Ford Alexander Charles, Vandvik Per Olav
Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK.
BMJ Clin Evid. 2012 Jan 6;2012:0410.
The prevalence of irritable bowel syndrome (IBS) varies depending on the criteria used to diagnose it, but it ranges from about 5% to 20%. IBS is associated with abnormal gastrointestinal motor function and enhanced visceral perception, as well as psychosocial and genetic factors. People with IBS often have other bodily and psychiatric symptoms, and have an increased likelihood of having unnecessary surgery compared with people without IBS.
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in people with IBS? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 27 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5HT(3) receptor antagonists (alosetron and ramosetron), 5HT(4) receptor agonists (tegaserod), antidepressants (tricyclic antidepressants and selective serotonin reuptake inhibitors [SSRIs]), antispasmodics (including peppermint oil), cognitive behavioural therapy (CBT), hypnotherapy, loperamide, and soluble and insoluble fibre supplementation.
肠易激综合征（IBS）的患病率因诊断标准而异，但范围约为5%至20%。IBS与胃肠运动功能异常、内脏感觉增强以及心理社会和遗传因素有关。IBS患者常伴有其他身体和精神症状，与非IBS患者相比，进行不必要手术的可能性增加。
我们进行了一项系统评价，旨在回答以下临床问题：IBS患者接受治疗的效果如何？我们检索了：截至2011年8月的医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、考克兰图书馆以及其他重要数据库（临床证据综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及保健品管理局（MHRA）等相关机构的危害警示。
我们发现27项系统评价、随机对照试验或观察性研究符合我们的纳入标准。我们对干预措施的证据质量进行了GRADE评估。
在本系统评价中，我们提供了以下干预措施有效性和安全性的相关信息：5-羟色胺（5HT）3受体拮抗剂（阿洛司琼和雷莫司琼）、5HT4受体激动剂（替加色罗）、抗抑郁药（三环类抗抑郁药和选择性5-羟色胺再摄取抑制剂[SSRIs]）、解痉药（包括薄荷油）、认知行为疗法（CBT）、催眠疗法、洛哌丁胺以及补充可溶性和不可溶性纤维。
