腹泻型肠易激综合征与小肠细菌过度生长关系的研究
发布时间：2018-10-07 19:45
【摘要】：目的1探讨腹泻型肠易激综合征（diarrhea-predominant irritable bowel syndrome，IBS-D）患者小肠细菌过度生长（small intestinal bacterial overgrowth，SIBO）、口-盲肠传递时间（orocecal transit time, OCTT）情况；2探讨OCTT与SIBO的关系； 方法1选取2012年01月至2013年12月在迁安市人民医院消化内科病房或门诊就诊符合罗马III诊断标准的IBS-D患者39人，正常对照组39人；所有受试者均进行乳果糖氢呼气试验，测定SIBO发生率、OCTT，统计IBS-D患者腹痛、腹胀、腹泻、腹部不适等主要症状程度及频率积分，并将两组的SIBO发生率、OCTT进行比较；将SIBO阳性与SIBO阴性组的IBS-D患者的OCTT进行比较；2SIBO阳性的IBS-D患者给与双岐杆菌三联活菌胶囊治疗，疗程4周，记录试验前后患者主要症状积分、SIBO情况、OCTT，比较治疗前后SIBO阳性的IBS-D患者的主要症状及OCTT变化情况，观察SIBO的阴转率。 结果1IBS-D患者SIBO发生率46.2%，OCTT79.23±16.12分钟，正常对照组OCTT87.69±19.02分钟，IBS-D患者的OCTT较正常对照组缩短（P0.05）；2SIBO阳性的IBS-D患者腹胀的程度及频率均较对照组严重，两组比较有统计学意义（P0.05），腹痛、腹泻、腹部不适等症状程度及频率两组比较无统计学意义（P0.05）；3SIBO阳性的IBS-D患者OCTT94.17±8.62分钟，SIBO阴性的IBS-D患者OCTT66.43±7.66分钟，两组OCTT比较差异有统计学意义（P0.05）；4存在SIBO的18例IBS-D患者治疗4周后，仍存在SIBO8例，SIBO阴转10例，SIBO阴转率（55.6%），治疗后患者主要症状程度及频率均较治疗前下降，，但腹痛、腹胀积分明显下降，与治疗前相比有统计学差异（P0.05），OCTT较治疗前缩短（P0.05）。 结论1腹泻型肠易激综合征患者中有较高的小肠细菌过度生长发生率，并且其口-盲肠传递时间存在异常。2小肠细菌过度生长可以引发口-盲肠传递时间延长。小肠细菌过度生长与腹泻型肠易激综合征患者的腹胀程度及频率具有相关性。3益生菌双岐杆菌三联活菌胶囊对IBS-D有较好的治疗效果，可以明显改善患者腹痛、腹胀的程度及频率，同时可使部分患者SIBO转阴，并可使OCTT缩短。
[Abstract]:Objective 1 to investigate the relationship between OCTT and SIBO in patients with diarrhea irritable bowel syndrome (diarrhea-predominant irritable bowel syndrome,IBS-D) and the (orocecal transit time, OCTT) of intestinal bacterial overgrowth (small intestinal bacterial overgrowth,SIBO) and oral to cecal transmission time (orocecal transit time, OCTT). Methods from January 2012 to December 2013, 39 IBS-D patients who met Rome III diagnostic criteria were selected from the Department of Digestive Medicine of Qianan people's Hospital or outpatient clinic, and 39 normal controls were selected. All subjects were tested with fructose hydrogen breath test, and the incidence of SIBO was measured. The main symptoms of IBS-D patients, including abdominal pain, abdominal distension, diarrhea, abdominal discomfort and so on, were measured. The incidence of SIBO was compared between the two groups. Comparison of OCTT in IBS-D patients with SIBO positive and SIBO negative IBS-D patients were treated with Bifidobacterium triplex capsule for 4 weeks. The main symptoms and OCTT changes of IBS-D patients with SIBO positive before and after treatment were compared and the negative conversion rate of SIBO was observed. Results the incidence of SIBO in patients with 1IBS-D was 79.23 卤16.12 minutes, and that in patients with OCTT87.69 卤19.02 minutes in normal control group was shorter than that in control group (P0.05). The degree and frequency of abdominal distension in IBS-D patients with positive OCTT were significantly higher than those in control group (P0.05). There was no significant difference in the degree and frequency of abdominal discomfort and other symptoms between the two groups (P0.05) OCTT94.17 卤8.62 minutes OCTT66.43 卤7.66 minutes in patients with IBS-D with SIBO positive and negative IBS-D, and there was significant difference in OCTT between the two groups (P0.05) after 4 weeks of treatment in 18 IBS-D patients with SIBO. There were still 10 cases of SIBO negative conversion rate (55.6%). After treatment, the degree and frequency of main symptoms were decreased, but abdominal pain and abdominal distension score were significantly decreased, compared with before treatment, there was statistical difference (P0.05) in OCTT compared with before treatment (P0.05). Conclusion (1) there is a higher incidence of intestinal bacterial overgrowth in patients with diarrhea irritable bowel syndrome, and the oral to cecal transit time is abnormal .2 intestinal bacterial overgrowth may trigger the prolongation of oro-cecum transmission time. The degree and frequency of abdominal distension in patients with diarrhea irritable bowel syndrome were correlated with intestinal bacterial overgrowth. 3 probiotic Bifidobacterium triple viable capsule had a better therapeutic effect on IBS-D, and could obviously improve abdominal pain in patients. The degree and frequency of abdominal distention can make SIBO turn negative and OCTT shorten in some patients at the same time.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574.4
