粪菌移植联合乳果糖治疗老年重度功能性便秘

Effect of fecal microbiota transplantation combined with lactulose on elderly with severe functional constipation

目的研究粪菌移植联合乳果糖治疗老年重度功能性便秘的临床效果。方法随机抽取2014年5月至2017年6月河北北方学院附属第一医院收治的120例老年重度功能性便秘患者,按就诊时间先后顺序分作三组,各40例,A组施予粪菌移植治疗,B组施予乳果糖治疗,C组施予粪菌移植联合乳果糖治疗,对比分析其症状评分、血清胃肠激素水平、肛门直肠动力学指标。结果治疗后,C组粪便性状评分(BSFS)比A、B组高,便秘症状评分(KESS)比A、B组低,差异有统计学意义(P <0.05);C组血清P物质(SP)、血浆胃动素(MTL)均比A、B组高,一氧化氮(NO)、血管活性肠肽(VIP)均比A、B组低,差异有统计学意义(P <0.05);C组直肠顺应性、直肠最低敏感量及最大耐受量均比A、B组低,差异有统计学意义(P <0.05)。结论粪菌移植联合乳果糖治疗老年重度功能性便秘有助于改善症状评分、血清胃肠激素水平及肛门直肠动力学指标,值得推广。

Objective To explore the clinical effect of fecal microbiota transplantatio combined with lactulose in the treatment of elderly with severe functional constipation.MethodTotally 120 cases of elderly patients with severe functional constipation in our hospital from May 2014 to June 2017 were randomly divided into three groups according to the time of visiting hospital,with 40 cases in each group. The patients in group A were given the treatment of fecal microbiota transplantation;those in group B received lactulose treatment and those in group C the combination therapy of fecal microbiota transplantation and lactulose. The symptom score,serum gastrointestinal hormone levels and anorectal dynamic indexes among the 3 groups were compared.Results After the treatment,the score of Bristol stool form scale(BSFS)of group C was higher than that of group A and B,on the contrary,the score of Knowles eccersley scott symptom(KESS)of group C was lower than that of group A and B,which indicated statistical significance(P < 0.05). The levels of substance P(SP)and motilin(MTL)of group C were higher than those of group A and B,while the levels of nitric oxide(NO)and vasoactive intestinal peptide(VIP)of group C were lower than those of group A and B,which was statistically significant(P < 0.05). The rectal compliance,the minimum sensitive dose as well as the maximum tolerance dose of rectum of group C were lower than those of group A and B and it was statistically significant(P < 0.05).Conclusions Microbiota transplantation combined with lactulose in treating elderly with severe functional constipation is conducive to improving the symptom score,serum gastrointestinal hormone levels and anorectal dynamic indexes,and is worthy to be popularized.