Objective To evaluate the reliability and validity of IBS-QOL scale in irritable bowel syndrome (IBS) patients. Methods IBS-QOL scale was applied to survey the quality of life of 123 IBS patients. The split-half and internal consistency method were used to evaluate the reliability, and with the construct method to evaluate the validity. Results The split-half reliability was 0.86. Cronbach’s α-coefficient of all domains was between 0.71 and 0.89 except body image and food avoidance; In the correlation analysis, the correlations between items and its subscale structure were above 0.60 (except interference with activity), but there were no correlations between items and other subscale structure. Eight components from factorial analysis were in accordance with theoretical structure.The cumulative contribution rate was 72.7%. Conclusions The reliability and validity of IBS-QOL scale are acceptable. It might be useful for us to assess the QOL of IBS patients in China.
目的:观察帕罗西汀治疗非便秘型肠易激综合征的临床疗效。方法:符合罗马Ⅲ诊断标准的非便秘型肠易激综合征患者107例,随机分为2组,治疗组57例,给予帕罗西汀20 mg,每日晨起顿服,匹维溴铵50 mg,3次/d,口服;对照组50例,给予谷维素30 mg, 3次/d,口服,匹维溴铵50 mg,3次/d,口服,疗程4周。观察患者腹痛、腹泻、腹部不适、排便次数、大便性状,以及焦虑、抑郁等改善情况。结果:治疗组总有效率为930%,对照组总有效率为760%,两组比较差异有统计学意义(Plt;001)。结论:帕罗西汀治疗非便秘型肠易激综合征有明确的临床意义。
Objective To compare the clinical therapeutic effect of probiotic agents in treating irritable bowel syndrome (IBS) by Meta-analysis. Methods Such databases as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese Biomedical Literature Database were searched from January 2001 to October 2011, and the domestic conference proceedings and relevant papers published in recent 1 year were also searched manually. All domestic randomized controlled trials (RCTs) on probiotic agents in treating irritable bowel syndrome (IBS) were collected, which were then selected according to the inclusion and exclusion criteria. The data were extracted, the methodological quality of the included studies was assessed, and the Meta-analysis was performed with Revman5.0. Results A total of 11 RCTs involving 1 065 patients were included. The total effective rate of the probiotic agents plus conventional treatment group was superior to that of the conventional treatment (trimebutine meleate/ pinaverium bromide) group (RR=1.26, 95%CI 1.18 to 1.34, Plt;0.000 01), it could effectively relieve abdominal pain (RR=1.10, 95%CI 1.03 to 1.18, P=0.004) and diarrhea (RR=1.15, 95%CI 1.07 to 1.24, P=0.000 3). But there was no significant difference between the two groups in alleviating abdominal distention (RR=1.08, 95%CI 0.95 to 1.24, P=0.25). The effectiveness of probiotic agents used alone was similar to that of the conventional treatment used alone, without significant differences (RR=0.85, 95%CI 0.66 to 1.09, P=0.19). Conclusion Probiotic agents combined with conventional drugs can improve the total therapeutic effect of IBS, especially in alleviating abdominal pain, diarrhea and so on. But the effectiveness of probiotic agents used alone is similar to that of the conventional treatment used alone. For the possibility of bias due to the lower quality of the included studies and unclear implementation of RCTs, this conclusion should be verified with more large-scale and high-quality RCTs.
Objective To evaluate the efficacy of probiotics for treating irritable bowel syndrome (IBS). Methods The following databases as PubMed, The Cochrane Library, Web of Science, EMbase, MD Consult, CNKI, CBM and WanFang Data were searched from the data of their establishment to June 2011 to collect the randomized controlled trials (RCTs) on probiotics for treating IBS. The data were extracted and cross-checked independently by two reviewers, the methodological quality of trials was evaluated with Cochrane Handbook 5.0.2 criteria, and Meta-analysis was conducted using RevMan 5.1 software. Results A total of 20 RCTs involving 1 713 patients were included. Results of meta-analyses showed that compared with the placebo, probiotics was statistically and significantly better in improving the overall symptoms, alleviating abdominal pain/discomfort and relieving abdominal distention. Conlusion Current evidence shows probiotics may play a role in improving the symptoms of IBS. Due to a lot of differences existing among the included studies in aspects of methodological quality, diagnostic criteria, evaluation methods, dosage and course of treatment, this conclusion should be further tested with more strictly-designed and high-quality RCTs.
Objective To make an individualized treatment plan for newly diagnosed irritable bowel syndrome by means of evidence-based medicine. Methods After clinical problems were put forward, systematic reviews and randomized controlled trials were collected from The Cochrane Library (Issue 3, 2008) and PubMed (1990 to 2008). Treatment protocol was produced by combining the evidence and the values of the patient. Results A total of 114 RCTs and 21 systematic reviews were identified. A rational treatment plan was made upon a serious evaluation of the data to control symptoms and improve the quality of life for the patient. After a sixteen-month follow-up, the plan proved to be optimal. Conclusion The treatment efficacy in diagnosed irritable bowel syndrome has been improved by determining an individualized treatment plan according to evidence-based methods.
