联用益生菌与水溶性膳食纤维对氯氮平所致便秘的改善效果

Clinical effect of probiotics combined with water-soluble dietary fiber on improving constipation induced by clozapine

目的:探讨益生菌联用水溶性膳食纤维(SDF)对氯氮平所致便秘的改善效果。方法:将160例经氯氮平治疗后便秘的精神分裂症患者随机分为对照组、益生菌组、SDF组和联合组。对照组给予健康教育,其余各组分别在健康教育基础上给予益生菌粉、SDF补充剂、益生菌粉联合SDF。各组连续干预4周后,观察患者的临床便秘改善效果。使用便秘患者症状自评量表(PAC-SYM)、便秘患者生活质量自评量表(PAC-QOL)、抑郁自评量表(SDS)和焦虑自评量表(SAS)分别评估患者的生活质量及心理状态。结果:经4周治疗后,各组便秘症状均得到改善,以联合组的效果最好(P均<0.05)。在PAC-SYM、SDS和SAS评分方面,干预方法与干预时间存在交互作用,益生菌组、SDF组和联合组的治疗效果均优于对照组,且联合组的治疗效果要优于益生菌组和SDF组(P均<0.05)。联合组治疗总有效率高于对照组(P<0.05)。结论:临床联用益生菌和SDF能够显著改善精神分裂症伴便秘患者的便秘症状及抑郁与焦虑水平。

Objective:To investigate the clinical effect of probiotics combined with water-soluble dietary fiber(SDF)on improving constipation induced by clozapine.Method:Total 160 schizophrenic patients with constipation induced by clozapine were randomly divided into control group,probiotics group,SDF group and combination group.The control group was given health education,and the other groups were given probiotic powder,SDF supplement and probiotic powder combined with SDF on the basis of health education,respectively.After continuous intervention for 4 weeks in each group,the clinical constipation improvement effect was observed.The quality of life and psychological state of the patients were assessed by Symptom Self-rating Scale for Constipation(PAC-SYM),Quality of Life Self-rating Scale for Constipation(PAC-QOL),Depression Self-rating Scale(SDS)and Anxiety Self-rating Scale(SAS),respectively.Results:After a total of 4 weeks of treatment,the clinical symptoms of all groups were improved,and the effect of the combination group was the best(all P<0.05).In terms of PAC-SYM score,SDS score and SAS score,there was an interaction between intervention method and intervention duration.The therapeutic effects of the probiotics group,the SDF group and the combination group were better than those of the control group,and the therapeutic effect of the combination group was better than those of the probiotics group and SDF group(all P<0.05).It was observed that the efficiency of the combination group was higher than that of the control group(P<0.05).Conclusion:Combined use of probiotics and SDF can significantly improve constipation symptoms,depression and anxiety in schizophrenic patients with constipation.