Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L
Section of Digestive Sciences, Department of Medicine, G d'Annunzio University, Chieti-Pescara, Italy.
Dig Liver Dis. 2007 Jun;39(6):530-6. doi: 10.1016/j.dld.2007.02.006. Epub 2007 Apr 8.
The use of peppermint oil in treating the irritable bowel syndrome has been studied with variable results probably due to the presence of patients affected by small intestinal bacterial overgrowth, lactose intolerance or celiac disease that may have symptoms similar to irritable bowel syndrome.
The aim of the study was to test the effectiveness of enteric-coated peppermint oil in patients with irritable bowel syndrome in whom small intestinal bacterial overgrowth, lactose intolerance and celiac disease were excluded.
Fifty-seven patients with irritable bowel syndrome according to the Rome II criteria, with normal lactose and lactulose breath tests and negative antibody screening for celiac disease, were treated with peppermint oil (two enteric-coated capsules twice per day or placebo) for 4 weeks in a double blind study. The symptoms were assessed before therapy (T(0)), after the first 4 weeks of therapy (T(4)) and 4 weeks after the end of therapy (T(8)). The symptoms evaluated were: abdominal bloating, abdominal pain or discomfort, diarrhoea, constipation, feeling of incomplete evacuation, pain at defecation, passage of gas or mucus and urgency at defecation. For each symptom intensity and frequency from 0 to 4 were scored. The total irritable bowel syndrome symptoms score was also calculated as the mean value of the sum of the average of the intensity and frequency scores of each symptom.
At T(4), 75% of the patients in the peppermint oil group showed a >50% reduction of basal (T(0)) total irritable bowel syndrome symptoms score compared with 38% in the placebo group (P<0.009). With peppermint oil at T(4) and at T(8) compared with T(0) a statistically significant reduction of the total irritable bowel syndrome symptoms score was found (T(0): 2.19+/-0.13, T(4): 1.07+/-0.10*, T(8): 1.60+/-0.10*, *P<0.01 compared with T(0), mean+/-S.E.M.), while no change was found with the placebo.
A 4 weeks treatment with peppermint oil improves abdominal symptoms in patients with irritable bowel syndrome.
薄荷油用于治疗肠易激综合征的研究结果各异，这可能是因为存在受小肠细菌过度生长、乳糖不耐受或乳糜泻影响的患者，这些病症可能有与肠易激综合征相似的症状。
本研究旨在测试肠溶薄荷油对已排除小肠细菌过度生长、乳糖不耐受和乳糜泻的肠易激综合征患者的疗效。
在一项双盲研究中，57名符合罗马II标准的肠易激综合征患者，乳糖和乳果糖呼气试验正常且乳糜泻抗体筛查为阴性，接受薄荷油治疗（每天两次，每次两粒肠溶胶囊）或安慰剂治疗4周。在治疗前（T(0)）、治疗的前4周后（T(4)）以及治疗结束后4周（T(8)）对症状进行评估。评估的症状包括：腹胀、腹痛或不适、腹泻、便秘、排便不尽感、排便时疼痛、排气或黏液排出以及排便急迫感。对每个症状的强度和频率从0到4进行评分。还计算了肠易激综合征症状总评分，即每个症状强度和频率评分平均值之和的平均值。
在T(4)时，薄荷油组75%的患者基础（T(0)）肠易激综合征症状总评分降低了>50%，而安慰剂组为38%（P<0.009）。与T(0)相比，在T(4)和T(8)时使用薄荷油发现肠易激综合征症状总评分有统计学显著降低（T(0)：2.19±0.13，T(4)：1.07±0.10*，T(8)：1.60±0.10*，*与T(0)相比P<0.01，平均值±标准误），而安慰剂组未发现变化。
用薄荷油治疗4周可改善肠易激综合征患者的腹部症状。
