微生态制剂培菲康经结肠途径给药联合补中益气丸治疗老年人肠道菌群失调相关性腹泻的临床研究

Therapeutic effect of Bifico administered colorectally combined with Buzhong Yiqi Pills on intestinal dysbiosis-associated diarrhea in elderly patients

目的观察微生态制剂培菲康经结肠途径给药联合补中益气丸治疗老年人肠道菌群失调相关性腹泻的临床疗效。方法选取2013年1月至2014年12月于浙江省农业科学院卫生所确诊为肠道菌群失调相关性腹泻的老年患者105例,采用随机数字表法将患者分为培菲康组、联合组和灌肠组,每组各35例。在常规治疗基础上,培菲康组患者给予口服培菲康,联合组患者在口服培菲康基础上,联合口服补中益气丸,灌肠组患者给予培菲康灌肠,联合补中益气丸治疗。观察并比较两组临床症状改善情况、粪便检查结果及临床疗效。结果 3组平均起效时间之间的差异有统计学意义(F=5.273,P<0.05),以灌肠组最快,其次为联合组、培菲康组。治疗14d后3组临床症状发生比例均较治疗前显著减少(P<0.05),治疗后3组之间差异无统计学意义(P>0.05)。治疗后3组间比较,双歧杆菌、乳杆菌数量、肠道定植抗力在3组间的差异均有统计学意义(P<0.05),其中,灌肠组显著优于其他两组(P<0.05)。联合组、灌肠组的真菌感染发生率显著低于培菲康组(P<0.05)。3组中以灌肠组的总有效率最高,其次为联合组、培菲康组。3组治疗过程中均未出现明显不良反应。结论与单用培菲康比较,联合使用补中益气丸可提高对老年人肠道菌群失调相关性腹泻的临床疗效,而培菲康经结肠途径给药疗效更优于口服给药,更有利于有益菌的定植生长,重建肠道微生态平衡,不良反应较轻,患者耐受良好,值得在临床推广应用。

Objective To observe the efficacy of colorectally-administered Bifico combined with Buzhong Yiqi Pills on intestinal dysbiosis-associated diarrhea in elderly patients.Methods 105 elderly patients diagnosed as intestinal dysbiosis associated diarrhea were divided into Bifico group,combination group or lavage group randomly with 35 cases in each group.On the basis of conventional therapy,the Bifico group was given Bifico orally,the combination group was give Bifico combined with Buzhong Yiqi Pills orally,while the lavage group was given Bifico via intestinal lavage and Buzhong Yiqi Pills orally.The improvement of symptoms,stool test results and clinical efficacy were observed and compared.Results The differences in the average onset times between the three groups were statistically significant（F=5.273,P〈0.05）,which was the shortest in the lavage group,followed by the combination group and Bifico group.After 14 days of treatment,the incidence of clinical symptoms in the three groups significantly reduced than before（P〈0.05）,but there were no statistically significant differences between the three groups（P〈0.05）;The differences in the quantity and intestinal colonization resistance of Bifidobacteriaand Lactobacilli were statistically significant between groups（P〈0.05）,with those in the lavage group significantly superior to the other two groups（P〈0.05）.The incidences of fungal infections in lavage group and combination group were significantly lower than in Bifico group（P〈0.05）.The total efficiency rate in lavage group was the highest,followed by combination group and then Bifico group.No obvious adverse reactions occurred during the treatment.Conclusion Compared with Bifico alone,Bifico combined with Buzhong Yiqi pills is more effective for intestinal dysbiosis associated diarrhea in the elderly,and Bifico by colorectal administration is superior to oral administration,which can promote the colonization of beneficial bacteria and help rebuild intestinal microflora balance,with mild adverse reactions and good tolerance.