Bafutto Mauro, Almeida José Roberto de, Leite Nayle Vilela, Oliveira Enio Chaves, Gabriel-Neto Salustiano, Rezende-Filho Joffre
Disciplina de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Goiás.
Arq Gastroenterol. 2011 Jan-Mar;48(1):36-40. doi: 10.1590/s0004-28032011000100008.
Recent studies support the hypothesis that postinfectious irritable bowel syndrome and some irritable bowel syndrome patients display persistent signs of minor mucosal inflammation. Mesalazine has intestinal anti-inflammatory properties including cyclooxygenase and prostaglandin inhibition. The effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome patients are still unknown.
To observe the effects of mesalazine on postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with diarrhea patients.
Based on Rome III criteria, 61 irritable bowel syndrome with diarrhea patients (18 years old or more) were included in the evaluation. Patients were divided into two groups: postinfectious irritable bowel syndrome group, with 18 patients medicated with mesalazine 800 mg 3 times a day for 30 days; noninfective irritable bowel syndrome group, with 43 patients medicated with mesalazine 800 mg 3 times a day for 30 days. Symptom evaluations at baseline and after treatment were performed by means of a four-point Likert scale including stool frequency, stool form and consistency (Bristol Stool Scale), abdominal pain and distension (maximum score: 16; minimum score: 4).
Postinfectious irritable bowel syndrome group presented a statistically significant reduction of the total symptom score (P<0.0001). The stool frequency was significantly reduced (P<0.0001), and stool consistency, improved (P<0.0001). Abdominal pain (P<0.0001) and abdominal distension were significantly reduced (P<0.0001). Noninfective irritable bowel syndrome group presented a statistically significant reduction of total symptom score (P<0.0001). Also, the stool frequency was significantly reduced (P<0.0001) and stool consistency, improved (P<0.0001). Abdominal pain (P<0.0001) and abdominal distention were significantly reduced (P<0.0001). There was no statistical difference between postinfectious irritable bowel syndrome group and noninfective irritable bowel syndrome group on total symptom score results at 30th day of therapy with mesalazine 800 mg 3 times a day. (P = 0.13).
Mesalazine reduced key symptoms of postinfectious irritable bowel syndrome and noninfective irritable bowel syndrome with diarrhea patients.
近期研究支持以下假说，即感染后肠易激综合征以及部分肠易激综合征患者存在轻微黏膜炎症的持续迹象。美沙拉嗪具有肠道抗炎特性，包括抑制环氧化酶和前列腺素。美沙拉嗪对感染后肠易激综合征和非感染性肠易激综合征患者的影响尚不清楚。
观察美沙拉嗪对感染后肠易激综合征和非感染性腹泻型肠易激综合征患者的影响。
根据罗马Ⅲ标准，纳入61例腹泻型肠易激综合征患者（年龄≥18岁）进行评估。患者分为两组：感染后肠易激综合征组，18例患者服用美沙拉嗪800mg，每日3次，共30天；非感染性肠易激综合征组，43例患者服用美沙拉嗪800mg，每日3次，共30天。通过四分制李克特量表进行基线及治疗后的症状评估，包括排便频率、粪便形状和稠度（布里斯托粪便量表）、腹痛和腹胀（最高分：16分；最低分：4分）。
感染后肠易激综合征组总症状评分有统计学显著降低（P<0.0001）。排便频率显著降低（P<0.0001），粪便稠度改善（P<0.0001）。腹痛（P<0.0001）和腹胀显著减轻（P<0.0001）。非感染性肠易激综合征组总症状评分有统计学显著降低（P<0.0001）。同样，排便频率显著降低（P<0.0001），粪便稠度改善（P<0.0001）。腹痛（P<0.0001）和腹胀显著减轻（P<0.0001）。在每日3次服用800mg美沙拉嗪治疗30天时，感染后肠易激综合征组和非感染性肠易激综合征组的总症状评分结果无统计学差异（P = 0.13）。
美沙拉嗪减轻了感染后肠易激综合征和非感染性腹泻型肠易激综合征患者的关键症状。
