Abstract:

Irritable bowel syndrome（IBS） is a common cause of chronic abdominal pain in children with the high incidence and long-term negative impact on quality of life. The pathogenesis of IBS is unknown. Intestinal microecological imbalance has been found to be closely related to IBS in recent years. In IBS patients，the intestinal microbial colonization resistance is impaired（B/E value is decreased），the diversity and stability of intestinal microbiology is generally decreased，and the number of  E.coli and Enterococcus increased with bifidobacteria and lactobacilli decreased. There is no specific treatment for IBS，and modulation  of  intestinal micro-ecological  could be an important target for treatment of IBS. In detail，probiotics could be used as an adjunct to IBS therapy，while the exact efficacy need to be evaluated by high quality clinical trials. There is no evidence that prebiotics, synbiotics and FMT could be used to treat IBS. Whether rifaximin be effective for treatment of IBS or not need more evidence.

Key words: intestinal microbiota, irritable bowel syndrome, child

摘要：

肠易激综合征（IBS）是儿童慢性腹痛的常见原因，发病率高，长期可严重影响生活质量。IBS确切发病机制不明，近年发现，肠道微生态失平衡与IBS关系密切，IBS患者肠道微生物定植抗力受损（B/E值降低），肠道微生物总体的多样性和稳定性普遍降低，大肠杆菌和肠球菌属数量增加，双歧杆菌和乳酸杆菌数量减少。IBS无特异性的治疗方法，调节肠道微生态是治疗IBS的重要靶点。益生菌可作为IBS治疗的辅助手段，能否作为主要治疗药物加以推荐尚需更充分的临床证据，确切疗效尚需要开展高质量的临床双盲、随机、对照研究进一步验证，尚无证据表明益生元、合生元、粪菌移植（FMT）可用于治疗IBS。利福昔明治疗IBS可能有效，但需要更多的证据。

关键词: 肠道微生态, 肠易激综合征, 儿童