粪菌移植联合乳果糖对老年慢性功能性便秘的治疗效果

Effect of fecal bacteria transplantation combined with lactulose in treatment of chronic functional constipation in the elderly

目的探讨粪菌移植联合乳果糖对老年慢性功能性便秘的治疗效果。方法以本院2017年9月至2018年9月收治的86例功能性便秘老年患者为对象,按电脑数字表法随机分为两组,每组各43例,对照组予以乳果糖治疗,实验组予以粪菌移植联合果乳糖治疗,对比两组疗效。结果治疗后,实验组氧菌群酵母菌水平是(4.21±0.20)logN·g^-1,肠杆菌是(8.89±0.22)logN·g^-1,分别较对照组的(5.34±0.14)logN·g^-1、(8.02±0.31)logN·g^-1低,实验组双歧杆菌水平是(9.38±0.21)logN·g^-1,厌氧菌群乳杆菌是(7.17±0.22)logN·g^-1,分别较对照组的(8.31±0.25)logN·g^-1、(6.28±0.15)logN·g^-1高,差异有统计学意义(P<0.05);治疗后,实验组血清血管活性肠肽(vasoactineintrestinalpeptide,VIP)水平较对照组低,乙酰胆碱(acetylcholine,ACH)、c-kit原癌基因(C-KIT)蛋白水平较对照组高,差异有统计学意义(P<0.05);治疗后,实验组胃肠动力的餐前与餐后平均幅值、餐前与餐后平均频率均较对照组高,差异有统计学意义(P<0.05);治疗后,实验组Bristol粪便性状评分(Bristolstoolformscale,BSFS)较对照组高,Wexner便秘评分、便秘患者生活质量评价表(Patient-Assessment of Constipation Quality Of Life,PAC-QOL)评分较对照组低,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慢性功能性便秘有助于改善患者肠道菌群及神经递质,并且提升胃肠道动力。

Objective To investigate the effect of fecal bacteria transplantation combined with lactulose in the treatment of chronic functional constipation in the elderly.Method A total of 86 cases of elderly patients with functional constipation admitted to our hospital from September 2017 to September 2018 were enrolled in the study and rando mLy divided into control group and experimental group with fecal transplantation com-bined with lactose,with 35 cases in each group.The efficacy was compared between the two groups.Result After the treatment,the level of oxygen bacteria yeast in the intestinal flora of the experimental group was(4.21±0.20)logN·g^-1,and enterobacter(8.89±0.22)logN·g^-1,which were lower than those of the control group(5.34±0.14)logN·g^-1 and(8.02±0.31)logN·g^-1 respectively).In the experimental group,the level of bifidobacteria was(9.38±0.21)logN·g^-1,and the Lactobacillus of anaerobic group was(7.17±0.22)logN·g^-1,which were higher than those of the control group,(8.31±0.25)logN·g^-1 and(6.28±0.15)logN·g^-1 respectively),and the difference was statistically significant(P<0.05).The level of VIP in the experimental group was lower than that of the control group,and the levels of ACH and C-KIT in the experimental group were higher than those of the control group,and the difference was statistically significant(P<0.05).The mean change amplitude and pre-and post-meal frequency of gastrointestinal motility in the experimental group were higher than those in the control group,which was statistically significant(P<0.05).The score of Bristol stool form scale(BSFS)in the experimental group was higher but the Wexner constipation score and Patient-Assessment of Constipation Quality Of Life(PAC-QOL)score were lower than those in the control group and the difference was statistically significant(P<0.05).Conclusion Fecal bacteria transplantation combined with lactulose in the treatment of chronic functional constipation in the elderly can help to improve the intestinal flora and neurotransmitters,as well as improve the gastrointestinal motility.