肠易激综合征药物治疗的循证医学评价

Evaluation of evidence-based medicine on drug therapy of irritable bowel syndrome

肠易激综合征是肠道动力和感觉异常的功能性肠病,人群患病率较高,但发病机制仍然不明,目前认为与胃肠动力异常、内脏感觉过敏、脑-肠轴改变、精神心理异常等多种因素有关。治疗IBS的药物种类较多,但主要是缓解症状,改善患者生活质量。目前评价治疗肠易激综合征药物疗效的临床试验越来越多,本文从循证医学的角度总结了近期有关6种主要药物(包括解痉剂、导泻药、止泻剂、肠道动力感觉调节剂、微生态制剂和抗抑郁药)的临床试验和综述,评价其疗效和安全性。

Irritable bowel syndrome （IBS） is a functional bowel disorder with abnormal gastrointestinal motility and sensitivity. The prevalence of IBS is high, but the mechanism is still unknown. It is considered to be associated with abnormal gastrointestinal motility, visceral hypersensitivity, abnormal brain-gut axis and psychology disorder. There are many drugs treating IBS available that are mainly targeted to manage individual symptoms and improve quality of life. There are also more and more clinical trials evaluating drug therapy of IBS. The aim of this review is to assess efficacy and safety of IBS pharmacological treatments which included antispasmodics, laxatives, anti-diarrhoeal agents, serotonergic agents, probiotics and antidepressant. The clinical data are mainly from clinical trials, systematic reviews and meta-analysis.