双歧杆菌三联活菌辅助治疗溃疡性结肠炎的疗效及其对患者肠道菌群状况及IgG水平的影响

Clinical efficacy of bifidobacterium triple live bacteria as adjuvant therapy for the treatment of ulcerative colitis and its effect on the intestinal microflora and IgG level in patients

目的观察双歧杆菌三联活菌辅助治疗溃疡性结肠炎的疗效,并探讨其对患者肠道菌群状况及免疫球蛋白G(IgG)水平的影响,为临床诊疗提供依据。方法选取2018年1月至2019年6月安康市汉滨区第一医院中西医结合科收治的90例溃疡性结肠炎患者为研究对象,采用随机数表法将患者分观察组和对照组,每组45例。对照组采用柳氮磺胺吡啶治疗,观察组在此基础上联合双歧杆菌三联活菌治疗,均治疗2个月。治疗结束时,比较两组患者的治疗效果,治疗前、治疗后的肠道菌群、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)和IgG水平,以及不良反应发生情况。结果观察组患者的治疗总有效率为93.33%,明显高于对照组77.78%,差异有统计学意义(P<0.05);治疗后,两组患者的乳酸杆菌、肠球菌、双歧杆菌数量均上升,且观察组的上述各项指标[(8.23±1.10)IgCFU/g、(8.87±1.07)IgCFU/g、(7.99±0.67)IgCFU/g]明显高于对照组[(6.87±0.99)IgCFU/g、(7.86±0.98)IgCFU/g、(6.85±0.69)IgCFU/g],差异均有统计学意义(P<0.05);观察组患者治疗后的TNF-α、IgG分别为(16.12±3.45)mg/L、(6.08±0.75)g/L,明显低于对照组的(21.18±3.19)mg/L、(6.08±0.75)g/L,而IL-10为(28.17±5.17)μmol/L,明显高于对照组的(23.15±4.88)μmol/L,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为4.44%,略低于对照组的8.89%,但差异无统计学意义(P>0.05)。结论双歧杆菌三联活菌辅助治疗溃疡性结肠炎患者疗效确切,其可纠正患者肠道菌群紊乱,抑制炎症反应,改善免疫球蛋白水平,减少并发症,可在临床推广使用。

Objective To observe the curative effect of Bifidobacterium triple live bacteria as adjuvant therapy for the treatment of ulcerative colitis,to explore its effect on patients'intestinal microflora and immunoglobulin G(IgG)level,and to provide a basis for clinical diagnosis and treatment.Methods Ninety patients with ulcerative colitis admitted to the Department of Integrated TCM and Western Medicine at the First Hospital of Hanbin District of Ankang City from January 2018 to June 2019 were selected as the research objects,which were randomly divided into the observation group and the control group,with 45 patients in each group.The control group was treated with sulfasalazine,and the observation group was treated by sulfasalazine combined with bifidobacterium triple live bacteria,both for 2 months.At the end of treatment,the treatment effect,the intestinal flora,serum tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),and IgG levels before treatment and after treatment,and the occurrence of complications were compared.Results The total effective rate of the observation group was 93.33%,which was significantly higher than 77.78%in the control group(P<0.05).After treatment,the number of lactobacilli,enterococci,and bifidobacteria in both groups increased,and the above indicators of the observation group were(8.23±1.10)IgCFU/g,(8.87±1.07)IgCFU/g,(7.99±0.67)IgCFU/g,which were significantly higher than(6.87±0.99)IgCFU/g,(7.86±0.98)IgCFU/g,(6.85±0.69)IgCFU/g in the control group(P<0.05).The TNF-αand IgG in the observation group were(16.12±3.45)mg/L,(6.08±0.75)g/L,which were significantly lower than(21.18±3.19)mg/L,(6.08±0.75)g/L in the control group,while IL-10 was(28.17±5.17)μmol/L,which was significantly higher than(23.15±4.88)μmol/L in the control group(P<0.05).The incidence of complications in the observation group was 4.44%,slightly lower than 8.89%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Bifidobacterium triple live bacteria is effective as adjuvant therapy for the treatment of patients with ulcerative colitis,which can correct patients'intestinal flora disturbance,inhibit inflammatory response,improve immunoglobulin levels,reduce complications,and can be promoted in clinical applications.