益生菌干预治疗阿司匹林相关小肠黏膜损伤的前瞻性随机对照临床研究

A prospective randomized controlled clinical study of probiotics investigation in the treatment of aspirin related small intestinal mucosal injury

目的探讨益生菌干预治疗对阿司匹林相关小肠黏膜损伤的效果。方法选取2019年5—12月就诊于首都医科大学附属北京安贞医院正在服用阿司匹林肠溶片的心血管疾病患者作为研究对象,采用随机数字表法分为益生菌组和对照组。益生菌组在服用原有药物基础上予复合乳酸菌胶囊口服,对照组继续服用原有药物,均连续治疗2个月。收集2组患者的一般资料,比较2组入组时、治疗后胃肠道症状评分及小肠磁控胶囊检查结果。结果共53例患者完成治疗,其中益生菌组25例、对照组28例。益生菌组服用阿司匹林肠溶片时间与对照组比较[36(1,66)个月比24(1,57)个月],差异无统计学意义(P=0.560);2组年龄、性别、体重指数、吸烟史、饮酒史及合并慢性疾病比较,差异均无统计学意义(均P>0.05)。2组入组时胃肠道症状评分、小肠黏膜损伤评分比较,差异均无统计学意义(均P>0.05)。治疗后,益生菌组胃肠道症状评分、小肠黏膜损伤评分均低于治疗前[(2.1±1.1)分比(3.2±1.9)分、1.00(0,2.00)分比2.00(2.00,3.00)分],且小肠黏膜损伤评分低于对照组[2.00(1.00,2.00)分],差异均有统计学意义(均P<0.05)。益生菌组患者在2个月的服药期间无不良反应发生。结论益生菌干预治疗可以减轻心血管病患者服用阿司匹林导致的小肠黏膜损伤。

Objective To investigate the effect of probiotics intervention on the treatment of aspirin induced small intestinal mucosal injury.Methods From May to December 2019,patients taking aspirin with cardiovascular disease in Beijing Anzhen Hospital,Capital Medical University were selected.They were divided into probiotics group and control group according to the random number table method.The probiotics group was given lactobacillus complex capsules orally on the basis of original drugs,and the control group continued to take original drugs.Both groups were treated for 2 months.The general data of patients in the two groups were collected.The gastrointestinal symptom scores and results of small intestinal magnetic capsule examination on admission and after treatment were compared between the two groups.Results There were 53 cases who completed the treatment,including 25 cases in probiotics group and 28 cases in control group.There was no significant difference in medication time of aspirin enteric-coated tablets between probiotics group and control group[36(1,66)months vs24(1,57)months](P=0.560).There were no significant differences in age,gender,smoking history,drinking history,body mass index and chronic comorbidity(all P>0.05).There were no significant differences in gastrointestinal symptom score and small intestinal mucosal injury score between the two groups on admission(both P>0.05).After treatment,the gastrointestinal symptom score and small intestinal mucosal injury score in probiotics group were lower than those on admission[(2.1±1.1)vs(3.2±1.9),1.00(0,2.00)vs 2.00(2.00,3.00)],and small intestinal mucosal injury score in probiotics group was lower than that in control group[2.00(1.00,2.00)](all P<0.05).No adverse events occurred in probiotics group during 2 months treatment.Conclusion Probiotics can ameliorate the small intestinal mucosal injury in patients taking aspirin with cardiovascular disease.