Objective To evaluate the efficacy and safety of Tongxiening granule （TXNG） in the treatment of diarrhea-predominant irritable bowel syndrome （IBS） （stagnation of the liver-qi attacking the spleen）. Methods In a prospective, randomized, placebo-controlled, double-blind clinical trial, 60 patients with diarrhea-predominant IBS were randomly divided into the TXNG group （TXNG, 5.0g, 3 times daily; n =30） and the placebo group （placebo, 5. 0g, 3 times daily; n =30）. The treatment was administered for 3 weeks, and the follow-up was conducted for 4 weeks.Results （1）Abdominal pain： The cure rates were 57. 7% vs. 16. 0% （ by per-protocol analysis, PP） and 31.0% vs. 7.1% （ by intention-to-treat analysis （ITT） ; and the overall improvement rates were 92.3% vs. 44.0% （PP） and 82.7% vs. 39.3% （ITT） in the TXNG and the placebo groups respectively （ P 〈0. 05）. （2） Diarrhea ： the cure rates were 46. 2% vs. 20. 0% （PP） and 41.4% vs. 17. 9% （ITT） , and the overall improvement rates were 96. 2% vs 48. 0% （PP） and 86. 2% vs 42.9% （ITT） in the two groups respectively （P 〈0.05）. （3）Traditional Chinese medicine symptoms： the cure rates were 30.8% vs. 4.0% （PP） and 27.6% vs. 3.6% （ITT） ; and the overall improevment rates were 92.3% vs. 48.0% （PP） and 82.7% vs 42.9% （ITT） in the two groups respectively （P 〈0. 05）. The pain duration after treatment in the TXNG group was significantly shortened compared with the placebo group （7.6 ±4. 6d vs 14. 4 ±4. 3d, P =0. 0125）. After 4-week follow-up, it suggested that the recrudescent duration in symptoms related to IBS in the TXNG group was longer than that in the placebo group （11.5 ±5.3 d vs 6.2 ±6.9 d, P = 0. 019）. No adverse effects were found in the TXNG group. Conclusion It was demonstrated that TXNG is effective and safe in the treatment of diarrhea-predominant ms （stagnation of the liver-qi attacking the spleen）.
Objective To provide best available evidence for clinical practice and further research planning on IBS treatment, we reviewed systematically all the randomised controlled trials on calcium channel blockers for irritable bowel syndrome. The primary objective was to determine whether there was enough evidence that calcium channel blocker was effective and safe in the treatment of patients with IBS. Method Searches were performed in Trials Register of the Cochrane Complementary Medicine Field, data from the pharmaceutical company were also retrieved. In addition we searched the electronic bibliographic databases: Cochrane Controlled Trials Register, Medline, Embase, Chinese Biological Medical Database (CBM-disc). We handsearched some important Chinese journals. Two reviewers included studies, assessed the quality of studies and extracted data independently. Disagreement was resolved by discussion or the third party when needed. The following primary outcomes were assessed: ① Effective rate at the end of experiment, ② Improvmemnt in abodeminal pain and distention, ③ Adverse events. Results 49 potentially eligible trials were identified, of which 9 trials (831 patients) were included. 8 trials were waiting for assessment. The mean percentage of patients with global improvement was 48.9% in control group and 75% in the calcium channel blockers group. In favour of calcium group with a mean OR 4.54, 95%CI (2.38, 8.66). Conclusions Selective calcium channel blockers might be effective and safe in the treatment of patients with IBS.Because the methodological quality of all included studies was poor,further high-quality randomised controlled trials should be performed.
目的 调查汶川地震灾区中学生肠易激综合征（IBS）的患病情况，分析罗马Ⅱ和罗马Ⅲ诊断标准对该人群IBS患病率的影响。 方法 在汶川地震后2年半和3年，分别用罗马Ⅱ和罗马Ⅲ标准制定IBS中学生问卷调查表对地震灾区和非地震灾区5所中学的中学生进行2次调查，分析比较IBS患病率的变化。 结果 用罗马Ⅱ标准调查发现地震灾区中学生IBS患病率为23.6%；非地震灾区患病率为21.6%，二者比较无统计学意义（P=0.267）；用罗马Ⅲ标准调查发现地震灾区中学生IBS患病率为6.2%，非地震灾区患病率为4.6%，二者比较无统计学意义（P=0.139）。符合两种诊断标准的地震灾区IBS学生有10.3%，非地震灾区IBS学生有9.2%，两者差异无统计学意义（P＞0.05）。②支持两种诊断标准的症状方面，地震灾区IBS学生每天排便＞3次或每周排便＜3次等症状相比较有统计学意义（P＜0.001）。③按罗马Ⅲ标准，各亚型构成比IBS-C为30.4%，IBS-D为28.4%，IBS-M为8.8%，IBS-U为32.4%；按罗马Ⅱ标准，各亚型构成比为IBS-C为28.5%，IBS-D为47.7%，腹泻和便秘交替型为18.6%，罗马Ⅲ标准中的IBS-M和IBS-U合为一组与罗马Ⅱ标准中的腹泻和便秘交替型的构成比进行比较，二者有统计学意义（P＜0.001）。 结论 罗马Ⅱ和罗马Ⅲ两种标准调查地震灾区中学生IBS患病率和分型存在着差异，但两种标准对地震灾区IBS患病率的影响是对等的，患病率和分型的不同是由两种标准的本身的差异造成，可能更接近罗马Ⅲ诊断标准。