奥替溴铵、蒙脱石散联合整肠生治疗腹泻型肠易激综合征的临床观察

[目的]观察奥替溴铵、蒙脱石散联合整肠生对腹泻型肠易激综合征患者的疗效及不良反应.[方法]分析120例腹泻型肠易激综合征患者的临床治疗效果.[结果]治疗组总有效率90％,对照组总有效率68％,2组比较差异有统计学意义（P＜0.05）,2组患者均未发现明显不良反应.[结论]整肠生、蒙脱石散联合奥替溴铵治疗对腹泻型肠易激综合征患者疗效高,不良反应少,在临床工作中值得应用.     

马来酸曲美布丁联合匹维溴胺治疗肠易激综合征的疗效观察

目的观察马来酸曲美布丁联合匹维溴胺治疗肠易激综合征的疗效。方法将100例肠易激综合征患者随机分为2组：实验组（57例）应用马来酸曲美布丁0.1g tid、匹维溴胺50 mg tid治疗;对照组（43例）应用匹维溴胺50 mg tid治疗,疗程均为4周。结果实验组总有效率88%,对照组总有效率74%,存在显著性差异。结论马来酸曲美布丁联合匹维溴胺治疗肠易激综合征的疗效更好。     

固肠止泻汤加味治疗腹泻型肠易激综合征40例

[目的]观察自拟固肠止泻汤治疗腹泻型肠易激综合征（IBS-D）疗效。[方法]将80例患者随机分成2组,各40例。治疗组以固肠止泻汤加味辨证施治;对照组以补脾益肠丸加蒙脱石散剂治疗。[结果]治疗组有效率为92．5％,对照组有效率为77．5％（P〈0．05）。[结论]固肠止泻汤治疗IRS-D疗效明显。     

自拟方健肠Ⅰ号治疗肠易激综合征197例

[目的]观察自拟方健肠Ⅰ号治疗肠易激综合征的临床疗效.[方法]将387例随机分为2组,观察组197例,采用健肠Ⅰ号治疗;对照组190例,给予马来酸曲美布丁治疗.[结果]观察组总有效率93.91％,对照组总有效率72.11％,两组间的差异有统计学意义（P＜0.01）.[结论]在痛泻要方的基础上自拟的健肠Ⅰ号治疗腹泻型肠易激综合征有较好临床疗效,可缓解腹痛、腹泻的症状.     

得舒特治疗肠易激综合征的临床疗效观察

目的:评价得舒特对肠易激综合征(IBS)的疗效。方法:56例根据罗马标准诊断为IBS的患者进入本研究。所有患者在服用得舒特治疗前一周服用安慰剂6天。安慰剂治疗无效的47例患者随后进入得舒特治疗,50mg,每日3次口服,疗程4周。结果:得舒特对肠易激综合征患者腹痛、腹泻和便秘单项症状的有效率分别为85.1％(40/47)、89.2％(33/37)和93.3％(14/15),对肠易激综合征的总有效率为85.1％(40/47)。治疗期间除2例诉头晕外,无其他不良反应。结论:得舒特治疗1BS疗效确切、副反应率低,临床上可作为治疗IBS的首选药物之一。     

黛力新治疗无明显精神症状的腹泻型感染后肠易激综合征30例

目的:观察黛力新联合培菲康治疗无明显精神症状的腹泻型感染后肠易激综合征的疗效和安全性.方法:将60例无明显精神症状的腹泻型感染后肠易激综合征患者分为2组,每组病例均30例.联合治疗组采用黛力新联合培菲康治疗:对照组单用培菲康治疗.治疗2 wk后,比较药物疗效和安全性.结果:联合治疗组总有效率90.0%,单用培菲康组总有效率60.0%,联合治疗组总有效率明显优于单用培菲康对照组(P＜0.05),两组患者均未发现明显的不良反应.结论:黛力新联合培菲康治疗无明显精神症状的腹泻型感染后肠易激综合征安全、有效.     

