肠内外营养对炎症性肠病的治疗价值

炎症性肠病是一种病程长且反复的疾病,它的发病可能与环境、免疫、肠道微生态与基因有关.由于摄入减少、消化吸收不良、丢失增加、能量-蛋白质改变和药物作用等各种原因,炎症性肠病患者不管在急性期还是缓解期常常出现营养不良.然而,营养不良又妨碍炎症性肠病治疗的效果,所以肠内外营养对炎症性肠病的治疗就显得至关重要.本文归纳了肠内外营养治疗的价值及成分改良对治疗价值影响的主要进展,最后在此基础上,为了使得营养治疗更有针对性,本文对炎症性肠病患者的营养遗传学及营养基因组学研究提出了展望.     

干细胞移植治疗炎症性肠病的进展

我国炎症性肠病(IBD)发病率逐年上升.近年来的研究发现干细胞移植对于炎症性肠病尤其是难治病例的治疗有效,故本文对既往干细胞移植治疗IBD的基础和临床研究进行回顾,总结干细胞移植对于炎症性肠病治疗的研究进展.     

炎症性肠病的临床治疗新进展

炎症性肠病是一种累及胃肠道的慢性疾病,目前主要治疗药物如氨基水杨酸制剂和免疫抑制剂均有一定的局限性.英夫利昔等多种生物制剂的使用,临床已取得可靠疗效,为患者带来更多治疗机会.随着对炎症性肠病发病机制认识的不断深入,针对免疫功能异常的新的治疗手段也越来越被人们所接受和使用,本文就目前IBD的生物免疫治疗进展做一综述.     

健康者肠道细菌移植治疗炎症性肠病的应用前景

炎症性肠病(inflammatory bowel disease,IBD)包括克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC),其病因和发病机制目前尚不清楚,近来研究显示肠道细菌参与IBD的发生.本文针对肠道菌群与IBD发病的相关性,以及肠道细菌移植在肠道疾病及代谢性疾病中的应用,探讨肠道细菌移植治疗IBD的应用前景.     

炎症性肠病的药物治疗现状及进展

炎症性肠病（IBD）病程迁延反复,影响患者生活质量,耗费卫生资源。虽然传统药物如5-氨基水杨酸、糖皮质激素、免疫抑制剂等仍是目前治疗主流,但是大量有关发病机制的研究以及循证医学的发展对IBD的治疗产生了积极的推进作用。IBD的治疗正步入免疫调节的生物学时代,多种新型生物制剂的出现为IBD的治疗提供了新的策略和选择。现就目前IBD药物治疗现状以及最新进展进行综述,以期对临床IBD治疗提供参考。     

炎症性肠病对育龄女性的影响及对策

炎症性肠病（IBD）临床表现为反复的黏液脓血便、腹痛、腹泻,甚至出现全身并发症。近年来其发病率呈逐年上升趋势。女性患者遗传给后代的几率高于男性患者,重症炎症性肠病往往需要手术治疗,影响女性患者的生育力,女性患者在妊娠、分娩期常常出现IBD活动或暴发加剧,使患者病情复杂化,严重影响育龄女性的身体健康。如何正确处理育龄女性IBD患者关系其生育力和妊娠、分娩安全以及胎儿安全。本文将从IBD对育龄女性生育力、妊娠、分娩、哺乳及胎儿的影响等方面进行综述,以帮助育龄女性IBD患者应对生育问题。     

炎症性肠病合并细菌感染

炎症性肠病(IBD)病因不明,微生物异常包括肠道微生态紊乱及某些病原微生物感染可能是其发病和反复发作的重要触发因素。研究发现缓解期IBD的复发常常由一些肠道感染因素诱发,因此在活动期的患者中经常可以发现肠道病原微生物的重叠感染,另一方面由于IBD在治疗过程中经常会使用免疫抑制剂、生物制剂及皮质激素等药物,本身机会感染的可能性也大大增加,例如难辨梭状芽孢杆菌、巨细胞病毒等,造成了病情的加重以及治疗困难。本文就IBD与细菌感染的关系综述如下。     

T细胞免疫球蛋白与黏蛋白-3与炎症性肠病异常免疫研究进展

T细胞免疫球蛋白与黏蛋白‐3（Tim‐3）是 T细胞免疫球蛋白与黏蛋白（Tims）家族中一个重要的成员，具有多种生物学作用，主要参与机体固有免疫及适应性免疫应答的调节，与过敏、哮喘、炎症性疾病、自身免疫性疾病、肿瘤等多类疾病相关。炎症性肠病（IBD ）是一组反复发作的慢性肠道炎症性疾病，其发病机制并不十分清楚，近年研究...     

肠易激综合征发病机制研究中的几个问题

肠易激综合征是一种肠道功能性疾病,是目前消化病领域的研究热点,近10年来肠易激综合征发病机制的研究没有突破性进展,本文从哲学基本原理的视角对肠易激综合征发病机制研究中的困惑进行思考与分析,希望给今后的肠易激综合征发病机制研究带来一些启示。     

肠易激综合征发病机制研究中的几个问题

肠易激综合征是一种肠道功能性疾病,是目前消化病领域的研究热点,近10年来肠易激综合征发病机制的研究没有突破性进展,本文从哲学基本原理的视角对肠易激综合征发病机制研究中的困惑进行思考与分析,希望给今后的肠易激综合征发病机制研究带来一些启示.     

