抗抑郁药在刺激性肠综合征:一个系统的审查和随机对照试验的元分析
Maria José Temido1, Margarida Cristiano1, Carolina Gouveia2,3
1Serviço de Gastrenterologia, Hospitais da Universidade de Coimbra, Unidade Local Saúde de Coimbra (Maria José Temido, Margarida Cristiano, Pedro Figueiredo, Francisco Portela).
Annals of gastroenterology
|May 15, 2025
概括
抗抑郁药有效地改善了刺激性肠综合征 (IBS) 患者的症状,包括疼痛和胀气. 这一元分析证实了它们的益处,特别是对于那些对初始治疗没有反应的人来说.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 刺激性肠综合征 (IBS) 治疗选择的证据支持其有效性的证据有限.
- 抗抑郁药物越来越多地被考虑用于IBS管理,但需要有力的证据.
研究的目的:
- 系统地审查和元分析随机,双盲,安慰剂对照试验 (RCT) 评估抗抑郁药在IBS中的疗效.
- 评估抗抑郁药对IBS整体症状改善和腹痛和胀气等特定症状的影响.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在PubMed,EMBASE和Cochrane图书馆搜索到到2024年1月的RCT.
- 使用Cochrane工具 (RoB 2) 评估研究质量,并使用随机效应模型分析数据.
主要成果:
- 包括16个RCT与1428名患者;抗抑郁药显著改善了整体IBS症状 (OR3.02,95%CI2.16-4.2).
- 疗效在各个子组中是一致的,包括那些对一线治疗耐药且没有并发性心理疾病的子组.
- 在腹部疼痛 (OR 3.27) 和膨胀 (OR 2.4) 中发现了显著的改善.
结论:
- 抗抑郁药在治疗刺激性肠综合征 (IBS) 中表现出显著的疗效.
- 这些药物为IBS患者提供了有价值的治疗选择,特别是那些对初始治疗没有反应或缺乏并发性心理疾病的患者.
相关概念视频
Drugs for Treatment of Diarrhea-Predominant IBS
126
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
126
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
101
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
101
Irritable Bowel Syndrome I: Introduction
210
Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
210
Irritable Bowel Syndrome III: Medical and Nursing Management
128
Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
128
Drugs for Treatment of Constipation-Predominant IBS
119
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
119
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
277
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
277


