小肠细菌过度生长和肠易激综合征关系的探讨93072.docVIP

小肠细菌过度生长和肠易激综合征关系的探讨 张丽萍　沙忠芬　张泰昌?【摘　要】目的　探讨小肠细菌过度生长与肠易激综合征发病中的关系。方法　用乳果糖氢呼气试验测定49例腹泻及便秘型肠易激综合征病人口-回盲瓣通过时间，并了解其阳性发生率；对其中10例阳性者给普瑞博思治疗1周，进行治疗前后比较。结果　在肠易激综合征病人中腹泻及便秘型口-回盲瓣通过时间较对照组延长(P＜0.05)，阳性发生率无差别(P＞0.05)，治疗后口-回盲瓣通过时间改善明显(P＜0.05)，症状改善。结论　小肠功能紊乱可导致小肠细菌过度生长，并可能是肠易激综合征发病因素之一。?【关键词】肠易激综合征　小肠细菌过度生长?中图分类号：R5　　文献标识码：A?文章编号：1005-2194(2000)11-0656-02?Relationship between intestinal bacterial overgrowth and the?irritable bowel syndrome?Zhang Liping,Sha Zhongfen,Zhang Taichang?(Department of?Digestive Diseases,Xuanwu Hospital,Capital?University of MedicalSciences,Beijing 100053)?【Abstract】Objective　To study the relationship between the irritable?bowel syndrome?and bacterial overgrowth in the intestines.Methods　Forty-nine cases of irritable bowel syndrome presenting as diarrhea or constipation were tested by the lactose-functose?hydrogen breath test?to determine the oral-cecal passage time and positive rate was noted.Of the cases with positive tests ten were selected for treatment with prepulsid for one week,and the pre-and post-treatment passage times were compared.Results　In regard to passage time both diarrhea and constipation types of the irritable bowel syndrome showed prolongation compared with controls(P＜0.05),no difference in the positive rates(P＞0.05),and improvement after treatment compared with pre-treatment,diarrhea was also improved by treatment.Conclusion　Intestinal dysfunction can lead to bacterial overgrowth in the intestines,which can be a cause of the irritable bowel syndrome.?【Key words】Irritable bowel syndrome(IBS)　Intestinal bacterial overgrowth?　　肠易激综合征是一组发病机制不明的征候群，特征是肠道功能的易激性，可能与精神因素及肠道动力紊乱有关［1］。我们于1996～1998年对49例肠易激综合征的病人进行了乳果糖氢呼气试验，以观察其小肠细菌过度生长的情况，现将结果报告如下。?1　对象与方法?　　本院门诊及消化病房住院病人，符合“罗马标准”［2］的病人49例，男性23例，女性26例，年龄22～67岁，平均44岁，除外消化道疾病及慢性肺功能不全，肠镜或钡餐造影检查正常，粪便常规检查正常。其中腹泻型13例(腹痛，大便次数增多，75%以上为稀便或水样便，病程3个月至10余年)，便秘型13例(腹痛，排便费力，粪便干结，每周少于2次，病程3个月至1年以上)。对照组10例，男6例，女4例，年龄40～60岁，平均45岁，来自体检的健康人群。全部受试者1个月内未服抗生素，2周内未服胃肠动力药物，试验前12h禁食、禁水、禁吸烟。平静坐位，用活瓣气袋收集