Quigley Eamonn M M
Alimentary Pharmabiotic Center, University College Cork, Cork, Ireland.
J Dig Dis. 2007 Feb;8(1):2-7. doi: 10.1111/j.1443-9573.2007.00277.x.
Irritable bowel syndrome (IBS) may, in part at least, result from a dysfunctional interaction between the indigenous flora and the intestinal mucosa which, in turn, leads to immune activation in the colonic mucosa. Some propose a role for bacterial overgrowth as a common causative factor in the pathogenesis of symptoms in IBS; other evidence points to more subtle qualitative changes in the colonic flora; both hypotheses remain to be confirmed but the likelihood that bacterial overgrowth will prove to be a major factor in IBS now seems remote. Nevertheless, short-term therapy with either antibiotics or probiotics does seem to reduce symptoms among IBS patients. It seems most likely that the benefits of antibiotic therapy are mediated through subtle and, perhaps, localized, quantitative and/or qualitative changes in the colonic flora. How probiotics exert their effects remain to be defined but an anti-inflammatory effect seems likely. While this approach to the management of IBS is in its infancy, it is evident that manipulation of the flora, whether through the administration of antibiotics or probiotics, deserves further attention in IBS.
肠易激综合征（IBS）至少部分是由于肠道固有菌群与肠黏膜之间的功能失调相互作用所致，进而导致结肠黏膜免疫激活。一些人认为细菌过度生长是IBS症状发病机制中的一个常见致病因素；其他证据则指向结肠菌群更细微的质的变化；这两种假说都有待证实，但细菌过度生长将被证明是IBS主要因素的可能性目前似乎很小。然而，使用抗生素或益生菌进行短期治疗似乎确实能减轻IBS患者的症状。抗生素治疗的益处很可能是通过结肠菌群细微的、或许是局部的数量和/或质量变化来介导的。益生菌如何发挥其作用尚待确定，但抗炎作用似乎是可能的。虽然这种IBS管理方法尚处于起步阶段，但很明显，无论是通过使用抗生素还是益生菌来调节菌群，在IBS中都值得进一步关注。
