非药物治疗便秘型肠易激综合征的研究进展

Research progress on non-pharmacological therapies for constipation-predominant irritable bowel syndrome

摘要:

肠易激综合征（IBS）是一种世界范围内的常见病，以长期慢性腹痛和排便习惯改变为主要特征。便秘型肠易激综合征（IBS-C）作为IBS中的一种亚型，以慢性反复腹痛、腹胀或腹部不适伴排便困难为主要症状，因其发病机制尚未明确，以缓泻剂为主的药物治疗在缓解症状和减少发病次数上效果欠佳。近年来，国内外专家越来越重视非药物治疗IBS-C。非药物治疗能有效改善患者胃肠部不适症状，减少发病次数，部分疗法还可改善患者焦虑、抑郁的不良心理状况。该文对非药物疗法治疗IBS-C的现状进行综述，对调节肠道菌群、脑-肠轴行为疗法、中医外治法、可发酵低聚糖、双糖、单糖、多元醇治疗IBS-C的研究进展进行浅析，为非药物治疗便秘型肠易激综合征提供参考。

Abstract:

Irritable bowel syndrome is a common global disorder characterized by chronic abdominal pain and altered bowel habits. Constipation-predominant irritable bowel syndrome (IBS-C), a subtype of IBS, is marked by chronic recurrent abdominal pain, bloating, or discomfort accompanied by difficult defecation. As its pathogenesis remains unclear, pharmacological treatments primarily involving laxatives often yield suboptimal results in alleviating symptoms and reducing recurrence. In recent years, experts worldwide have increasingly emphasized non-pharmacological interventions for IBS-C. These approaches can effectively improve gastrointestinal symptoms, decrease the frequency of episodes, and some therapies may also ameliorate associated anxiety and depression. This article reviews the current status of non-pharmacological therapies for IBS-C, providing an analysis of research advances in modulating gut microbiota, brain–gut axis behavioral therapy, external therapies of traditional Chinese medicine, and the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, aiming to offer a reference for the non-pharmacological management of IBS-C.