刺激性肠综合征与腹:是时候改变做法了吗?
Cristina Caranfil1,2, Luisa Bertin1,2, Fabiana Zingone1,2
1Department of Surgery, Oncology and Gastroenterology, University of Padua.
Current opinion in gastroenterology
|February 9, 2026
概括
当代证据支持与腹 (IBS-D) 诊断和治疗的易怒肠综合征转移. 现在的重点是针对性研究和基于机制的疗法,包括神经调节剂和饮食改变,以获得更好的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 神经免疫学 神经免疫学
- 临床实践指南 临床实践指南
背景情况:
- 传统的刺激性肠综合征与腹 (IBS-D) 管理涉及广泛的排斥性测试和经验性症状控制.
- 最近神经免疫病理生理学,诊断,生物标志物和治疗疗效方面的进展需要重新评估当前的IBS-D实践.
研究的目的:
- 评估积累的证据是否证明了对IBS-D当代诊断和治疗实践的重大变化.
- 评估神经免疫路径和新生物标志物的新理解对IBS-D管理的影响.
主要方法:
- 审查最近的系统审查和新出现的关于诊断算法和治疗疗效的证据.
- 分析新型生物标志物及其在IBS-D诊断中的潜在作用.
- 评估治疗策略,包括神经调节剂,饮食干预和行为疗法.
主要成果:
- 诊断方法正在转向基于症状的策略,针对特定疾病进行有针对性的测试.
- 新兴的生物标志物,如中性粒细胞与白蛋白的比率和microRNA-148显示出诊断潜力.
- 有效的治疗方法包括三环抗抑郁药,低FODMAP和地中海饮食,以及脑肠行为疗法.
结论:
- 证据支持从排斥性测试转向针对可治疗疾病的有针对性的调查.
- 建议采用基于机制的多式干预措施,整合神经调节剂,饮食和行为疗法.
- 基于表型和并发症的个性化治疗选择,通过综合护理模式提供,对于最佳的IBS-D管理至关重要.
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