[根据食物特异性IgG抗体消除过敏食物对肠易激综合征的治疗作用]

Yang Chong-mei, Li Yan-qing

Department of Digestive Disease, Shandong Provincial Hospital, Jinan 250021, China.

Zhonghua Nei Ke Za Zhi. 2007 Aug;46(8):641-3.

OBJECTIVE

To explore the therapeutic effects on irritable bowel syndrome (IBS) by eliminating the allergic foods according to food-specific IgG antibodies and to clarify the etiopathological role and mechanism of food allergy.

METHODS

The food-specific IgG antibodies to a panel of 14 different food antigens in serum were detected with ELISA in fifty five cases with diarrhea-dominant IBS, thirty two with constipation-dominant IBS and eighteen normal controls. The frequency and severity index of symptoms and scores of Irritable Bowel Syndrome Quality of Life (IBS-QOL) in thirty five cases with positive food-specific IgG were observed before and after elimination of allergic foods for two months.

RESULTS

The positive rate of serum food-specific IgG antibodies was 63.6 percent in patients with diarrhea-dominant IBS and 43.8 percent in constipation-dominant IBS. Both were higher than that in normal controls. After eliminating allergic foods for four weeks according to the levels of serum food-specific IgG antibodies, the frequency of symptoms decreased from (3.79 +/- 1.58) to (1.67 +/- 0.70) per week and the severity from 3.18 +/- 1.46 to 1.52 +/- 0.67 with significant differences. After eight weeks, the frequency of symptoms decreased from (3.79 +/- 1.58) to (1.53 +/- 0.69) per week and the severity from 3.18 +/- 1.46 to 1.45 +/- 0.66, also with significant differences. After eliminating allergic foods, the overall health score and the eight dimensionality integrals of QOL except avoiding food in patients with IBS increased significantly than those before treatment. At the end of eight weeks, the symptoms relieved completely in 31.4 percent of the cases and remarkably in 34.3 percent.

CONCLUSIONS

Abnormal immune reactions mediated by IgG antibodies coexisted in patients with IBS. It is of great significance in treating IBS by eliminating the allergic foods according to the serum level of food-specific IgG antibodies.

目的

根据食物特异性IgG抗体排除过敏食物，探讨其对肠易激综合征（IBS）的治疗作用，并阐明食物过敏在发病机制中的作用及机制。

方法

采用酶联免疫吸附测定法（ELISA）检测55例腹泻型IBS患者、32例便秘型IBS患者及18名正常对照者血清中14种不同食物抗原的特异性IgG抗体。观察35例食物特异性IgG阳性的IBS患者在排除过敏食物2个月前后的症状发生频率、严重程度指数及肠易激综合征生活质量（IBS-QOL）评分。

结果

腹泻型IBS患者血清食物特异性IgG抗体阳性率为63.6%，便秘型IBS患者为43.8%，均高于正常对照组。根据血清食物特异性IgG抗体水平排除过敏食物4周后，症状发生频率由每周（3.79±1.58）次降至（1.67±0.70）次，严重程度由3.18±1.46降至1.52±0.67，差异有统计学意义。8周后，症状发生频率由每周（3.79±1.58）次降至（1.53±0.69）次，严重程度由3.18±1.46降至1.45±0.66，差异亦有统计学意义。排除过敏食物后，IBS患者的总体健康评分及生活质量除避免食物维度外的8个维度积分均较治疗前显著提高。至8周结束时，31.4%的患者症状完全缓解，34.3%的患者症状明显缓解。