益生菌治疗成人特应性皮炎疗效评价

Assessment of efficacy of probiotics in the treatment of atopic dermatitis

目的:评价益生菌治疗成人特应性皮炎(AD)的疗效。方法:40例AD患者随机分为A组和B组,A组给予抗组胺药、0.05%地奈德乳膏及益生菌制剂,B组仅给予抗组胺药和0.05%地奈德乳膏,两组均治疗12周。20名健康者作为对照。治疗前、后及治疗后2个月用SCORAD和VAS法进行病情评分,并用PCR荧光定量法检测受试者粪便中的细菌水平。结果:治疗结束时,A组、B组评分较治疗前均显著降低(P<0.01);停药2个月时,A组评分仍低于治疗前(P<0.01),而此时B组评分与治疗前相比无统计学差异。治疗前A、B组双歧杆菌及乳酸杆菌的数量明显低于健康对照组(P<0.01)。治疗结束及停药2个月时,A组两种杆菌较治疗前均显著增加(P<0.01),B组两种杆菌较治疗前均无显著差异。结论:益生菌可通过增加肠道双歧杆菌及乳酸杆菌菌群而改善病情并延缓复发。

Objective： To evaluate clinical efficacy of probiotics for the treatment of adult AD patients. Methods：Forty patients were enrolled in this study and divided into two groups：the patients in the probiotics group were treated with antihistamine,topical steroid and probiotics. The patients in the non-probiotics group were treated with antihistamine and topical steroid only. The course of the treatment was 12 weeks. Twenty healthy people were used as control. The disease severity was assessed by SCORAD and VAS score at base-line,week 12 and month 2 after stopping the treatment. The change in fecal microbiota was detected by PCR. Results：The SCORAD and VAS scores were significantly reduced in the two groups （ P〈0.01） after the treat-ment,compared with those before the treatment. At month 2 after stopping the treatment, the SCORAD and VAS scores continued to be lower than those at baseline in the probiotics group （ P〈0.01）,but not in the non-probiotics group. Before the treatment, the amount of Bifidobacterium and Lactobacilli in stool of the two groups was higher than that in the healthy control （ P〈0.01） . At end of the treatment and month 2 after stop-ping the treatment, the amount of Bifidobacterium and Lactobacilli was significantly increased （P〈0.01） in probiotics group,rather than in non-probiotics group. Conclusion：Probiotics can improve the clinical status of the disease through increasing the amount of Bifidobacterium and Lactobacilli,and prolong relapse of AD.