肠道菌群移植、益生菌分别联合美沙拉嗪对轻、中度溃疡性结肠炎肠道屏障功能的影响

The effects of intestinal flora transplantation and probiotics combined with mesalazine on intestinal barrier function in mild and moderate ulcerative colitis

目的探讨肠道菌群移植、益生菌分别联合美沙拉嗪对轻、中度溃疡性结肠炎肠道屏障功能的影响。方法选取116例溃疡性结肠炎患者,采用抽签随机分为A组38例、B组38例和C组40例,A组采用甲硝唑+美沙拉嗪;B组采用益生菌+美沙拉嗪;C组采用肠道菌群移植+美沙拉嗪,三组均治疗6周,对比治疗前后Mayo内镜积分、临床疗效、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、血沉(ESR)及尿乳果糖/甘露醇(L/M)和不良反应。结果治疗后A、B组Mayo内镜积分比较,差异无统计学意义(P>0.05),C组Mayo内镜积分低于A、B组,治疗总有效率高于A、B组(P<0.05);三组治疗后IL-6、TNF-α、CRP、ESR及L/M值较治疗前降低,且C组各项指数低于其他两组(P<0.05);三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论肠道菌群移植联合美沙拉嗪对轻、中度溃疡性结肠炎的治疗临床疗效较好,可有效改善肠道屏障功能,临床价值较高。

Objective To investigate the effect of intestinal flora transplantation or probiotics combined with mesalazine on intestinal barrier function in patients with mild and moderate ulcerative colitis.Methods One hundred and sixteen patients with ulcerative colitis admitted to our hospital were randomly divided into group A(n=38),B(n=38)and C(n=40).The group A was treated with metronidazole+mesalazine,the group B was treated with probiotics and mesalazine and the group C was treated with intestinal flora transplantation+mesalazine.All the three groups were observed for 6 weeks.Mayo endoscopic score,clinical efficacy,IL-6,TNF-α,C-reaction protein(CRP),erythrocyte sedimentation rate(ESR),urinary lactulose/mannitol(L/M)ratio and adverse reactions before and after treatment were compared among the three groups.Results There was no significant difference in Mayo endoscopic score between the group B and the group A(P>0.05).The score of Mayo endoscopy in the group C was significantly lower than that in the group A and B(P<0.05).The total effective rate of the group C was significantly higher than that of the group A and B(P<0.05).After treatment,the levels of IL-6,TNF-α,CRP,ESR and L/M ratio in the three groups were lower than those before treatment,and the indexes in the group C were significantly lower than those in the other two groups(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion The clinical effect of intestinal flora transplantation combined with mesalazine in the treatment of mild and moderate ulcerative colitis is better.It can effectively improve the intestinal barrier function and has a higher clinical value.