[中医中药]GERD讲座-常熟2012.pptVIP

PPI和小肠细菌过度生长 意大利Torino的科学家用氢呼气检测： 450服用至少3年PPI的病人：50%有SIBO。 50从来没有服用PPI的健康人:6%有SIBO。 结论：服用PPI更容易发生SIBO。 大剂量rifaximin 可以治疗87%-91% 持续服用PPI的病人的SIBO。 氢呼气检测3组人群： 200 GERD 平均服用3年PPI：一半有SIBO 200 IBS 过去3年没有服用PPI：四分之一有SIBO 50健康人过去10年没有服用PPI：6%有SIBO. 结论： 服用1年PPI后SIBO的风险大增. 有SIBO的GERD 更容易有腹胀和体重下降。 SIBO Following PPI Therapy，Barbara Bradley Bolen, Ph.D., A Clin Gastroenterol Hepatol, 2010 June; 8(6):504-8 GHBTs were given to 450 consecutive patients (200 with gastroesophageal reflux disease who received PPIs for a median of 36 months; 200 with irritable bowel syndrome [IBS], in absence of PPI treatment for at least 3 years; and 50 healthy control subjects that had not received PPI for at least 10 years). Each subject was given a symptoms questionnaire. SIBO was detected in 50% of patients using PPIs, 24.5% of patients with IBS, and 6% of healthy control subjects; there was a statistically significant difference between patients using PPIs and those with IBS or healthy control subjects (P .001). The prevalence of SIBO increased after 1 year of treatment with PPI. The eradication rate of SIBO was 87% in the PPI group and 91% in the IBS group. L. Lombarda, et al. Increased Incidence of Small Intestinal Bacterial Overgrowth During Proton Pump Inhibitor Therapy. Clinical Gastroenterology and Hepatology Vol 8, Issue 6 , Pages 504-508 PPI和SIBO研究在中国 H2呼气检测 57个服用PPI的病人：28个SIBO阳性，27个SIBO阴性 30个健康人：3个SIBO阳性，27个SIBO阴性 P=0.05 服用PPI的时间与SIBO阳性率有关。 JIN Ling-xiao, et al. Possibility of small intestinal bacterial overgrowth in patients treated with PPI. Chinese Journal of Microecology. 2010-12（浙一附院） 相反的结果 A total of 1,191 patients (70 % female) were included, of whom 566 (48 % ) were on PPI therapy. GHBT positivity did not differ significantly between PPI users and nonusers by any of the diagnostic criteria used and PPI use was not significantly associated with GHBT positivity using any of these criteria. GHBT positivity was associated with older age (odds ratio (OR) 1.03, 95 % confidence in