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目的:观察褪黑素治疗伴有睡眠障碍的肠易激综合征(IBS)的疗效。方法:IBS伴有睡眠障碍入选标准参照罗马Ⅲ标准及匹兹堡睡眠质量指数(PSQI),IBS患者45例(男性25例,女性20例,年龄20~70岁),进行电子肠镜检查,均在直乙状结肠交界处取活检做褪黑素受体(MR)免疫组化检查,并记录IBS症状积分及睡眠质量指数积分,给予褪黑素3 mg每日1次睡前口服,疗程4周。结果:IBS患者MR表达与IBS症状相关(P=0.02,r=0.345 Pearson相关),褪黑素治疗2周、4周较治疗前IBS症状改善,差异有统计学意义(P<0.05);褪黑素治疗2周,睡眠质量无改善(P=0.15),褪黑素治疗4周,睡眠质量改善(P<0.05)。结论:IBS患者结肠黏膜MR表达异常,与IBS症状相关,褪黑素治疗IBS症状改善提示褪黑素与IBS发病有关。
Objective: To observe the efficacy of melatonin in treating irritable bowel syndrome (IBS) associated with sleep disorders. Methods: According to Rome Ⅲ standard and Pittsburgh Sleep Quality Index (PSQI), 45 IBS patients (25 males and 20 females, aged 20-70 years) were enrolled in this study. Strains of the straight sigmoid colon biopsies for melatonin receptor (MR) immunohistochemical examination, and record IBS symptom scores and sleep quality index points, given melatonin 3 mg once daily bedtime oral administration, the course of 4 weeks. Results: The expression of MR in IBS patients was correlated with IBS symptoms (P = 0.02, r = 0.345 Pearson correlation), melatonin treatment for 2 weeks and 4 weeks improved IBS symptoms before treatment, the difference was statistically significant (P <0.05) There was no improvement in sleep quality (P = 0.15), melatonin treatment for 4 weeks and sleep quality (P <0.05) after 2 weeks of melanoma treatment. Conclusion: The abnormal expression of MR in colonic mucosa of patients with IBS is related to the symptoms of IBS. The improvement of IBS symptoms by melatonin suggests that melatonin is associated with the pathogenesis of IBS.