CAJ | 학술논문

目的：探讨小肠细菌过度生长与肠易激综合征的关系，为肠易激综合征的发病和治疗寻找新思路。方法选择2013年1月-2015年1月在我院就诊的120例肠易激综合征(irritable bowel syndrome，IBS)患者作为观察组，选取同期我院体检中心60例健康查体者作为对照组。两组均行乳糖甲烷-氢呼吸试验检查、炎性细胞因子检测及完善 IBS 症状积分调查问卷。小肠细菌过度生长(small intestinal bacterial overgrowth，SIBO)阳性的 IBS 患者接受利福昔明治疗2周后复查甲烷-氢呼吸试验，根据氢呼吸试验结果将 SIBO 阳性的 IBS 患者分为转阴组和未转阴组，观察 IBS 的治疗有效率。结果观察组与对照组 SIBO 阳性率(68.33% vs 18.33%)存在统计学差异(P ＜0.05)；利福昔明治疗 SIBO 的转阴率为70.73%；转阴组(症状积分：3.96±1.42 vs 12.45±3.78，IL-6：97.32±13.83 vs 158.84±15.51，TNF-α：29.67±6.19 vs 42.67±7.65)及未转阴组(症状积分：7.89±2.37 vs 12.39±3.69，IL-6：126.79±14.29 vs 156.43±15.49，TNF-α：35.12±6.67 vs 43.27±7.64)治疗后 IBS 症状积分及炎性细胞因子均明显低于治疗前(P ＜0.05)；转阴组治疗后 IBS 治疗有效率(82.75% vs 62.50%)、IBS 症状积分(3.96±1.42 vs 7.89±2.37)及炎性细胞因子(IL-6：97.32±13.83 vs 126.79±14.29，TNF-α：29.67±6.19 vs 35.12±6.67)均优于未转阴组(P ＜0.05)。结论 SIBO在IBS患者中有较高的发病率，治疗SIBO可以改善IBS患者的临床症状。
목적：탐토소장세균과도생장여장역격종합정적관계，위장역격종합정적발병화치료심조신사로。방법선택2013년1월-2015년1월재아원취진적120례장역격종합정(irritable bowel syndrome，IBS)환자작위관찰조，선취동기아원체검중심60례건강사체자작위대조조。량조균행유당갑완-경호흡시험검사、염성세포인자검측급완선 IBS 증상적분조사문권。소장세균과도생장(small intestinal bacterial overgrowth，SIBO)양성적 IBS 환자접수리복석명치료2주후복사갑완-경호흡시험，근거경호흡시험결과장 SIBO 양성적 IBS 환자분위전음조화미전음조，관찰 IBS 적치료유효솔。결과관찰조여대조조 SIBO 양성솔(68.33% vs 18.33%)존재통계학차이(P ＜0.05)；리복석명치료 SIBO 적전음솔위70.73%；전음조(증상적분：3.96±1.42 vs 12.45±3.78，IL-6：97.32±13.83 vs 158.84±15.51，TNF-α：29.67±6.19 vs 42.67±7.65)급미전음조(증상적분：7.89±2.37 vs 12.39±3.69，IL-6：126.79±14.29 vs 156.43±15.49，TNF-α：35.12±6.67 vs 43.27±7.64)치료후 IBS 증상적분급염성세포인자균명현저우치료전(P ＜0.05)；전음조치료후 IBS 치료유효솔(82.75% vs 62.50%)、IBS 증상적분(3.96±1.42 vs 7.89±2.37)급염성세포인자(IL-6：97.32±13.83 vs 126.79±14.29，TNF-α：29.67±6.19 vs 35.12±6.67)균우우미전음조(P ＜0.05)。결론 SIBO재IBS환자중유교고적발병솔，치료SIBO가이개선IBS환자적림상증상。
Objective To investigate the relationship between small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) and look for new ideas for the pathogenesis and treatment of irritable bowel syndrome. Methods From January 2013 to January 2015, 120 IBS patients in our hospital were chosen as observation group, 60 healthy volunteers in physical examination center in our hospital at the same period were selected as control group. Patients in two groups underwent lactose methane-hydrogen breath test, inflammatory cytokines detection and IBS symptoms integral questionnaire. IBS patients with SIBO positive were treated for 2 weeks by rifaximin capsule, then they received methane-hydrogen breath test. IBS patients with SIBO positive were divided into SIBO turning-negative group and not turning- negative group according to the results of hydrogen breath test and the treatment efficacy were observed. Results The SIBO positive rate between observation group and control group (68.33% vs 18.33 %) had statistical differences (P < 0.005); The turning-negative rate of rifaximin capsule was 70.73%; After treatment, IBS symptoms score and inflammatory cytokines in both SIBO turning-negative group (symptoms score: 3.96±1.42 vs 12.45±3.78; IL-6: 97.32± 13.83 vs 158.84±15.51; TNF-α: 29.67±6.19 vs 42.67±7.65) and not turning- negative group (symptoms score: 7.89±2.37 vs 12.39±3.69; IL-6: 126.79±14.29 vs 156.43±15.49; TNF-α: 35.12±6.67 vs 43.27±7.64) were significantly lower than before (P <0.05); IBS symptoms score (3.96±1.42 vs 7.89±2.37), inflammatory cytokines (IL-6: 97.32±13. 83 vs 126.79±14.29; TNF-α:29.67±6.19 vs 35.12±6.67) and treatment efficacy (82.75% vs 62.50%) in SIBO turning-negative group were superior to not turning- negative group (P < 0.05). Conclusion There is a high incidence of SIBO in patients with IBS. Treating SIBO can improve the clinical symptoms of patients with IBS.