双歧杆菌三联活菌辅助治疗IBS-C的临床观察

Clinical Observation of Live Combined Bifidobacterium,Lactobacillus and Enterococcus in the Adjuvant Treatment of IBS-C

目的:探究双歧杆菌三联活菌辅助莫沙必利治疗便秘型肠易激综合征(IBS-C)的疗效。方法:选取2019年10月~2020年10月某院收治84例IBS-C患者,按抓阄法随机分为对照组和辅治组各42例,对照组采用莫沙必利治疗,辅治组在此基础上另予双歧杆菌三联活菌治疗,两组均治疗4周后,比较临床疗效、肠道微生态及血清消化道激素水平变化情况,统计治疗结束后随访半年内复发率。结果:治疗4周后,辅治组总有效率为88.10%,明显高于对照组的总有效率69.05%(P<0.05);两组治疗4周后的乳酸杆菌、双歧杆菌明显高于治疗前,肠杆菌、球杆菌水平明显低于治疗前,且辅治组优于对照组,差异均有统计学意义(P<0.05);治疗4周后,两组胃动素水平升高,胰泌素水平降低,且辅治组升高(或降低)幅度均大于对照组,差异均有统计学意义(P<0.05);辅治组复发率为19.05%明显低于对照组的复发率47.60%,且差异有统计学意义(P<0.05)。结论:双歧杆菌三联活菌辅助治疗IBS-C临床疗效切确,可通过调节肠道菌群紊乱及胃肠道激素水平,重构肠道微生态,改善消化功能,进而降低患者复发率,改善预后。

Objective:To investigate the curative effect of live combined bifidobacterium,lactobacillus and enterococcus combined with mosapride in the treatment of constipation-predominant irritable bowel syndrome(IBS-C).Methods:A total of 84 patients with IBS-C admitted to the hospital from October 2019 to October 2020 were selected and randomly divided into control group and auxiliary treatment group according to the drawing lots method,with 42 cases in each group.The control group were treated with mosapride,and on this basis,the observation group were treated with live combined bifidobacterium,lactobacillus and enterococcus.Both groups received 4 weeks of treatment.The clinical effects and changes of intestinal microecology and serum digestive tract hormone levels were compared between the two groups.After treatment,the two groups of patients were followed up for half a year,and the recurrence rate was recorded.Results:After 4 weeks of treatment,the total effective rate in the auxiliary treatment group was 88.10%,higher than 69.05%in the control group(P<0.05).After 4 weeks of treatment,the levels of lactobacillus and bifidobacterium in the two groups were higher than those before treatment,while the levels of enterobacteriaceae and coccobacillus were lower than those before treatment,the auxiliary group was better than the control group,and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the level of motilin was increased and the level of secretin was decreased in the two groups,the increase(or decrease)range in the auxiliary treatment group was greater than that in the control group,and the difference was statistically significant(P<0.05).The recurrence rate in the auxiliary treatment group was 19.05%,lower than 47.60%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The clinical efficacy of live combined bifidobacterium,lactobacillus and enterococcus in the adjuvant treatment of IBS-C is confirmed,which can reconstruct the intestinal microecology and improve the digestive function by regulating intestinal flora disorders and gastrointestinal hormone levels,and then reduce the recurrence rate of patients and improve the prognosis.