Substance P at the nexus of mind and body in chronic inflammation and affective disorders

For decades, research has demonstrated that chronic diseases characterized by dysregulation of inflammation are particularly susceptible to exacerbation by stress and emotion. Likewise, rates of depression and anxiety are overrepresented in individuals suffering from chronic inflammatory disease. In recent years, substance P has been implicated in both the pathophysiology of inflammatory disease and the pathophysiology of depression and anxiety by 2 parallel fields of study. This review integrates the literature from these 2 parallel fields and examines the possibility that substance P dysregulation may be a point of convergence underlying the overlap of chronic inflammatory disease and mood and anxiety disorders. First, the involvement of substance P in peripheral inflammation and in the immune events associated with chronic inflammatory disease is discussed, with a focus on inflammatory bowel disease and asthma. Next, the function of substance P in the communication of peripheral inflammation to the brain is considered. Finally, to complete the bidirectional loop of brain-immune interactions, substance P expression in anxiety and depression as well as its potential role in the neural regulation of peripheral inflammation is reviewed.     

The Experience of Self-conscious Emotions in Inflammatory Bowel Disease: A Thematic Analysis

Journal of Clinical Psychology in Medical Settings - Few studies have investigated emotional experiences in people living with inflammatory bowel disease (IBD). However, self-conscious emotions,...     

Resilience Factors in Paediatric Inflammatory Bowel Disease: Health Care Provider,Parent and Youth Perspectives

Journal of Child and Family Studies - Exploring factors related to resilience in youth with inflammatory bowel disease may elucidate modifiable risk factors and inform interventions. Yet, how...     

Participation and Attrition in a Coping Skills Intervention for Adolescent Girls with Inflammatory Bowel Disease

The current study examined factors associated with adolescent and parent participation in a coping skills intervention for adolescent girls with inflammatory bowel disease (IBD) and examined factors associated with attrition related to intermittent missing data. Thirty-one adolescent girls with IBD and their parents enrolled in the intervention. Psychosocial and disease factors related to participation in the 6-week web component of the coping skills intervention were examined as were baseline group differences between those who provided post-treatment data and those who did not. Adolescents experiencing more difficulties related to their disease and psychosocial functioning participated less in the web component of the treatment intervention. Families who attrited had higher baseline levels of parental catastrophic thoughts, parenting stress, and adolescent depression. Families experiencing greater levels of psychological and disease-related difficulties may be at risk for low participation and eventual dropout from pediatric IBD psychological treatment interventions.     

Patient Perspectives on Medical Trauma Related to Inflammatory Bowel Disease

Journal of Clinical Psychology in Medical Settings - Post-traumatic stress symptoms (PTSS) in response to medical trauma are understudied in inflammatory bowel disease (IBD). Two studies identify...     

Collaborating With Pediatric Gastroenterologists to Treat Co-Occurring Inflammatory Bowel Disease and Anxiety in Pediatric Medical Settings

Children and adolescents with inflammatory bowel disease (IBD) have distinct physical and emotional challenges that may place them at risk for developing anxiety and that may impede their receipt of mental health treatment. Only a handful of studies have applied empirically validated cognitive behavioral therapy (CBT) to IBD-related issues and no studies have examined the benefit of CBT for anxiety disorders in pediatric IBD. The aim of this paper is to describe a newly adapted cognitive behavioral treatment protocol, Treatment of Anxiety and Physical Symptoms related to IBD (TAPS + IBD), that has been tailored to concurrently address anxiety, including IBD-specific anxiety, and disease management in children and adolescents with IBD in pediatric medical offices. Two case studies are presented to demonstrate treatment implementation and preliminary assessment data. General considerations for health providers working with youth with comorbid anxiety and IBD from a multidisciplinary perspective and future research directions are provided.     

People Living with Inflammatory Bowel Disease Want Multidisciplinary Healthcare: A Qualitative Content Analysis

This study reports on the preferences of people with inflammatory bowel disease (IBD) for their healthcare. Overall, 477 people with IBD responded to an open-ended survey question within a larger study. We qualitatively content-analysed these responses with open coding using NVivo. Respondents expressed a desire for (1) better communication, (2) multidisciplinary care, (3) better treatment, services and specialist care, (4) whole person care, (5) health promotion, (6) proactive healthcare, (7) fewer administrative issues and (8) improved hospital experience. Patients with IBD want patient-centred, multidisciplinary care. Healthcare professionals should facilitate patients’ access to proactive care.

     

腹腔镜在盆腔炎中的应用

急性盆腔炎发病率高,并发症多,是常见妇科急腹症之一,而早期明确诊断和及时处理是治疗成功的关键。本文初步探讨了腹腔镜作为一种检查和治疗的手段在急性盆腔炎的应用价值,结果提示其具有较好的临床应用价值。     

Das Reizdarmsyndrom

Irritable bowel syndrome is a common disorder that can be associated with significant disability and health care costs. Beyond it is the most common disease diagnosed by gastroenterologists. Diagnosis is based on typical complaints including abdominal pain, bloating, irregularities of bowel movements and defecation. The discussion of different etiopathogenetic models showed that irritable bowel syndrome is a biopsychosocial disorder in which psychosocial factors, altered motility and visceral hypersensitivity interact. When symptoms are moderate to severe and are associated with psychological distress and impaired quality of life, psychological treatments can be considered. Apart from symptomatic treatment with loperamide for diarrhoea and antidepressants for abdominal pain and comorbid psychological symptoms for example cognitive behavioral treatment, hypnotherapy, psychodynamic short-term psychotherapy and functional relaxation are being evaluated.