腹泻型肠易激综合征与显微镜下结肠炎的诊治进展  

Advances in diagnosis and treatment of diarrhea-predominant irritable bowel syndrome and microscopic colitis

作　　者：李桂红[1] 晏喻婷 蒋波涛[1] Li Guihong;Yan Yuting;Jiang Botao(Department of Gastroenterology,Guangzhou University of Chinese Medicine Affiliated Chongqing Beibei Hospital of Traditional Chinese Medicine,Chongqing 400711,China)

机构地区：[1]广州中医药大学附属重庆市北碚中医院消化科,400711

出　　处：《中华消化病与影像杂志（电子版）》2018年第4期173-177,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)与显微镜下结肠炎(microscopic colitis,MC)在临床表现上均为反复发作的、非出血性、水样或稀糊状腹泻,且结肠镜检查均为正常黏膜像,但二者却为不同性质的2种疾病。IBS-D的诊断是基于症状学基础的罗马Ⅲ标准,MC的确诊方法是结肠镜下结肠黏膜组织活检。由于IBS-D与MC在临床症状上的重叠和阴性结肠镜表现,极易造成二者之间的误诊。目前全球尚无统一的MC诊断共识,国内的临床医师对MC的认识不足、结肠镜下黏膜活检率低,造成MC临床极高的误诊率。本文从IBS-D和MC的流行病学、病因、临床症状、诊断、治疗,及其临床症状重叠情况的研究进展进行综述。The diarrhea-predominant irritable bowel syndrome（IBS-D）and microscopic colitis（MC）are recurrent,non hemorrhagic,water or dilute diarrhea in the clinical manifestations,and the colonoscopy shows normal mucosa.But the two are two diseases of different nature.The diagnosis of IBS-D is based on the Rome Ⅲ standard based on symptomatology.The diagnostic method of MC is colonoscopic colonic mucosa biopsy.Because of the overlap of clinical symptoms and negative colonoscopy between IBS-D and MC,it is easy to cause misdiagnosis.At present,there is no unified consensus on MC diagnosis in the world.The lack of understanding of MC by clinicians in China and the low rate of mucosal biopsy under colonoscopy cause the high misdiagnosis rate of MC.This paper makes a review of the research progress of epidemiology,etiology,clinical symptoms,diagnosis,treatment and clinical symptoms overlap of IBS-D and MC.

关 键 词：腹泻型肠易激综合征 显微镜结肠炎 结肠镜诊断 症状 鉴别诊断 

分 类 号：R574.62[医药卫生—消化系统]