腹瀉型腸易激綜合征與小腸細菌過度生長關(guān)系的研究
發(fā)布時間：2018-10-07 19:45
【摘要】：目的1探討腹瀉型腸易激綜合征（diarrhea-predominant irritable bowel syndrome，IBS-D）患者小腸細菌過度生長（small intestinal bacterial overgrowth，SIBO）、口-盲腸傳遞時間（orocecal transit time, OCTT）情況；2探討OCTT與SIBO的關(guān)系； 方法1選取2012年01月至2013年12月在遷安市人民醫(yī)院消化內(nèi)科病房或門診就診符合羅馬III診斷標(biāo)準(zhǔn)的IBS-D患者39人，正常對照組39人；所有受試者均進行乳果糖氫呼氣試驗，測定SIBO發(fā)生率、OCTT，統(tǒng)計IBS-D患者腹痛、腹脹、腹瀉、腹部不適等主要癥狀程度及頻率積分，并將兩組的SIBO發(fā)生率、OCTT進行比較；將SIBO陽性與SIBO陰性組的IBS-D患者的OCTT進行比較；2SIBO陽性的IBS-D患者給與雙岐桿菌三聯(lián)活菌膠囊治療，療程4周，記錄試驗前后患者主要癥狀積分、SIBO情況、OCTT，比較治療前后SIBO陽性的IBS-D患者的主要癥狀及OCTT變化情況，觀察SIBO的陰轉(zhuǎn)率。 結(jié)果1IBS-D患者SIBO發(fā)生率46.2%，OCTT79.23±16.12分鐘，正常對照組OCTT87.69±19.02分鐘，IBS-D患者的OCTT較正常對照組縮短（P0.05）；2SIBO陽性的IBS-D患者腹脹的程度及頻率均較對照組嚴(yán)重，兩組比較有統(tǒng)計學(xué)意義（P0.05），腹痛、腹瀉、腹部不適等癥狀程度及頻率兩組比較無統(tǒng)計學(xué)意義（P0.05）；3SIBO陽性的IBS-D患者OCTT94.17±8.62分鐘，SIBO陰性的IBS-D患者OCTT66.43±7.66分鐘，兩組OCTT比較差異有統(tǒng)計學(xué)意義（P0.05）；4存在SIBO的18例IBS-D患者治療4周后，仍存在SIBO8例，SIBO陰轉(zhuǎn)10例，SIBO陰轉(zhuǎn)率（55.6%），治療后患者主要癥狀程度及頻率均較治療前下降，，但腹痛、腹脹積分明顯下降，與治療前相比有統(tǒng)計學(xué)差異（P0.05），OCTT較治療前縮短（P0.05）。 結(jié)論1腹瀉型腸易激綜合征患者中有較高的小腸細菌過度生長發(fā)生率，并且其口-盲腸傳遞時間存在異常。2小腸細菌過度生長可以引發(fā)口-盲腸傳遞時間延長。小腸細菌過度生長與腹瀉型腸易激綜合征患者的腹脹程度及頻率具有相關(guān)性。3益生菌雙岐桿菌三聯(lián)活菌膠囊對IBS-D有較好的治療效果，可以明顯改善患者腹痛、腹脹的程度及頻率，同時可使部分患者SIBO轉(zhuǎn)陰，并可使OCTT縮短。
[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 鹵16.12 minutes, and that in patients with OCTT87.69 鹵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 鹵8.62 minutes OCTT66.43 鹵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.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：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 鹵16.12 minutes, and that in patients with OCTT87.69 鹵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 鹵8.62 minutes OCTT66.43 鹵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.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R574.4
【參考文獻】
相關(guān)期刊論文 前2條
1 羅金燕，郭劍峰，董雷，龔均，朱有玲;腸易激綜合征患者的胃腸道通過時間測定[J];中華消化雜志;1994年S1期
2 熊理守,陳e
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