Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome.
Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome.
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DOI：
10.5009/gnl.2011.5.3.253
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发表时间：
2011-09
期刊：
影响因子：
3.4
通讯作者：
Saad R
中科院分区：
文献类型：
--
作者：
Chey WD;Maneerattaporn M;Saad R
肠易激综合征（IBS）是一种慢性功能性胃肠道疾病，其特征是与排便习惯改变（腹泻和/或便秘）相关的发作性腹痛或不适。其他胃肠道症状，如腹胀和肠胃气胀，也很常见。许多因素被认为在IBS症状的发展中起作用，包括改变的肠动力、内脏高敏感性、心理社会应激源、改变的脑-肠相互作用、免疫激活/低度炎症、肠道微生物组的改变和遗传因素。在缺乏可以基于病理生理学区分IBS亚组的生物标志物的情况下，这种病症的治疗取决于患者最令人烦恼的症状。在临床试验中，有效的治疗方法只提供了7- 15%的治疗增益超过安慰剂。便秘型IBS（IBS-C）总体症状的循证疗法包括鲁比前列酮和替加色罗;腹泻型IBS（IBS-D）总体症状的循证疗法包括益生菌双歧杆菌、不可吸收抗生素利福昔明和阿洛司琼。此外，有令人信服的证据表明，选择的解痉药和抗抑郁药对IBS患者腹痛的治疗有益。最后，一些具有新作用机制的新兴疗法正在开发中。补充和替代医学疗法，包括益生菌，草药疗法和针灸，在IBS患者中越来越受欢迎，尽管对制造标准和缺乏高质量疗效和安全性数据的担忧仍然存在。
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by episodic abdominal pain or discomfort in association with altered bowel habits (diarrhea and/or constipation). Other gastrointestinal symptoms, such as bloating and flatulence, are also common. A variety of factors are believed to play a role in the development of IBS symptoms, including altered bowel motility, visceral hypersensitivity, psychosocial stressors, altered brain-gut interactions, immune activation/low grade inflammation, alterations in the gut microbiome, and genetic factors. In the absence of biomarkers that can distinguish between IBS subgroups on the basis of pathophysiology, treatment of this condition is predicated upon a patient's most bothersome symptoms. In clinical trials, effective therapies have only offered a therapeutic gain over placebos of 7-15%. Evidence based therapies for the global symptoms of constipation predominant IBS (IBS-C) include lubiprostone and tegaserod; evidence based therapies for the global symptoms of diarrhea predominant IBS (IBS-D) include the probiotic Bifidobacter infantis, the nonabsorbable antibiotic rifaximin, and alosetron. Additionally, there is persuasive evidence to suggest that selected antispasmodics and antidepressants are of benefit for the treatment of abdominal pain in IBS patients. Finally, several emerging therapies with novel mechanisms of action are in development. Complementary and alternative medicine therapies including probiotics, herbal therapies and acupuncture are gaining popularity among IBS sufferers, although concerns regarding manufacturing standards and the paucity of high quality efficacy and safety data remain.
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影响因子：
3.1
作者：
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