理气安肠汤内服配合结肠宁灌肠治疗肠易激综合征65例

1995年1月～1998年4月,用自拟理气安肠汤内服配合结肠宁灌肠治疗肠易激综合征65例,并设对照组44例对照,疗效满意,现报告如下.     

黛安神加匹维溴胺与单剂匹维溴胺治疗肠易激综合征的疗效比较

目的比较黛安神联合匹维溴胺与单剂匹维溴胺治疗肠易激综合症的疗效.方法将108例肠易激综合征病人随机分为2组,治疗组56例(男23例,女33例,年龄41a+10d)应用黛安神(Deanxit)1片PO.Bid加匹维溴胺(Pinaveriumbromide)50毫克PO.Tid简称D-P组,对照组52例(男20例,女32例,年龄44a±11a),应用单剂匹维溴胺50毫克PO.Tid简称P组.疗程均为4周.结果治疗组总有效率为100%.对照组为81%(χ2P＜0.01).治疗组对缓解腹痛、腹胀、腹泻、便秘、粘液便优于对照组,特别对腹痛、腹胀疗效更为明显.结论黛安神联合匹维溴胺是治疗肠易激综合征更有效的药物治疗方法.     

隔姜灸加莫沙必利对阳虚型便秘型肠易激综合征的疗效观察

[目的]观察隔姜灸加莫沙必利治疗阳虚型便秘型肠易激综合征的疗效.[方法]选取126例阳虚型便秘型肠易激综合征患者,随机分为2组,每组63例,观察组采用隔姜灸加莫沙必利治疗,对照组采用莫沙必利治疗,对2组疗效进行比较.[结果]治疗后治疗组显效34例,有效23例,无效6例,总有效率为90.5％;对照组显效29例,有效21例,无效13例,总有效率为79.4％;治疗组有效率显著高于对照组.[结论]隔姜灸联合莫沙必利可以更好改善阳虚型便秘型肠易激综合征患者的便秘症状.     

肠益清治疗肠易激综合征脾虚湿盛证的疗效观察

[目的]观察肠益清配方颗粒治疗腹泻型肠易激综合征脾虚湿盛证的临床疗效.[方法]将106例患者随机分为治疗组和对照组,每组各53例.治疗组予以肠益清配方颗粒加减治疗,对照组用匹维溴胺和复方嗜酸乳杆菌口服治疗,4周为1个疗程.采用症状尺度表、大便性状表及生活质量量表记录2组患者的症状变化.[结果]治疗组总有效率为88.7％,对照组为67.9％,治疗组疗效明显优于对照组（P＜0.05）.[结论]肠益清配方颗粒治疗肠易激综合征脾虚湿盛证的临床疗效满意,值得推广.     

得舒特加中药理气安肠汤治疗腹泻型肠易激综合征的疗效观察

目的 观察得舒特加中药理气安肠汤治疗腹泻型肠易激综合征(IBS)的疗效及对胃动素、胃泌素的影响。方法 将110例患者随机分为中药治疗组、西药治疗组和中西医结合治疗组3组，疗程8周，观察治疗前后症状，并测定血浆胃动素及胃泌素的含量变化。结果 中西医结合组的治愈率和有效率明显高于单用中药组或单用西药组；IBS患者的血浆胃动素与胃泌素水平明显高于正常对照组，三种疗法都能不同程度地降低血浆胃动素与胃泌素水平，而以中西医结合组的作用最明显，优于单用中药组或单用西药组。结论 得舒特和中药理气安肠汤是治疗腹泻型IBS的有效药物，中西药联合应用可进一步提高疗效。     

复方枸橼酸阿尔维林合用四磨汤治疗腹泻型肠易激综合征的疗效评价

目的 为观察复方枸橼酸阿尔维林合用四磨汤治疗肠易激综合征的近期疗效。方法 采用随机对照方法，将90例IBS病人随机分为治疗组（45例）和对照组（45例），15天观察疗效。结果 治疗组的显效率和总有效率分别为57.8％和96.6％，对照组则分别为26．7％和66．6％，差异非常显著性。结论 复方枸橼酸阿尔维林合用四磨汤可以有效缓解腹泻型IBS病人的临床症状，近期疗效明显。     

