Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disor...Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient’s most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS.展开更多
We studied the effects of electroacupuncture at Zusanli （ST 36） on neurons in the colonic myenteric plexus and on defecation in rats with irritable bowel syndrome with constipation （IBS-C）. We also used intragastr...We studied the effects of electroacupuncture at Zusanli （ST 36） on neurons in the colonic myenteric plexus and on defecation in rats with irritable bowel syndrome with constipation （IBS-C）. We also used intragastric administration of pinaverium bromide as a positive control treatment to reveal the pathway mediating the onset of IBS-C. Both electroacupuncture and pinaverium bromide greatly improved defecation in rats with IBS-C. Immunohistochemical staining of the enteric nervous system neuronal marker protein gene product 9.5 in the colonic myenteric plexus showed that electroacupuncture by itself, or in combination with pinaverium bromide, increased the number of neurons and the staining intensity of protein gene product 9.5 in the colonic myenteric plexus. We conclude that visceral hypersensitivity is likely to be a primary cause of constipation in IBS-C rats.展开更多
AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general ...AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population.METHODSBetween January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.RESULTSWe enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.CONCLUSIONIBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.展开更多
Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized con...Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.展开更多
OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key word...OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key words"irritable bowel syndrome","constipation",and"Chinese medicine";the relevant articles were retrieved and evaluated.Cure rate,"remarkable efficacy",recurrence rate and the incidence of adverse reactions were the outcome indicators.Review Manager ver 5.1 was used for this meta-analysis,and funnel plots used to detect publication bias.RESULTS:Nineteen randomized controlled trials were included and 1510 patients involved.The treatment guided byTCM based on the liver was superior to Western Medicine[odds ratio(OR)=2.46,95%confidence interval(CI)1.80,3.35)],cure rate[OR=2.61,95%CI(1.93,3.52)],remarkable efficacy[OR=2.68,95%CI(1.82,3.95)],recurrence rate[OR=0.19,95%CI(0.12,0.29)]and the incidence of adverse reactions[OR=0.24,95%CI(0.09,0.65)].However,funnel plots showed publication bias.CONCLUSION:Compared with Western Medicine,the treatment of IBS-C based on the liver is significantly better but the results must be treated with caution because publication bias was recorded.展开更多
文摘Irritable bowel syndrome (IBS) is a highly prevalent functional disorder that reduces patients’ quality of life. It is a chronic disorder characterized by abdominal pain or discomfort associated with disordered defecation in the absence of identifiable structural or biochemical abnormalities. IBS imposes a significant economic burden to the healthcare system. Alteration in neurohumoral mechanisms and psychological factors, bacterial overgrowth, genetic factors, gut motility, visceral hypersensitivity, and immune system factors are currently believed to influence the pathogenesis of IBS. It is possible that there is an interaction of one or more of these etiologic factors leading to heterogeneous symptoms of IBS. IBS treatment is predicated upon the patient’s most bothersome symptoms. Despite the wide range of medications and the high prevalence of the disease, to date no completely effective remedy is available. This article reviews the literature from January 2008 to July 2013 on the subject of IBS peripherally acting pharmacological treatment. Drugs are categorized according to their administration for IBS-C, IBS-D or abdominal pain predominant IBS.
基金the State Key Development Program for Basic Research of China, No.2011CB505206 Practice Innovation Development Program of College Students in Higher Education Institutions of Jiangsu Province, No. 00485
文摘We studied the effects of electroacupuncture at Zusanli （ST 36） on neurons in the colonic myenteric plexus and on defecation in rats with irritable bowel syndrome with constipation （IBS-C）. We also used intragastric administration of pinaverium bromide as a positive control treatment to reveal the pathway mediating the onset of IBS-C. Both electroacupuncture and pinaverium bromide greatly improved defecation in rats with IBS-C. Immunohistochemical staining of the enteric nervous system neuronal marker protein gene product 9.5 in the colonic myenteric plexus showed that electroacupuncture by itself, or in combination with pinaverium bromide, increased the number of neurons and the staining intensity of protein gene product 9.5 in the colonic myenteric plexus. We conclude that visceral hypersensitivity is likely to be a primary cause of constipation in IBS-C rats.
文摘AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population.METHODSBetween January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.RESULTSWe enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.CONCLUSIONIBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.
基金supported by National Natural Science Foundation of China:International (regional)cooperation and exchange project (81820108033)China Academy of Chinese Medical Sciences Youth Talent Project (ZZ14-YQ-020)。
文摘Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.
基金Supported by The National Key Basic Research And Development Plan(973 PlanNo.2011CB505100l)+1 种基金National Spleen-Stomach Diseases Key Clinical Specialist Construction ProjectsSpleen And Stomach Disease Key Discipline of State Administration of Traditional Chinese Medicine
文摘OBJECTIVE:To assess the efficacy of Traditional Chinese Medicine(TCM)on constipation-predominant irritable bowel syndrome by focusing on the liver.METHODS:Databases(domestic and foreign)were searched with the key words"irritable bowel syndrome","constipation",and"Chinese medicine";the relevant articles were retrieved and evaluated.Cure rate,"remarkable efficacy",recurrence rate and the incidence of adverse reactions were the outcome indicators.Review Manager ver 5.1 was used for this meta-analysis,and funnel plots used to detect publication bias.RESULTS:Nineteen randomized controlled trials were included and 1510 patients involved.The treatment guided byTCM based on the liver was superior to Western Medicine[odds ratio(OR)=2.46,95%confidence interval(CI)1.80,3.35)],cure rate[OR=2.61,95%CI(1.93,3.52)],remarkable efficacy[OR=2.68,95%CI(1.82,3.95)],recurrence rate[OR=0.19,95%CI(0.12,0.29)]and the incidence of adverse reactions[OR=0.24,95%CI(0.09,0.65)].However,funnel plots showed publication bias.CONCLUSION:Compared with Western Medicine,the treatment of IBS-C based on the liver is significantly better but the results must be treated with caution because publication bias was recorded.
