Faculty of Medicine, Ovidius University of Constanta.
Department of Gastroenterology, Constanta County Clinical Emergency Hospital.
Medicine (Baltimore). 2021 Jan 8;100(1):e24059. doi: 10.1097/MD.0000000000024059.
Microbiota plays an important role in many diseases including inflammatory bowel diseases. Inflammatory bowel disease patients can have concurrent irritable bowel syndrome symptoms similar to those associated with a flare. The potential role of gut dysbiosis in the pathogenesis of inflammatory bowel disease provides a rationale for treating such patients with rifaximin. This study aimed to assess the efficacy of rifaximin in the management of irritable bowel syndrome-like symptoms (bloating, abdominal pain, stool consistency) and quality of life in patients with Crohn's disease in remission.The present study included 86 patients with Crohn's disease in remission (fecal calprotectin <50 μg/g, C-reactive protein <0.5 mg/dL, simple endoscopic score for Crohn's disease <2) and associated irritable bowel syndrome-like symptoms (bloating, abdominal pain, diarrhea). These patients were randomly assigned to rifaximin treatment group (44 patients) and the control group (42 patients). Besides the baseline inflammatory bowel disease treatment and antispasmodics (as needed), patients in the rifaximin treatment group received 3 repeated courses of treatment, each course being represented by 1200 mg/d of rifaximin for 10 days and 20 days free of treatment (3 months consecutively); patients in the control group also received antispamodics as needed and were observed for 3 months.Monthly analyses of bloating score, abdominal pain score, stool consistency score, and quality of life score showed significant improvement after treatment in the rifaximin group in contrast with control group. Significantly more patients in the rifaximin group than in the control group met the criteria for adequate improvement of bloating score after 3 months of treatment (59.09% vs 19.04%, P = .01), adequate improvement of abdominal pain score (54.5% vs 21.4%, P = .04), stool consistency score (34.09% vs 14.2%, P = .03), and quality of life score (70.4% vs 21.4%, P < .001).Rifaximin in a dose of 1200 mg/d, 10 d/mo, 3 months consecutively is an effective medication for concurrent irritable bowel syndrome-like symptoms in patients with Crohn's disease in remission.
肠道微生物在许多疾病中发挥着重要作用，包括炎症性肠病。炎症性肠病患者可能同时伴有肠易激综合征症状，类似于与疾病活动相关的症状。肠道菌群失调在炎症性肠病发病机制中的潜在作用为使用利福昔明治疗此类患者提供了依据。本研究旨在评估利福昔明治疗缓解期克罗恩病患者肠易激综合征样症状（腹胀、腹痛、粪便稠度）和生活质量的疗效。本研究纳入了 86 例缓解期克罗恩病（粪便钙卫蛋白<50μg/g，C 反应蛋白<0.5mg/dL，克罗恩病简单内镜评分<2）和相关肠易激综合征样症状（腹胀、腹痛、腹泻）的患者。这些患者被随机分为利福昔明治疗组（44 例）和对照组（42 例）。除了基础的炎症性肠病治疗和抗痉挛药物（按需使用）外，利福昔明治疗组患者接受 3 个重复疗程的治疗，每个疗程为 1200mg/d 利福昔明治疗 10 天，20 天无治疗（连续 3 个月）；对照组患者也按需使用抗痉挛药物，并观察 3 个月。与对照组相比，利福昔明组治疗后每月腹胀评分、腹痛评分、粪便稠度评分和生活质量评分均显著改善。治疗 3 个月后，利福昔明组中满足腹胀评分充分改善标准的患者显著多于对照组（59.09%比 19.04%，P=0.01），满足腹痛评分充分改善标准的患者也显著多于对照组（54.5%比 21.4%，P=0.04）、粪便稠度评分（34.09%比 14.2%，P=0.03）和生活质量评分（70.4%比 21.4%，P<0.001）。利福昔明 1200mg/d，10d/月，连续 3 个月的剂量是缓解期克罗恩病患者并发肠易激综合征样症状的有效治疗药物。
