中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (7): 579-583.DOI: 10.19538/j.ek2026070608

• 专题笔谈 • 上一篇    下一篇

儿童肠易激综合征诊疗思路：从罗马Ⅳ到罗马V

  

  1. 上海交通大学医学院新华医院儿消化营养科，上海　　200092
  • 出版日期:2026-07-06 发布日期:2026-09-17
  • 通讯作者: 王莹，电子信箱：wangying02@xinhuamed.com.cn

Diagnostic and therapeutic perspectives of pediatric irritable bowel syndrome: from Rome Ⅳ to Rome Ⅴ

  1. Division of Pediatric Gastroenterology and Nutrition，Xinhua Hospital Affiliated to Shanghai Jiao Tong University，School of Medicine，Shanghai  200092，China
  • Online:2026-07-06 Published:2026-09-17

摘要： 儿童肠易激综合征（irritable bowel syndrome，IBS）是儿科最常见的肠- 脑互动异常（disorders of gut-brain interaction，DGBI）之一。危险因素包括家庭环境因素、饮食因素、感染因素、遗传因素等。中国儿童IBS 的流行病学数据较少，临床可能存在过度检查、不合理饮食限制及心理行为干预不足等问题。文章主要基于从罗马Ⅳ到罗马Ⅴ标准的演变，从诊断标准更新、亚型、报警征象识别、诊断策略及分层治疗等方面阐述儿童IBS 的临床诊疗思路，强调心理行为干预、饮食管理以及多学科协作，以期为中国儿科临床工作和研究提供参考。

关键词: 肠易激综合征, 儿童, 罗马Ⅴ标准, 肠- 脑互动异常

Abstract: Irritable bowel syndrome（IBS）is one of the most common disorders of gut-brain interaction（DGBI）in pediatric practice.Risk factors include environmental and family factors，dietary factors，infectious factors，and genetic factors. Epidemiological data on childhood IBS in China remain limited，and in current clinical practice there may be excessive diagnostic testing，inappropriate dietary restrictions，and inadequate psychobehavioral intervention.This review discusses the clinical approach to diagnose and manage pediatric IBS in the context of the transition from the Rome Ⅳ to the Rome V criteria.Key aspects include updates to the diagnostic criteria，disease subtyping，recognition of alarm features，diagnostic strategies，and stratified treatment，with emphasis on psychobehavioral intervention， dietary management，and multidisciplinary collaboration. The aim is to provide references for clinical practice and future research in pediatrics in China.

Key words:  , irritable bowel syndrome, children, Rome Ⅴ criteria, disorders of gut-brain interaction