双歧杆菌四联活菌片对胆囊切除术后腹泻患者肠道微生态及胃肠激素的影响

Influence of tetragenous Bifidobacterium tablets on intestinal microecology and gastrointestinal hormone of patients with postcholecystectomy diarrhea

目的探讨双歧杆菌四联活菌片对胆囊切除术后腹泻(PCD)患者肠道微生态及胃肠激素的影响。方法选取72例PCD患者随机分为观察组与对照组。两组均给予饮食调整和蒙脱石散口服等治疗。观察组加用双歧杆菌四联活菌片1.5g/次,3次/d,温水送服,连用8周。评估两组治疗前后肠道菌群数量[乳酸杆菌、双歧杆菌、大肠杆菌和双歧杆菌(B)与大肠杆菌(E)的比值]及血清胃肠激素[血管活性肠肽(VIP)和5-羟色胺(5-HT)]的变化,并比较其临床效果。结果治疗8周后,两组双歧杆菌、乳酸杆菌数量及B/E比值与其治疗前数据比较上升,大肠杆菌数量与其治疗前数据比较下降(P<0.05或P<0.01),且治疗后观察组改善更显著(P<0.05);两组血清VIP和5-HT与其治疗前数据比较下降(P<0.05或P<0.01),且治疗后观察组下降更显著(P<0.05);同时观察组总有效率较对照组更佳(χ2=5.26,P<0.05)。结论双歧杆菌四联活菌片治疗PCD的疗效确切,能调节肠道菌群紊乱,重建肠道微生态平衡;并能调节血清胃肠激素的分泌,降低血清VIP和5-HT水平,改善肠道功能。

Objective To discuss the influence of tetragenous Bifidobacterium tablets on intestinal microecology and gastrointestinal hormones of patients with postcholecystectomy diarrhea（PCD）.Methods Seventy-two patients with PCD were randomly divided into observation group or control group.Both groups were given diet adjustment and oral Montmorillonite powder,while the observation group was additionally given tetragenous Bifidobacterium tablets,1.5 g tid for 8 weeks.The changes of quantities of intestinal flora[Lactobacilli,Bifidobacteria,Escherichia coli and the ratio of Bifidobacterium（B）/Escherichia coli（E）]and serum gastrointestinal hormones [vasoactive intestinal peptide（VIP）and 5-hydroxytryptamine（5-HT）]in two groups before and after treatment,as well as the clinical effect were observed and compared.Results After treatment,the quantities of Bifidobacteria and Lactobacilli and the ratio of B/E in both groups increased,while that of Escherichia coli declined（P〈0.05 or P〈0.01）.The improvement of intestinal flora in observation group was superior to that in control group（P〈0.05）.The serum VIP and5-HT of patients in both groups declined after treatment（P〈0.05 or P〈0.01）,and the declining rate in observation group was much higher than that in control group（P〈0.05）.The total clinical efficiency rate in observation group was much higher than that in control group（χ2=5.26,P〈0.05）.Conclusion Tetragenous Bifidobacterium tablets have reliable curative effect on PCD,which can adjust the disorder of intestinal flora,rebuild the balance of intestinal microecology,regulate the secretion of serum gastrointestinal hormones,reduce the levels of serum VIP and 5-HT,and improve intestinal function.