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功能性消化不良与肠道菌群失调有关吗?

Is Associated Functional Dyspepsia Correlated With Dysbiosis?

作者信息

Kim Yeon-Ji, Chung Woo Chul, Kim Byung Wook, Kim Sung Soo, Kim Jin Il, Kim Na Jin, Yoo Jinho, Kim Soo Hwan

机构信息

Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

Medical Library, The Catholic University of Korea, Seoul, Korea.

出版信息

J Neurogastroenterol Motil. 2017 Oct 30;23(4):504-516. doi: 10.5056/jnm17066.


DOI:10.5056/jnm17066
PMID:28992674
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5628982/
Abstract

BACKGROUND/AIMS: To assess the long-term effect of eradication on symptomatic improvement according to the type of antibiotic and the duration of treatment in -associated functional dyspepsia. METHODS: We searched Pubmed, Embase, CINAHL, and the Cochrane library databases for randomized controlled trials written in English and undertaken up to August 2016 that met our eligibility criteria. The search methodology used combinations of the following keywords: OR OR HP; dyspepsia OR functional dyspepsia OR non-ulcer dyspepsia; eradication OR cure OR treatment. The study outcome was the summary odds ratio (OR) for symptomatic improvement in -associated functional dyspepsia with successful eradication therapy. Subgroup analyses were performed based on the type of antibiotic, and the duration of treatment, whether or not patients had symptoms of irritable bowel syndrome, and on race. RESULTS: Sixteen randomized controlled trials met the inclusion criteria. The summary OR for symptomatic improvement in patients in our eradication group was 1.33 (95% confidence interval [CI], 1.16-1.54; < 0.01). In a subgroup analysis on type of antibiotic, symptomatic improvement with metronidazole-containing regimen (OR, 1.87; 95% CI, 1.26-2.77) was better than treatment with clarithromycin (OR, 1.29; 95% CI, 1.11-1.50). eradication therapy given for 10-14 days was the more effective for symptom improvement than 7-day therapy. When the studies excluding irritable bowel syndrome cases were analyzed, there were no therapeutic effects of eradication on symptomatic improvement. CONCLUSIONS: In the clinical setting, the most effective eradication regimen for functional dyspepsia to provide relief of symptoms is a metronidazole-based treatment regimen for at least 10 days. The explanation for this is that -associated functional dyspepsia could be associated with dysbiosis.

摘要

背景/目的:根据抗生素类型和治疗时长评估根除幽门螺杆菌对幽门螺杆菌相关性功能性消化不良症状改善的长期影响。 方法:我们检索了Pubmed、Embase、CINAHL和Cochrane图书馆数据库,查找截至2016年8月撰写的、符合我们纳入标准的英文随机对照试验。检索方法使用了以下关键词的组合:幽门螺杆菌或HP;消化不良或功能性消化不良或非溃疡性消化不良;根除或治愈或治疗。研究结果是成功根除治疗的幽门螺杆菌相关性功能性消化不良症状改善的汇总比值比(OR)。基于抗生素类型、治疗时长、患者是否有肠易激综合征症状以及种族进行亚组分析。 结果:16项随机对照试验符合纳入标准。我们根除组患者症状改善的汇总OR为1.33(95%置信区间[CI],1.16 - 1.54;P < 0.01)。在抗生素类型的亚组分析中,含甲硝唑方案的症状改善(OR,1.87;95% CI,1.26 - 2.77)优于含克拉霉素治疗(OR,1.29;95% CI,1.11 - 1.50)。给予10 - 14天的根除治疗比7天治疗对症状改善更有效。当分析排除肠易激综合征病例的研究时,根除幽门螺杆菌对症状改善没有治疗效果。 结论:在临床环境中,对功能性消化不良提供症状缓解最有效的根除幽门螺杆菌方案是基于甲硝唑的治疗方案,至少持续10天。对此的解释是幽门螺杆菌相关性功能性消化不良可能与肠道菌群失调有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/b061f6c9f064/jnm-23-504f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/4f89d8243907/jnm-23-504f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/9ef6f48256bd/jnm-23-504f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/4c173f20aac5/jnm-23-504f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/5fa356bc9cde/jnm-23-504f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/b0186b2d321e/jnm-23-504f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/da224512f840/jnm-23-504f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/b061f6c9f064/jnm-23-504f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/4f89d8243907/jnm-23-504f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/9ef6f48256bd/jnm-23-504f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/4c173f20aac5/jnm-23-504f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/5fa356bc9cde/jnm-23-504f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/b0186b2d321e/jnm-23-504f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/da224512f840/jnm-23-504f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/869a/5628982/b061f6c9f064/jnm-23-504f7.jpg

相似文献

[1]
Is Associated Functional Dyspepsia Correlated With Dysbiosis?

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[2]
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J Clin Gastroenterol. 2014-3

[3]
[Helicobacter pylori infection and functional dyspepsia. Meta-analysis of efficacy of eradication therapy].

Med Clin (Barc). 2002-3-30

[4]
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World J Gastroenterol. 2016-3-28

[5]
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Hepatogastroenterology. 2001

[6]
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[7]
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Cochrane Database Syst Rev. 2013-12-11

[8]
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[9]
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[10]
Predictors of long-term outcome of functional dyspepsia and duodenal ulcer after successful Helicobacter pylori eradication--a 7-year follow-up study.

Eur J Gastroenterol Hepatol. 2009-4

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J Int Med Res. 2024-5

[2]
Exhaled Hydrogen after Lactulose Hydrogen Breath Test in Patient with Duodenal Ulcer Disease-A Pilot Study for -Associated Gastroduodenal Disease.

Life (Basel). 2022-12-23

[3]
GG supplementation on eradication rate and dyspepsia in infection treated with three-in-one bismuth quadruple therapy.

Front Microbiol. 2022-12-5

[4]
The Role of Gastrointestinal Microbiota in Functional Dyspepsia: A Review.

Front Physiol. 2022-6-8

[5]
Current Treatment Options and Therapeutic Insights for Gastrointestinal Dysmotility and Functional Gastrointestinal Disorders.

Front Pharmacol. 2022-1-25

[6]
Iron Dysregulation and Inflammagens Related to Oral and Gut Health Are Central to the Development of Parkinson's Disease.

Biomolecules. 2020-12-29

[7]
Functional Dyspepsia: A Narrative Review With a Focus on Sex-Gender Differences.

J Neurogastroenterol Motil. 2020-7-30

[8]
Is there an association between infection and irritable bowel syndrome? A meta-analysis.

World J Gastroenterol. 2019-10-7

[9]
Response to Treatment of -associated Dyspepsia: Eradication of or Correction of Gastric or Intestinal Dysbiosis?

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本文引用的文献

[1]
Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia.

Aliment Pharmacol Ther. 2017-3

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Gut. 2017-6

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Gastroenterology. 2016-2-18

[4]
Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis.

World J Gastroenterol. 2016-3-28

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Small Intestinal Bacterial Overgrowth in Patients with Refractory Functional Gastrointestinal Disorders.

J Neurogastroenterol Motil. 2016-1-31

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Arch Med Sci. 2015-10-12

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