益生菌对肠易激综合征和炎症性肠病的作用

由于胃肠道微生物参与炎症性肠病（inflammatory bowel disease,IBD）的病理过程,而且最近研究表明微生物可能在肠易激综合征（irritable bowel syndrome,IBS）中扮演重要作用.本文重点关注益生菌在这两种疾病中的作用机制和疗效.胃肠道微生物的组成受多种因素调节,包括年龄、饮食和疾病状态.益生菌可能通过影响宿主的微生物菌群和提高黏膜的免疫调节作用发挥疗效.益生菌的口服耐受性较好.许多短期研究表明益生菌在IBS中有效,尽管只是在部分的特殊菌株和某些特定症状中有效.在IBD中,许多临床试验表明大量的益生菌在结肠袋炎和溃疡性结肠炎中有效,而对克罗恩病无明显疗效.显然,益生菌在IBS和IBD的治疗中能起到巨大的作用,但是,这些只是针对特殊的菌株.将来迫切需要进行高质量的临床研究和实验观察益菌对IBD和IBS的疗效.

Effect of probiotics on irritable bowel syndrome and inflammatory bowel disease

The pathogenesis of inflammatory bowel disease （IBD） involves the gastrointestinal microorganism and some evidence show that the microorganism might also play a similar role in irritable bowel syndrome （IBS）.The aim of this article is to review the emerging evidence for the mechanisms and effectiveness of probiotics on the management of these disorders.The composition of the gastrointestinal microorganism is strongly influenced by some factors including age,diet and disease.Probiotics may be effective through their impact on the host gastrointestinal microorganism and promotion mucosal immunoregulation of gastrointestinal tract.Probiotics are considered to be well tolerated,although the quality of studies have controversy.There are many short-term studies demonstrating the effectiveness of probiotics in IBS,although recommendations should be made for specific strains and for specific symptoms.With regard to IBD,a number of trials have shown the benefits of a range of probiotics in pouchitis and in ulcerative colitis,but current evidence in Crohn＇ s disease is less promising.Clearly,some probiotics have considerable potentials in the management of IBS and IBD.However,the benefits are strain specific.High-quality trials of clinical and laboraton investigations are meeded to observe the curative effect of probiotics on IBD and IBS.