双歧三联活菌胶囊对胆囊切除术后腹泻患者血清D-乳酸及肠道菌群的影响

Influence of Bifid Triple Viable Capsules on serum D-lactic acid and intestinal microflora in patients with postcholecystectomy diarrhea

目的探讨双歧三联活菌胶囊对胆囊切除术后腹泻(PCD)患者血清D-乳酸及肠道菌群的影响。方法选取80例PCD患者,随机分为观察组(n=40)和对照组(n=40)。两组均予以低脂饮食和止泻药等常规治疗。观察组加用双歧三联活菌胶囊420mg/次,3次/d,连用6周,温开水或温牛奶送服。检测两组治疗前后血清D-乳酸水平及肠道菌群数量变化,并比较其临床疗效及不良反应。结果观察组与对照组分别失访2例(5.0%)和4例(10.0%),两组失访率比较差异无统计学意义(P>0.05)。治疗6周后,两组血清D-乳酸指标较治疗前均明显下降(对照组治疗前后比较,P<0.05;观察组治疗前后比较,P<0.01),观察组下降幅度较对照组更明显(P<0.05);同时观察组双歧杆菌和乳酸杆菌数量增加,肠杆菌和肠球菌数量下降(P<0.05),而对照组肠道菌群数量变化差异无统计学意义(P>0.05);同时观察组其总有效率(92.11%)较对照组(72.22%)高(χ2=5.05,P<0.05)。结论双歧三联活菌胶囊治疗PCD具有确切疗效,能降低血清D-乳酸指标,纠正并调节患者肠道微生态紊乱,重建肠道微生态平衡,改善其肠道功能。

Objective To discuss the influence of Bifid Triple Viable Capsules on serum D-lactic acid and intestinal microfloras in patients with postcholecystectomy diarrhea（PCD）.Methods Eighty patients with PCD were selected and divided into observation group（n=40）or control group（n=40）at random.Both groups were given routine medical treatment such as low-fat diet,antidiarrheal drugs etc.;The patients in observation group were additionally given 420 mg Bifid Triple Viable Capsules t.i.d.for 6weeks.The changes of serum D-lactic acid level and intestinal microflora were detected,and the clinical efficacy and untoward effect were compared between the two groups.Results Two and four cases of loss to follow-up appeared in observation group（5.0%）and control group（10.0%）respectively;the difference was not statistically obvious（P〉0.05）.The serum D-lactic acid of patients in both groups obviously decreased after treatment（control group P〈0.05,observation group P〈0.01）,and the decreasing rate in observation group was much higher than that in control group（P〈0.05）.The amount of Bifidobacteriaand Lactobacilliin observation group increased obviously,and that of Enterobacteria and Enterococci decreased obviously（P〈0.05）,while the intestinal microflora in control group showed no obvious changes（P〉0.05）.The total efficiency rate in observation group（92.11%）was much higher than that in control group（72.22%）（χ^2=5.05,P〈0.05）.Conclusion Bifid Triple Viable Capsules has reliable curative effect on PCD,which can reduce serum D-lactic acid,correct and adjust disorder of intestinal microflora,rebuild intestinal microecological balance and improve intestinal function.