van Kessel Lente, Teunissen Doreth, Lagro-Janssen Toine
Department of Primary and Community Care / Gender and Women's Health, Radboud University Medical Centre, Nijmegen, the Netherlands.
Int J Gen Med. 2021 Mar 15;14:867-884. doi: 10.2147/IJGM.S291964. eCollection 2021.
In recent years, research on sex-gender differences in health care has increasingly recognized that men and women differ in the way symptoms occur, in risk factors for certain conditions and in the way they respond to the same treatment. A disease that is known to often present differently in women and men is irritable bowel syndrome (IBS). Given the difference in prevalence, predominant symptoms and possible other pathophysiology, it is conceivable that a difference in treatment effectiveness in men and women is a discovery waiting to be found.
To determine whether there are differences in treatment effectiveness between men and women with irritable bowel syndrome.
We searched on PubMed and EMBASE, selecting randomized controlled trials comparing IBS treatment in men and women over 18 years old. One researcher performed the inclusion process, and two researchers independently performed a quality assessment. A descriptive analysis was conducted.
Twelve studies, randomizing 1847 men and 3562 women, were included in this review. Treatment with serotonin antagonist alosetron, treatment with ibodutant and crofelemer and adding cognitive behavioral therapy to medical treatment found significant differences between men and women in favor of effectiveness towards women in either satisfactory relief of overall IBS symptoms or percentage of pain-free days.
Sex-gender can be a determining factor in the effectiveness of IBS treatment. Due to the limited number of studies per treatment option, no recommendations can be made on the choice of a specific treatment. It is clear, however, that so as not to miss beneficial treatment options for either sex, the inclusion, analysis and description of data on the basis of sex is of the utmost importance.
近年来，医疗保健领域关于性别差异的研究越来越认识到，男性和女性在症状出现方式、某些疾病的风险因素以及对相同治疗的反应方式上存在差异。肠易激综合征（IBS）是一种已知在女性和男性中表现往往不同的疾病。鉴于患病率、主要症状以及可能的其他病理生理学方面存在差异，可以想象，男性和女性在治疗效果上的差异有待发现。
确定肠易激综合征男女患者在治疗效果上是否存在差异。
我们在PubMed和EMBASE上进行检索，选择比较18岁以上男女IBS治疗的随机对照试验。由一名研究人员进行纳入过程，两名研究人员独立进行质量评估。进行描述性分析。
本综述纳入了12项研究，共随机分配了1847名男性和3562名女性。使用血清素拮抗剂阿洛司琼治疗、使用依波度坦和克罗felemer治疗以及在药物治疗中加入认知行为疗法，发现男性和女性之间存在显著差异，在总体IBS症状的满意缓解或无痛天数百分比方面，女性治疗效果更佳。
性别可能是IBS治疗效果的一个决定性因素。由于每种治疗方案的研究数量有限，无法就具体治疗的选择提出建议。然而，很明显，为了不遗漏任何一种性别的有益治疗方案，基于性别的数据纳入、分析和描述至关重要。
