Cole S J, Duncan H D, Claydon A H, Austin D, Bowling T E, Silk D B A
Department of Gastroenterology and Nutrition, Central Middlesex Hospital, London, United Kingdom.
Dig Dis Sci. 2002 Feb;47(2):345-55. doi: 10.1023/a:1013722122622.
With the aim of improving end organ treatment, we describe a new system of classifying irritable bowel syndrome (IBS) according to clinical features into four groups, spastic colon syndrome (SCS), functional diarrhea (FD), diarrhea-predominant spastic colon syndrome (DPSCS), and midgut dysmotility (MGD). The aim of the study was to investigate fasting and postprandial distal colonic motility in the four groups of patients and to compare the results with normal controls. Distal colonic motility studies were performed in the unprepared colon. 2.5-hr recordings were made from four channels with a standard meal administered at 0.5 hr. The intubated colon was treated as a study segment and data analyzed for study segment activity index (SSAI) and number and mean amplitude of pressure peaks over 30-min epochs. Patients with SCS had significantly higher (P < 0.05) mean amplitude of pressure peaks (60 min, 120 min) and SSAI (120 min) than controls and patients with FD, DPSCS, and MGD. In contrast, patients with FD and DPSCS had significantly (P < 0.05) lower postprandial SSAI than controls and patients with SCS (60 min, 120 min). With the exception of raised postprandial mean amplitude of pressure peaks (120 min), MGD patients had normal distal colonic motility. Division of IBS patients into subgroups has highlighted significant differences in distal colonic motility that provide insights into etiopathogenesis and should assist targeting of current and newly developed therapies, particularly receptor active agents.
为了改善终末器官治疗，我们描述了一种根据临床特征将肠易激综合征（IBS）分为四组的新系统，即痉挛性结肠综合征（SCS）、功能性腹泻（FD）、腹泻型痉挛性结肠综合征（DPSCS）和中肠动力障碍（MGD）。本研究的目的是调查这四组患者空腹和餐后远端结肠的动力，并将结果与正常对照组进行比较。在未做准备的结肠中进行远端结肠动力研究。在四个通道进行2.5小时的记录，并在0.5小时时给予标准餐。将插管的结肠作为研究节段，并分析数据以计算研究节段活动指数（SSAI）以及30分钟时段内压力峰值的数量和平均幅度。SCS患者的压力峰值平均幅度（60分钟、120分钟）和SSAI（120分钟）显著高于（P<0.05）对照组以及FD、DPSCS和MGD患者。相比之下，FD和DPSCS患者的餐后SSAI显著低于（P<0.05）对照组以及SCS患者（60分钟、120分钟）。除了餐后压力峰值平均幅度升高（120分钟）外，MGD患者的远端结肠动力正常。将IBS患者分为亚组突出了远端结肠动力的显著差异，这为病因发病机制提供了见解，并应有助于当前和新开发疗法的靶向治疗，特别是受体活性剂。
