便秘临床分型与病因分类探讨  

Etiology and clinical classification of constipation

作　　者：曾兴琳 杨向东[2] 杨桃 黄晓丽[4] 刘闪 Zeng Xinglin;Yang Xiangdong;Yang Tao;Huang Xiaoli;Liu Shan(College of Clinical Medicine,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Department of Constipation,Chengdu Anorectal Hospital,Chengdu 610015,China;Department of Anorectology,The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,China;Department of Geriatrics,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]成都中医药大学临床医学院,成都610075 [2]成都肛肠专科医院便秘科,成都610015 [3]贵州中医药大学第一附属医院肛肠科,贵阳550001 [4]四川大学华西医院老年科,成都610041

出　　处：《中华胃肠外科杂志》2022年第12期1120-1125,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：2020年国家卫健委科研项目(WA2020RW06)。

摘　　要：便秘的病因极为复杂,至今仍未完全明确,除了器质性和药物等继发性因素外,便秘还可能与遗传、饮食、肠道菌群、年龄和性别等因素有关。目前,国内外指南一致按病因,将慢性便秘分为原发性便秘和继发性便秘,但对于原发性便秘的临床分型,各指南仍存在着较大差异。部分指南将原发性便秘分为结肠慢传输型(STC)、出口梗阻型(OOC)和混合型;有指南将原发性便秘分为STC、排粪障碍型(DD)、混合型和正常传输型(NTC);更有指南提出了与上述不一样的分型。且各指南对功能性便秘(FC)与原发性便秘关系的理解及便秘型肠易激综合征(IBS-C)的归属不一致。通过查阅国内外便秘指南及相关文献,得出以下结论:原发性便秘可分为IBS-C和FC,FC又可分为STC、OOC和混合型;不应将原发性便秘与FC相混淆,也不应将IBS-C归属于FC。The causes of constipation are extremely complex and are still not fully clear.In addition to secondary factors such as organic diseases and drugs,constipation may also be related to genetics,diet,intestinal flora,age,gender and so on.At present,according to the etiology,chronic constipation is divided into primary constipation and secondary constipation.However,there are significant differences among current clinical guidelines in the clinical classification of primary constipation.Some guidelines classify primary constipation as slow-transit constipation(STC),outlet obstruction constipation(OOC),and mixed constipation;however,some guidelines classify primary constipation as STC,defecation disorder(DD),mixed constipation,and normal-transit constipation(NTC);what's more,some even propose types which are different from the above sub-types.There are also differences in the understanding of the relationship between functional constipation(FC)and primary constipation and the classification of irritable bowel syndrome predominant constipation(IBS-C)among various clinical guidelines.By reviewing domestic and international guidelines and relevant literature on constipation,the following conclusions are drawn:primary constipation can be divided into IBS-C and FC,and FC can be further divided into STC,OOC,and mixed constipation;primary constipation should not be confused with FC,nor should IBS-C be classified as FC.

关 键 词：便秘 便秘病因 临床分型 

分 类 号：R574.62[医药卫生—消化系统]