小麦纤维素颗粒联合凝结芽孢杆菌活菌片治疗晚期妊娠便秘的临床观察

Wheat cellulose granules combined with viable Bacillus coagulans tablets in treatment of constipation in late pregnancy

目的评估小麦纤维素颗粒联合凝结芽孢杆菌活菌片治疗晚期妊娠便秘的临床疗效及安全性。方法选择210例晚期妊娠便秘孕妇,采用随机数字表方法,将孕妇分为三组,分别为小麦纤维素组、益生菌组和联合组,每组70例。小麦纤维素组孕妇给予服用小麦纤维素颗粒(商品名:非比麸),3.5g/次,每天2次,连续服用2周。益生菌组孕妇给予口服凝结芽孢杆菌活菌片,首次2.1g,以后1.05g/次,3次/d,温水送服,连续服用2周。联合组孕妇给予口服凝结芽孢杆菌活菌片和小麦纤维素颗粒(用法同前),连续服用2周。比较三组孕妇治疗前后大便性状评分和每周排便次数,粪便菌群中乳杆菌属、肠球菌属、酵母样真菌变化情况。观察三组孕妇治疗过程中的不良反应。结果联合组孕妇总有效率为91.43%,明显高于益生菌组(84.29%)和小麦纤维素组(82.86%),差异均具有统计学意义(P<0.05)。治疗结束后,联合组孕妇大便性状评分和每周排便次数均优于小麦纤维素组和益生菌组,差异均具有统计学意义(P<0.05);联合组孕妇乳杆菌属和肠球菌属均高于小麦纤维素组和益生菌组,差异均具有统计学意义(P<0.05);联合组孕妇酵母样真菌均低于小麦纤维素组和益生菌组,差异均具有统计学意义(P<0.05)。三组孕妇治疗过程中未出现明显的恶心、呕吐、腹痛、腹泻、过敏等不良反应,治疗期间检测血糖无异常。结论麦纤维素颗粒联合凝结芽孢杆菌活菌片治疗晚期妊娠便秘具有良好的临床疗效,可有效改善孕妇的大便性状和增加排便次数,能有效改善肠道菌群分布,安全性较高,值得临床推广使用。

Objective To evaluate the clinical efficacy and safety of wheat cellulose granules combined with viable Bacillus coagulans tablets in the treatment of constipation in late pregnancy.Methods 210 cases of late pregnancy with constipation were selected and randomly divided into wheat cellulose group,probiotic group or combination group respectively,with 70 patients in each group.The wheat cellulose group received Fiberform,3.5g bid for two weeks.The probiotic group was treated with viable Bacillus coagulans tablets,2.1g for the first time,then 1.05 g tid for two weeks.The combination group was given oral wheat cellulose granules and viable Bacillus coagulans tablets（usage as above）for two weeks.The stool form scale and weekly defecation frequency,as well as the changes of Lactobacilli,Enterococci and Yeast-like fungi in fecal flora before and after the treatment were compared between the groups.Adverse reactions during the treatment were observed.Results The total efficiency rate in combination group was 91.43%,significantly higher than probiotic group（84.29%）and wheat cellulose group（82.86%）（P〈0.05）.After treatment,the stool form scale and weekly defecation frequency of combination group were better than those of wheat cellulose group and probiotic group;the differences were statistically significant（P〈0.05）.The amounts of Lactobacilli and Enterococci of combination group were significantly higher than those of wheat cellulose group and probiotic group（P〈0.05）.The amount of yeast-like fungi of combination group was significantly lower than that of wheat cellulose group and probiotic group（P〈0.05）.No obvious adverse reactions were found in the three groups during treatment.Conclusion Wheat cellulose granules combined with viable Bacillus coagulans tablets has good clinical efficacy in the treatment of constipation in late pregnancy,which can effectively improve stool characters,increase defecation frequency,and effectively improve intestinal flora balance with high safety.