54) and hyperventilation syndrome (n=49); 98% of those with irritable bowel syndrome (n=43); and at least 90% of patients with noncardiac chest pain (n=129), pain syndrome (n=130), or any somatoform disorder (n=178). The overall agreement of bodily distress syndrome with any of these diagnostic categories was 95% (95% CI 93.1-96.0; kappa 0.86, P<.0001). Symptom profiles of bodily distress syndrome organ subtypes were similar to those of the corresponding functional somatic syndromes with diagnostic agreement ranging from 90% to 95%.

Conclusion

Bodily distress syndrome seem to cover most of the relevant “somatoform” or “functional” syndromes presenting with physical symptoms, not explained by well-recognized medical illness, thereby offering a common ground for the understanding of functional somatic symptoms. This may help unifying research efforts across medical disciplines and facilitate delivery of evidence-based care.     

Importance of neural mechanisms in colonic mucosal and muscular dysfunction in adult rats following neonatal colonic irritation

Previous studies have shown that early life trauma induced by maternal separation or colonic irritation leads to hypersensitivity to colorectal distension in adulthood. We tested the hypothesis that repetitive colorectal distension in neonates leads to abnormalities in colonic permeability and smooth muscle function in the adult rat. In neonatal rats, repetitive colorectal distension was performed on days 8, 10, and 12. As adults, stool consistency was graded from 0 (formed stool) to 3 (liquid stool). Colonic tissue was isolated for histology and myeloperoxidase levels. The colonic mucosa was placed in modified Ussing chambers for measurements of permeability and short-circuit current responses to forskolin, electrical field stimulation, and carbachol. Segments of colonic musculature were placed in organ baths and contractile response to potassium chloride, electrical field stimulation, and carbachol were determined. In adult rats that experienced neonatal colonic irritation, no significant changes in colonic histology or myeloperoxidase activity were observed; however, stool consistency scores were increased. Mucosal permeability, measured as an increase in basal conductance, was significantly increased but no changes in short-circuit current responses were observed. In adulthood, rats that underwent colorectal distension as neonates exhibited an elevated smooth muscle contractile response to potassium chloride, but no changes in response to electrical field stimulation or carbachol. In summary, neonatal colonic irritation, shown previously to produce colonic hypersensitivity, leads to significant alterations in colonic mucosal and smooth muscle function characterized by loose stools, increased mucosal permeability, and increased smooth muscle contractility in the absence of colon inflammation in adulthood.     

升阳止泻汤治疗腹泻型肠易激综合征89例疗效观察

[目的]观察中药治疗腹泻型肠易激综合征的临床疗效。[方法]89例随机分为治疗组49例,对照组40例。治疗组合用升阳止泻汤与痛泻要方加减治疗．对照组服用思密达。[结果]治疗组显效率为81．6％．对照组为40％。（P〈0．01）。[结论]中药对腹泻型肠易激综合征有较好疗效.     

参倍固肠胶囊治疗脾肾阳虚型肠易激综合征临床观察

目的：参与完成参倍固肠胶囊治疗脾肾阳虚型IBS的III期临床试验,并观察其I临床疗效。方法：将92例脾肾阳虚型IBS．D患者实验组46例和对照组46例,实验组服用参倍固肠胶囊,对照组1：2服固本益肠片模拟剂,4W作为观察周期。结果：实验组总有效率为86．7％,对照组为64．4％。2组总有效率比较有统计学意义（P〈0．05）,实验组在大便性状、大便次数、倦息乏力、腰膝酸痛4项症状改善上优于对照组（P〈0．05）,但在腹胀腹痛症状改善上两组无显著性差异（P〉0．05）。结论：参倍固肠胶囊对脾肾阳虚型IBS—D有效。