枯草杆菌二联活菌肠溶胶囊对溃疡性结肠炎患者肠道菌群的影响

Influence of enteric-coated Bacillus subtilis and Enterococcus faeciumcapsules on gut flora of patients with ulcerative colitis

目的探讨枯草杆菌二联活菌肠溶胶囊对溃疡性结肠炎患者肠道菌群的影响。方法选取2017年4月至2017年9月同济大学附属第十人民医院消化内科门诊收治的10例溃疡性结肠炎患者为研究对象。患者均在美沙拉嗪治疗基础上加用枯草杆菌二联活菌肠溶胶囊治疗1个月,留取治疗前后新鲜粪便样本,并采用16SrRNA细菌检测技术鉴定肠道菌群。结果患者经过治疗后其肠道菌群的丰富度没有发生改变,菌群的多样性增高。在门水平上,厚壁菌门丰度增高,而变形菌门的丰度下降。在属水平上,Actinobacillus和Escherichia/Shigella的丰度下降,Veillonella、Clostridium XIVa、Blautia、Proteus、Flavonifractor等的丰度增高(P<0.05)。通过Lefse分析发现c_Gammaproteobacteria和p_Firmicutes是患者治疗前后的特征性菌群。结论枯草杆菌二联活菌肠溶胶囊可以改善溃疡性结肠炎患者的肠道菌群失调,在常规治疗中添加益生菌可成为一种新的治疗策略。

Objective To observe the changes of gut microbiota during the treatment of ulcerative colitis（UC）with enteric-coated Bacillus subtilis and Enterococcus faecium capsules.Methods 10 UC patients in the department of gastroenterology of our hospital from July,2017 to September,2017 were selected.Fresh stool samples were collected before and after one month′s treatment with enteric-coated Bacillus subtilis and Enterococcus faecium capsules based on mesalamine therapy.16 SrRNA were used to identify the intestinal bacteria（V4 region）.Results After treatment,the gut microbiota of UC patients had significant changes in the diversity instead of richness.At phylum level,the abundance of Proteobacteria decreased（P〈0.05）while that of Firmicutes increased（P〈0.05）after the treatment.At genus level,the abundances of Actinobacillus and Escherichia/Shigelladecreased while those of Veillonella,Clostridium XIVa,Blautia,Proteus and Flavonifractorincreased（P〈0.05）.Lefse analysis found that c_Gammaproteobacteriaand p _Firmicutes were the characteristic genera for the treatment.Conclusion Enteric-coated Bacillus subtilis and Enterococcus faecium capsules can improve the gut bacterial structure of UC patients.Combination of the capsules with conventional therapy is expected to be a promising therapeutical strategy for UC treatment.