肠易激综合征患者肠道菌群分析及应用益生菌疗效观察

Therapeutic efficacy of probiotics and analysis of intestinal flora in patients with irritable bowel syndrome

目的了解益生菌治疗肠易激综合征的疗效及治疗前后患者肠道菌群变化。方法选取符合罗马Ⅲ标准的IBS患者26例及年龄、性别相匹配的对照组25人,采用细菌培养法对肠道五种常见菌群进行定量检测,肠易激综合征(IBS)患者给予益生菌治疗,比较治疗前后患者粪便中五种常见菌群数量的变化,同时根据患者治疗前后肠道症状评分评价疗效。结果与健康对照组相比,IBS患者粪便中肠杆菌明显增加(P<0.05);双歧杆菌及乳杆菌差异数量均少于正常人群(P<0.01,P<0.05);B/E值显著低于健康对照组(P<0.01);而肠球菌和拟杆菌差异无统计学意义;治疗后粪便中双歧杆菌及乳杆菌含量均高于治疗前(P<0.01,P<0.05);B/E值增加(B/E>1)但较治疗前差异无统计学意义;肠杆菌、肠球菌、拟杆菌治疗前后差异无统计学意义。服用益生菌制剂4周后,26例IBS患者中16例有效,10例无效,有效率为62%;症状总积分显著降低(P<0.01)。结论 IBS患者存在肠道菌群异常,肠道定植抗力减弱;益生菌制剂能够增加IBS患者肠道有益菌数量,改善肠道症状。

Objective To study the therapeutic efficacy and intestinal flora in patients with irritable bowel syndrome（IBS） before and after treatment with probiotics.Method 26 patients with IBS,defined by the RomeⅢ,in our hospital from March 2011 to June 2011,compared with age-/gender-matched control subjects（n=25）.IBS patients were given bifid triple viable capsule（3 capsules,3 times/d）treatment.At the beginning and 4 weeks after treatment,score of patient＇s clinical symptoms was evaluated by a questionnaire.On the same time,five kinds ofcommon intestinal bacteria was analyzed by using the method of bacterial culture.Results Compared with the control group,the level of enteric bacilli was significantly higher（P0.05）;the level of bifidobacterium and cillobacterium were significantly lower（P0.01 or P0.05）;B/E was significant lower（P0.05）.After taking bifid 4 weeks,16 of 26 IBS patients were effective,while 10 patients were ineffective,and the effective rate was 62%;bifidobacteria and lactobacilli were higher than before treatment（P0.01 or P0.05）;B/E was higher,but not significant（P 0.05）;enterobacter,field bacteria,bacteroides was no significant change（P0.05）.Conclusion Most IBS patients have dysbacteria,probiotics can relive the symptoms of some patients with IBS by increasing the number of probiotics.