IBS诊断和治疗PPT.ppt

匹维溴胺（得舒特，Dicetel） 　　　可用于IBS、与肠功能紊乱的腹痛、肠蠕动异常与不适、结肠痉挛、对症治疗与胆道功能紊乱的腹痛、胆囊运动障碍；为钡灌作准备。 机制明确： 钙离子拮抗剂 对靶器官选择性强 －安全 – 长期使用安全 调节动力及内脏高敏感 －减轻IBS症状 对IBS这样一个多因素作用的疾病具有多重作用 疗效得到国际认可 －科学及医疗卫生权威的认可 －300余篇文献报道 －超过60个国家批准使用 总 结 便秘为主要症状 腹泻为主要症状 轻度 中度 重度 健康宣教、解除顾虑、祛除诱因、放松心态 抗抑郁药、心理和行为治疗 膳食纤维及纤维制剂、运动、增加饮水量等 试验性剔除饮食治疗，如乳糖、咖啡等 渗透性轻泻剂、解痉药等 洛哌丁胺、解痉药等 IBS的治疗流程 参考文献（1） Saito YA, Schoenfeld, Locke GRI. The epidemiology of irritable boewl syndrome in North America: a systemic review. Am J Gastroenterol 2002; 97: 1910-1915. Xong LS, Chen MH, Chen HX, et al. A population-based epidemiologic study of irritable bowel syndrome in South China?: strafified randomized study by cluster sampling. Aliment Pharmarcol Ther 2004; 19: 1217-24. Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA technical review on irritable bowel syndrome. Gastroenterology 2002; 123: 2108-2131. Devaux M. Role of visceral sensitivity in the pathophysiology of irritable bowel syndrome. Gut 2002; 51 Suppl 1: i67-i71. Drossman DA, Ringel Y, Vogt BA, Leserman J, Lin W, Smith JK, Whitehead W. Alterations of brain activity associated with resolution of emotional distress and pain in a case of severe irritable bowel syndrome. Gasroenterology 2003; 124: 754-761. Wang L-H, Fang X-C, Pan G-Z. Bacillary dysentery as a causative factor of irritable bowel syndrome and its pathogenesis. Gut 2004; 53:1096-1101. Longstreth GF, Thompson WG, Chey WD. Functional Bowel Disorders. In Rome III: the functional gastrointertinal disorders. Drossman DA(editor). 2006: 487-555. 参考文献（2） 潘国宗，鲁素彩，韩少梅. 肠易激综合征症状学诊断标准的研究. 中华内科杂志 1999; 38:81-84. Hahn BA, Kirchdoerfer LJ, Fullerton S, et al. Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life. Aliment Pharmacol Ther 1997;11:553-559. Drossman DA, Morris CB, Hu Y,et al. A prospective assessment of bowel habit in irritable bowel syndrome in women: defining an alternator. Gastroenterol 2005;128:580-589. Longstreth GF. Defini