幽门螺杆菌根除对肠易激综合征或慢传输型便秘的长短期疗效  

The short and long influences of the helicobacter pylori eradication in the patients with the irritable bowel syndrome or slow transit constipation

作　　者：杨杰[1] 北條麻理子 荻原正雄 李玉栋[3] 

机构地区：[1]贵阳医学院附属医院消化科,贵阳550004 [2]日本东京顺天堂大学附属医院消化科,1130022 [3]日本东京顺天堂大学附属医院感染防御及小儿科教研室,1130022

出　　处：《重庆医学》2014年第9期1031-1033,共3页Chongqing medicine

基　　金：国家留学基金委留学资助项目(留金法20105013)

摘　　要：目的探讨幽门螺杆菌(Hp)根除对肠易激综合征(IBS)或慢传输型便秘(STC)的长短期疗效及Hp感染在IBS和STC病因中的地位。方法收集伴随功能性消化不良及Hp感染(13C或14C呼气试验阳性)的IBS或STC患者共98例,均给予7dHp根除治疗。治疗后1个月复查13C或14C呼气试验。依据呼气试验结果将患者分为Hp阳性组和Hp阴性组。分别对根除前、根除治疗后第1天、根除治疗后1个月的排便习惯、大便性状等进行评分并比较。结果 87例患者Hp成功根除,11例失败。在Hp阳性组,Hp根除前、根除治疗后第1天、根除治疗后1个月之间比较,各型IBS、STC的总有效率降低(P<0.05)。在根除治疗后第1天Hp阴性组腹泻型IBS总有效率最高,STC最低(P<0.05)。但根除治疗后第1天和根除治疗后1个月比较,各型IBS、STC总有效率均下降(P<0.05)。结论 Hp根除不能对IBS或STC产生长期疗效,Hp感染不是IBS或STC的主要病因。Hp根除治疗可使部分患者的排便习惯、大便性状等短期改善,这可能是肠道菌群改变所致。Objective To explore the short and long-term therapeutic effect of helicobacter pylori （Hp） eradication and patho-genic role of Hp infection in the irritable bowel syndrome（IBS） and slow transit constipation（STC） .Methods 98 patients with pos-itive Hp infection which determined by 13C or 14C breath test ,suffered with either the IBS or STC and with concomitant dyspep-sia ,were treated with 7 days regimen of Hp eradication .All cases were re-examined with the 13C or 14C breath test one month after treatment and then divided into Hp positive group and Hp negative group according to the positive or negative Hp infection .And both groups were scored on the change of the habitual defecation and the stool consistency before one day and one month after Hp eradication .Results Hp infection in 87 cases was successfully eradicated ,11 cases failed .Among the Hp positive group ,the total effective rate decreased in comparison with before ,one day ,one month after Hp treatment （P＆lt;0 .05） .And among the Hp negative group ,the highest therapeutic effect was found in the diarrhea-IBS and lowest in the STC was found in the first day after treatment （P＆lt;0 .05） .Compared with the first day after treatment ,both IBS and STC showed significantly decreased therapeutic effect one month after Hp treatment（P＆lt;0 .05） .Conclusion Hp eradication couldn′t induce long term therapeutic effect in IBS and STC , which indicate Hp infection plays a minor role in the pathogenesis of both IBS and STC .The short term improvement of the defeca-tion and the stool consistence in some patients may relate to the change of the gut microbiota .

关 键 词：螺杆菌  幽门 肠易激综合征 慢传输型便秘 

分 类 号：R574.62[医药卫生—消化系统]