幽门螺杆菌感染与肠易激综合征关系研究

目的研究幽门螺杆菌(H.pylori)感染与肠易激综合征(IBS)之间的关系。方法随机选取肠易激综合征患者40例为实验组,另选取40例正常健康者为对照组,应用13C尿素呼气试验及快速尿素酶法分别测定二者的H.pylori感染率。并根据检测结果将26例H.pylori阳性的IBS患者随机分为观察组(13例)和对照组(13例),观察组加用根除H.pylori药物治疗2周,观察其疗效。结果 IBS患者中的H.pylori感染率(65.00%)明显高于对照组(42.50%),二者相比差异有统计学意义(P<0.05)。H.pylori阳性的IBS患者,观察组治疗有效率(92.31%)明显高于对照组(38.46%),差异有统计学意义(P<0.05)。结论 H.pylori感染与肠易激综合征之间有一定关系,根除H.pylori可能在IBS的治疗中起一定作用。     

赛乐特联合匹维溴铵治疗肠易激综合征

目的 观察匹维溴铵、赛乐特对肠易激综合征的疗效。方法 98例随机分为两组,实验组(S组)58例,赛乐特20mg,1次/日,匹维溴铵薄膜包衣片50mg,每天3次;对照组(P组)40例;单用匹维溴铵50mg,每天3次,两组均每3天进行心理疏导1次,4周为1个疗程。结果 S组显效率58.62％,有效率37.93％,总有效率96.55％;P组显效率47.50％,有效率32.50％,总有效率80％(P<0.05)。结论 赛乐特,匹维溴铵联合治疗肠易激综合征较单用匹维溴铵疗效好。     

广州市居民肠易激综合征及功能性便秘的流行病学调查

目的：探讨广州市居民肠易激综合征（IBS）及功能性便秘的流行病学情况。方法：采用整群随机抽样法抽取广州市居民2892人进行问卷调查,同时问卷普通内科及消化专科门诊连续病例各1006及495例。结果：（1）广州市居民IBS的患病率为5．6％,普通内科门诊及消化专科门诊中IBS所的比例分别为10．1％、34．3％,IBS女性患病率显著高于男性,男女比例为1：1．51（P＝0．27）,年龄对IBS的患病率无显著影响,IBS患者的就诊率为22．4％,男女就诊率差异无显著性。IBS各亚型构成比为：腹泻主导型占63．2％,便秘主导型占27．0％,男女就诊率鞠显著性,IBS各亚型构成比为：腹泻主导型占63．2％,便秘主导型占27．0％,其他型占9．8％,（2）广州市居民功能性便秘的患病率为3．0％,普通内科门诊及消化专科门诊中所占的比例分别为5．4％及4．8％。男性患病率显著低于女性,男女比例为1：1．877。随着年龄的增加,功能性便秘的患病率升高,社区人群中功能性便秘的就诊率为17．6％,男女差异无显著性。结论：广州市居民IBS及功能性便秘的患病率低于国外报道水平。     

穴位注射法治疗偏头痛

目的 :探讨穴位内药物注射法对偏头痛的疗效及机理。方法 :将川芎嗪、利多卡因、6 5 4-2按一定比例混合 ,在率谷穴及丝竹穴之间皮下相互透刺 ,并注入药物混合液 ,在风池穴同样注入药物 ,每周 1次 ,6次为一疗程。结果 :15 6例患者中 ,治愈 113例 ( 72 .44% )、显效 2 9例 ( 18.5 9% )、好转 10例 ( 6 .41% )、无效 4例 ( 2 .5 6 % ) ,总有效率 97.44%。结论 :数药合用 ,具有解痉、止痛、活血化瘀、改善循环的作用。药物注入特定穴位 ,不但有药物的直接作用 ,而且有针灸及留针作用 ,取得了药物与针灸的协同作用 ,不但疗效好 ,且经济实用 ,值得推广     