[Abstract]:Objective 1 to investigate the relationship between OCTT and SIBO in patients with diarrhea irritable bowel syndrome (diarrhea-predominant irritable bowel syndrome,IBS-D) and the (orocecal transit time, OCTT) of intestinal bacterial overgrowth (small intestinal bacterial overgrowth,SIBO) and oral to cecal transmission time (orocecal transit time, OCTT). Methods from January 2012 to December 2013, 39 IBS-D patients who met Rome III diagnostic criteria were selected from the Department of Digestive Medicine of Qianan people's Hospital or outpatient clinic, and 39 normal controls were selected. All subjects were tested with fructose hydrogen breath test, and the incidence of SIBO was measured. The main symptoms of IBS-D patients, including abdominal pain, abdominal distension, diarrhea, abdominal discomfort and so on, were measured. The incidence of SIBO was compared between the two groups. Comparison of OCTT in IBS-D patients with SIBO positive and SIBO negative IBS-D patients were treated with Bifidobacterium triplex capsule for 4 weeks. The main symptoms and OCTT changes of IBS-D patients with SIBO positive before and after treatment were compared and the negative conversion rate of SIBO was observed. Results the incidence of SIBO in patients with 1IBS-D was 79.23 卤16.12 minutes, and that in patients with OCTT87.69 卤19.02 minutes in normal control group was shorter than that in control group (P0.05). The degree and frequency of abdominal distension in IBS-D patients with positive OCTT were significantly higher than those in control group (P0.05). There was no significant difference in the degree and frequency of abdominal discomfort and other symptoms between the two groups (P0.05) OCTT94.17 卤8.62 minutes OCTT66.43 卤7.66 minutes in patients with IBS-D with SIBO positive and negative IBS-D, and there was significant difference in OCTT between the two groups (P0.05) after 4 weeks of treatment in 18 IBS-D patients with SIBO. There were still 10 cases of SIBO negative conversion rate (55.6%). After treatment, the degree and frequency of main symptoms were decreased, but abdominal pain and abdominal distension score were significantly decreased, compared with before treatment, there was statistical difference (P0.05) in OCTT compared with before treatment (P0.05). Conclusion (1) there is a higher incidence of intestinal bacterial overgrowth in patients with diarrhea irritable bowel syndrome, and the oral to cecal transit time is abnormal .2 intestinal bacterial overgrowth may trigger the prolongation of oro-cecum transmission time. The degree and frequency of abdominal distension in patients with diarrhea irritable bowel syndrome were correlated with intestinal bacterial overgrowth. 3 probiotic Bifidobacterium triple viable capsule had a better therapeutic effect on IBS-D, and could obviously improve abdominal pain in patients. The degree and frequency of abdominal distention can make SIBO turn negative and OCTT shorten in some patients at the same time.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574.4
【参考文献】
相关期刊论文 前2条
1 罗金燕，郭剑峰，董雷，龚均，朱有玲;肠易激综合征患者的胃肠道通过时间测定[J];中华消化杂志;1994年S1期
2 熊理守,陈e
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