Department of Geriatric Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Department of Anorectal Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ann Palliat Med. 2021 Mar;10(3):3364-3370. doi: 10.21037/apm-21-427.
The aim of the present study was to analyze the relationship between small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) and the prognosis of treatment.
A total of127 IBS patients (IBS group) were selected, and based on the results of the methane/hydrogen breath test, they were divided into SIBO-positive group (subdivided into the antibiotic group, microecological group, and placebo group according to difference in treatment methods) and the SIBO-negative group. The incidence of SIBO and inflammatory factors in different populations were compared. Moreover, differences in the negative conversion rate of intestinal bacterial overgrowth, symptom improvement, interleukin (IL)-1β, and IL-10 levels in the antibiotic group, microecological group, and placebo group before and after treatment were compared.
The IL-1β level of the IBS group was higher than that of the control group, but the level of IL-10 was lower than that of the control group (P<0.05). The level of IL-1β in the SIBO-positive group was higher than that in the SIBO-negative group, while IL-10 level was lower in the SIBO-positive group compared with the SIBO-negative group (P<0.05). Symptom scores after treatment in the antibiotic group and the microecological group were lower than those in the same groups before treatment and those in the placebo group after treatment (P<0.05). After treatment, the level of IL-1β in the antibiotic group and the microecological group decreased, whereas the level of IL-10 increased (P<0.05). Furthermore, the total clinical effective rate and negative conversion rate of the antibiotic group and the microecological group were higher than those of the placebo group (P<0.05); however, the comparison of symptom scores, inflammatory factors, and total clinical effective rate before and after treatment in the placebo group was not statistically significant (P<0.05). The symptom score after treatment in the negative conversion group was lower than that in the non-negative conversion group (P<0.05).
SIBO plays an important role in the occurrence of IBS. Antibiotics and microecological agents can be used to correct SIBO in clinical practice to improve the symptoms of IBS patients and peripheral blood inflammatory factors.
本研究旨在分析小肠细菌过度生长（SIBO）与肠易激综合征（IBS）的关系及其治疗预后。
选取 127 例 IBS 患者（IBS 组），根据甲烷/氢气呼气试验结果分为 SIBO 阳性组（根据治疗方法不同分为抗生素组、微生态组和安慰剂组）和 SIBO 阴性组，比较不同人群的 SIBO 发生率及炎症因子，比较抗生素组、微生态组、安慰剂组治疗前后肠道细菌过度生长的转阴率、症状改善情况及白细胞介素（IL）-1β、IL-10 水平的差异。
IBS 组的 IL-1β水平高于对照组，IL-10 水平低于对照组（P<0.05）。SIBO 阳性组的 IL-1β水平高于 SIBO 阴性组，IL-10 水平低于 SIBO 阴性组（P<0.05）。抗生素组和微生态组治疗后症状评分均低于同组治疗前及安慰剂组治疗后（P<0.05）。治疗后，抗生素组和微生态组的 IL-1β水平降低，IL-10 水平升高（P<0.05）。此外，抗生素组和微生态组的总临床有效率和转阴率均高于安慰剂组（P<0.05）；但安慰剂组治疗前后症状评分、炎症因子及总临床有效率比较差异均无统计学意义（P<0.05）。转阴组治疗后的症状评分低于未转阴组（P<0.05）。
SIBO 在 IBS 的发生中起重要作用。在临床实践中，可以使用抗生素和微生态制剂来纠正 SIBO，以改善 IBS 患者的症状和外周血炎症因子。