The development of irritable bowel syndrome after Shigella infection: 3 year follow-up study]

BACKGROUND/AIMS: Bacterial gastroenteritis seems to be a risk factor of irritable bowel syndrome (IBS). The incidence of post-infectious IBS (PI-IBS) was reported to be in the range of 7-31%, but few studies have reported long term follow-up results. So, we investigated the clinical course and prognosis of PI-IBS three years after shigella infection. METHODS: The subjects were recruited from our previous study, in which we investigated the incidence and risk factors of PI-IBS. We had a questionnaire based on interview with 120 controls and 124 patients who had shigella infection three years ago. Both groups were evaluated for the presence of IBS, functional bowel disorders (FBD) except IBS before, one and three years after the infection, respectively. RESULTS: Ninety-five patients (76.6%) and 105 controls (87.5%) completed the questionnaire. In patients group, 7 cases had IBS prior to infection (previous IBS), 12 cases (13.8%) had IBS after 1 year (PI-IBS). Four cases developed IBS newly after 3 years (new IBS). Thirteen cases (14.9%) in patients and 4 cases (4.5%) in controls had IBS over 3 years (OR 3.93: 1.20-12.86). The recovery rate over 3 years were 50.0% (2/4) in previous IBS and 25% (3/12) in PI-IBS. The incidence of PI-IBS after 3 years in previous FBD subjects was 28.6% and was 10.6% in normals (p<0.05). The female gender was a risk factor for FBD. CONCLUSIONS: Bacterial gastroenteritis is a trigger factor of IBS. About a quarter of PI-IBS patients are recovered over 3 years. Previous FBD except IBS is a risk factor after 3 years.     

Travel and Travelers�� Diarrhea in Patients with Irritable Bowel Syndrome

This study evaluated occurrence of travel and travelers’ diarrhea in patients with irritable bowel syndrome (IBS). A survey was mailed to 591 patients of a clinical practice who had IBS. Based on survey responses, patients were categorized as having IBS, post-infectious IBS (PI-IBS), unclassified functional bowel disorder (UFBD), or post-infectious UFBD (PI-UFBD). Of 201 persons who returned questionnaires meeting inclusion criteria, 57.7%, 11.4%, 24.9%, and 6.0% had IBS, UFBD, PI-IBS, and PI-UFBD, respectively. Travel during six months before illness onset was more common in patients with PI-IBS or PI-UFBD than in persons with idiopathic IBS or UFBD (P = 0.006). Survey results demonstrated that 16.1% of post-infectious bowel disorder cases and 7.5% of overall IBS cases in a general medical population developed chronic disease within six months of an international trip. Symptoms of established functional bowel disorder in each clinical category were shown to worsen after travel-related acute diarrhea.     

Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria

Background: The new guidelines for diagnosing irritable bowel syndrome (IBS) in clinical practice recommend the use of the Rome II criteria. In this study the agreement between general practitioners (GPs) and the Rome II criteria for diagnosing of IBS and functional bowel disorders (FBD) is examined. Methods: Consecutive patients in general practice were asked to report on abdominal complaints, for which they had consulted or wanted to consult a GP. Patients with such complaints completed a questionnaire based on the Rome II criteria for FBD. After consultations, the GPs reported their diagnoses on the abdominal complaints. Results: Of 3097 screened patients, 553 patients were diagnosed by their GP and had complete data in the questionnaire. Of these patients, 107 had IBS according to the GPs and 209 had IBS according to the Rome II criteria (agreement 58%, kappa 0.01 (CI: ?0.06; 0.09)). Agreement on IBS and FBD in patients without organic disease, without reflux or dyspepsia and in patients with a verified diagnosis was 45%–58%, with kappa values from ?0.02 to 0.13. IBS and FBD cases were diagnosed by the Rome II criteria more often than by the GPs in all these groups of patients (P?Conclusions: This study shows poor agreement in the diagnosis of IBS between GPs and the Rome II criteria. Therefore, current knowledge about IBS based on strict criteria is not necessarily transferable to patients with IBS in general practice.