乳果糖联合双歧杆菌四联活菌治疗功能性消化不良的疗效及其对肠道菌群的影响

Effect of lactulose combined with Bifidobacterium tetravaccine in treatment of functional dyspepsia and its influence on intestinal flora

目的观察乳果糖联合双歧杆菌四联活菌通过调节肠道菌群治疗功能性消化不良的临床疗效。方法功能性消化不良患者194例,随机分为A组(给予莫沙必利5 mg口服,每日3次)49例,B组(给予乳果糖10~30 mL口服,每日3次)49例、C组(给予双歧杆菌四联活菌片1.5 g口服,每日3次)48例,D组(给予乳果糖10~30 mL口服,每日3次,双歧杆菌四联活菌片1.5 g口服,每日3次)48例,连续治疗4周。比较4组治疗前后临床症状评分、口-结肠转运时间(OCTT)和粪便乳杆菌、双歧杆菌、肠球菌、肠杆菌和酵母菌数量的变化情况。结果与治疗前比较,治疗后4组的临床症状评分均降低(P <0.01),OCTT均缩短(P <0.01),除A组肠道菌群数量未见明显变化(P> 0.05),其他3组肠道双歧杆菌和乳杆菌数量均上升,肠杆菌、肠球菌和酵母菌数量均下降(P <0.05)。与其他3组相比,D组临床症状评分下降幅度大(P <0.01),OCTT缩短明显(P <0.01),双歧杆菌和乳杆菌数量上升,肠杆菌、肠球菌和酵母菌数量下降(P <0.05)。D组临床总有效率高于其他3组(P <0.01)。结论乳果糖联合双歧杆菌四联活菌片治疗功能性消化不良疗效优于单用乳果糖、双歧杆菌四联活菌或莫沙必利,更利于调整患者肠道菌群数量、缩短胃肠运动时间及改善临床症状。

AIM To observe the clinical effect of lactulose combined with Bifidobacterium tetravaccine in the treatment of functional dyspepsia by regulating intestinal flora. METHODS One hundred and ninety-four patients with functional dyspepsia were randomly divided into group A(mosabili 5 mg was taken orally three times a day), group B(lactulose 10-30 mL was given orally three times a day), group C(Bifidobacterium tetravaccine 1.5 g was given orally three times a day), and group D(lactulose 10-30 mL and Bifidobacterium tetravaccine 1.5 g were given orally three times a day) for 4 weeks. The changes of clinical symptom score, oral colon transit time, fecal lactobacillus, Bifidobacterium, Enterococcus, Enterobacterium and Yeast quantity in the four groups before and after treatment were observed and compared. RESULTS Compared with before treatment, the clinical symptom scores of the 4 groups were reduced after treatment(P < 0.01), and OCTT was shortened(P < 0.01). Except for group A, there was no significant change in the number of intestinal flora(P > 0.05), the number of intestinal Bifidobacterium and Lactobacillus in the other three groups were increased, and the number of Enterococcus, Enterobacterium and Yeast were decreased(P < 0.05). Compared with the other 3 groups, the clinical symptom scores of the group D were decreased greatly(P < 0.01), OCTT was significantly shortened(P < 0.01), the number of Bifidobacterium and Lactobacillus was increased, and the number of Enterococcus, Enterobacterium and Yeast was decreased(P < 0.05). The clinical total effective rate of group D was higher than that of the other 3 groups(P < 0.01). CONCLUSION The efficacy of lactulose combined with Bifidobacterium tetravaccine in the treatment of functional dyspepsia is better than lactulose, Bifidobacterium tetravaccine or mosabili alone, and it is more conducive to adjust the number of intestinal flora, shorten the time of gastrointestinal movement and improve the clinical symptoms.