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目的探讨依据食物特异性抗体 IgG(SIgG),剔除过敏食物治疗肠易激综合征(IBS)的疗效,进一步证实食物过敏在 IBS 发病中的作用。方法取腹泻型 IBS(D-IBS)患者55例、便秘型IBS(C-IBS)患者32例和健康对照18例的静脉血,应用酶联免疫方法检测14种 SIgG。对35例 SIgG抗体升高的 IBS 患者,剔除过敏食物治疗2个月,观察治疗前后患者症状频率和程度的变化以及 IBS专用生活质量量表(IBS QOL)积分的改变。结果 D-IBS 患者 SIgG 抗体的阳性率为63.6%(35/55),C-IBS 患者 SIgG 抗体的阳性率为43.8%(14/32),二者均高于对照组。依据 SIgG 抗体剔除过敏食物治疗2个月,31.4%的患者症状完全缓解,34.3%的患者症状明显缓解。剔除过敏食物4周后,IBS患者的症状频率、严重程度积分分别由(3.79±1.58)次/周降至(1.67±0.70)次/周,3.18±1.46降至1.52±0.67;8周后,分别由(3.79±1.58)次/周降至(1.53±0.69)次/周,3.18±1.46降至1.45±0.66,差异均有统计学意义(P<0.05)。IBS QOL 8个维度积分除挑食外其他积分和总体健康积分均比治疗前显著升高。结论 IBS 患者存在食物特异性 IgG 抗体介导的免疫异常反应,根据 SIgG 水平剔除过敏食物治疗 IBS 是有意义的。
Objective To investigate the efficacy of food-specific IgG (SIgG) in the treatment of irritable bowel syndrome (IBS) based on the elimination of allergic foods, and to further confirm the role of food allergy in the pathogenesis of IBS. Methods Fifty-five patients with diarrhea-type IBS (D-IBS), 32 patients with constipation-type IBS (C-IBS) and 18 healthy controls were enrolled in this study. Fourteen SIgGs were detected by enzyme-linked immunosorbent assay. In 35 IBS patients with elevated SIgG antibody, allergy-free foods were treated for 2 months. Changes in the frequency and degree of symptoms before and after treatment, and changes in IBS QOL scores were observed. Results The positive rate of SIgG antibody in D-IBS patients was 63.6% (35/55), and the positive rate of SIgG antibodies in C-IBS patients was 43.8% (14/32), both of which were higher than the control group. According to SIgG antibody to eliminate allergic food for 2 months, 31.4% of patients had complete remission of symptoms and 34.3% of patients had obvious symptoms relief. After 4 weeks of eliminating allergic food, the symptom frequency and severity score of IBS decreased from (3.79 ± 1.58) / week to (1.67 ± 0.70) week and 3.18 ± 1.46 to 1.52 ± 0.67, respectively. After 8 weeks, Respectively, from (3.79 ± 1.58) times / week to (1.53 ± 0.69) times / week and from 3.18 ± 1.46 to 1.45 ± 0.66, respectively, with statistical significance (P <0.05). The scores of IBS QOL 8 dimensions were significantly higher than those before treatment except picky eaters. Conclusions Food-specific IgG antibody-mediated immune abnormalities exist in IBS patients. It is significant to eliminate allergic foods based on SIgG levels in patients with IBS.