益生菌协助治疗老年缺血性结肠炎的临床疗效分析

Clinical Curative Effect of the Combined Treatment with Probiotics on Ischemic Colitis in the Elderly

目的探讨不同益生菌联合改善循环治疗对缺血性结肠炎的临床疗效。方法回顾性分析复旦大学附属华东医院2012年12月-2017年8月收治的193例缺血性结肠炎患者,其中男性54例,女性139例,年龄范围为(60~95)岁,平均年龄(71±3.0)岁,根据治疗用药分为4组:丹参多酚酸盐改善循环治疗组(丹参多酚组)99例,酪酸梭菌活菌联合丹参多酚盐治疗组(酪酸梭菌活菌联合用药组)38例,双歧杆菌三联活菌联合丹参多酚治疗组(三联活菌联合用药组)33例,枯草杆菌、肠球菌二联活菌联合丹参多酚治疗组(二联活菌联合用药组)23例,疗程均为(7~14) d,观察患者的疗效、便血消失时间、腹痛缓解时间以及不良反应发生情况。结果治疗后丹参多酚组、酪酸梭菌活菌联合用药组、三联活菌联合用药组、二联活菌联合用药组的治愈率分别为22.22%(22/99)、39.47%(15/38)、27.27%(9/33)、30.43%(7/23),4组总有效率分别为95.96%(95/99)、97.37%(37/38)、96.97%(32/33)、95.65%(22/23),4组疗效差异不具有统计学意义(P>0.05)。丹参多酚组与联合用药组在便血消失时间、腹痛缓解时间方面差异具有统计学意义(P<0.05),联合用药组在便血消失时间、腹痛缓解时间方面相互之间差异不具有统计学意义(P>0.05)。治疗后4组总不良反应率比较差异无统计学意义(P>0.05)。结论改善循环药物治疗缺血性结肠炎与益生菌联合应用的总有效率基本相同,益生菌联合治疗对缓解临床症状有一定效果,不良反应无明显增加,但经济-成本效益有待进一步深入研究。

Objective To explore the clinical curative effect of different kinds of probiotics combined in the treatment of improving blood circulation in the elderly with ischemic colitis.Methods A retrospective analysis was made to the clinical data of 193 cases with ischemic colitis hospitalized during the period from Dec.2012 to Aug.2017;the 193 cases were divided,according to drug administration,into 4 groups:salvianolate group(n=99,salvanolate was administrated for circulation improvement),clostridium butyricum combined group(n=38,the live bacteria of clostridium butyricum combined with salvianolate),triple viable bacteria group(n=33,bifid triple viable bacteria combined with salvianolate) and double viable live bacteria group(n=23,double viable bacillus subtilis and enterococcus combined with salvianolate);the courses all lasted for 7 to 14 days;an observation was made to the curative effect,the time of hematochezia disappearance,the time of abdominal pain relief and the occurrence of adverse reaction in all the cases.Results After after drug administration,the cure rate was 22.22%(22/99)in salvianolate group,39.47%(15/38) in clostridium butyricum combined group,27.27%(9/33) in triple viable bacteria group and 95.65%(22/23) in double viable live bacteria group,the differences were of no statistical significance among the 4 groups(P>0.05);there existed a statistical difference in the time of hematochezia disappearance and abdominal pain relief between salvianolate group and the 3 combined groups(P<0.05) while no statistical differences were found among the combined groups(P>0.05);The total occurrence of adverse reactions was of no statistical difference among the 4 groups.Conclusions The application of drugs for circulation improvement and that combined with probiotics are of the same total curative effect while the combined treatment is of help in relieving clinical symptoms with no more adverse reactions,which is safe and effective.