胆汁酸代谢异常与肠易激综合征相关性研究

Correlation study between bile acid metabolism and irritable bowel syndrome

肠易激综合征(irritable bowel syndrome,IBS)是一种以腹痛或腹部不适伴排便习惯和粪便性状改变为主要表现的胃肠功能紊乱性疾病,临床上根据排便特点和粪便的性状可分为腹泻型、便秘型和混合型。IBS的发生与胆汁酸代谢密切相关,胆汁酸具有促进结肠运动的功能,胆汁酸产生过多、重吸收减少会导致腹泻发生,相反,胆汁酸产生过少、重吸收增加则会引起便秘。与健康人群相比,IBS患者在粪便胆汁酸含量、血清C4水平、结肠运动频率等方面均有显著改变。治疗胆汁酸相关性IBS的思路主要在于调节胆汁酸代谢,通过负反馈机制直接调节胆汁酸的分泌,或通过胆汁酸转运机制影响胆汁酸的重吸收率,或间接通过调节益生菌恢复胆汁酸代谢都是治疗IBS的有效机制。

Irritable bowel syndrome（IBS） is a common disease of intestinal disorder. It is characterized by abdominal pain or discomfort along with altered bowel movement characteristics and the excrement character. It can be divided into diarrhea-predominant type,constipation-predominant type and mixed type according to the bowel movement characteristics and the excrement character. IBS is closely related to the metabolism of bile acid. Bile acid can accelerate the movement of colon. Overmuch production or reduction of reabsorption of bile acid will lead to diarrhea. On the contrary,insufficient production or too much reabsorption will lead to constipation. Compared with healthy people,IBS patients have significant changes in the colon movement frequency,content and proportion of stool bile acid and level of serum C4. The treatment of bile acid-related IBS aims at regulating the metabolism of bile acid. Directly regulating the secretion of bile acid via negative feedback,or affecting the reabsorption rate,or indirectly renewing the metabolism of bile acid are effective ways to treat IBS.