Borowiec Anna M, Fedorak Richard N
Division of Gastroenterology, University of Alberta, Zeidler Ledcor Centre, 130 University Campus, Edmonton, AB T6G 2X8, Canada.
Curr Gastroenterol Rep. 2007 Oct;9(5):393-400. doi: 10.1007/s11894-007-0048-6.
Irritable bowel syndrome (IBS) affects a significant proportion of the North American population; however, the etiology and pathophysiology of this disease remain poorly understood, and treatment is focused on symptom management. Over the years, research has revealed that the bacterial flora in the human gut interact with the bowel in a complex and dynamic relationship and may be responsible for the induction and progression of some of the pathophysiologic aspects of IBS. Probiotics are nonpathogenic bacteria that benefit the host, and the roles they can play in the bacterio-gut relationship provide hope of a safe treatment that would allow for modulation of IBS disease states. Probiotic treatment for IBS has undergone significant exploration, yet the exact therapeutic effects and doses of these beneficial bacteria remain unclear due to the conflicting nature of available evidence. This review discusses the evidence from randomized controlled trials on probiotic treatment of IBS and presents the current understanding of the mechanisms of action of probiotics as they apply to IBS and provides a plausible explanation for the variability in evidence documented by the various trials under review.
肠易激综合征（IBS）影响着相当一部分北美人群；然而，这种疾病的病因和病理生理学仍知之甚少，治疗主要集中在症状管理上。多年来，研究表明，人类肠道中的细菌菌群与肠道以复杂且动态的关系相互作用，可能是IBS某些病理生理方面的诱发和进展的原因。益生菌是对宿主有益的非致病细菌，它们在细菌与肠道关系中所起的作用为安全治疗带来了希望，这种治疗可以调节IBS疾病状态。针对IBS的益生菌治疗已经进行了大量探索，但由于现有证据相互矛盾，这些有益细菌的确切治疗效果和剂量仍不明确。本综述讨论了关于益生菌治疗IBS的随机对照试验的证据，阐述了目前对益生菌作用机制的理解，因为它们适用于IBS，并为所审查的各种试验中记录的证据变异性提供了合理的解释。
