布拉氏酵母菌联合柳氮磺吡啶对溃疡性结肠炎患者Baron内镜评分及肠黏膜屏障功能的影响

Effects of Saccharomyces Boulardii Combined with Sulfasalazine on Baron Endoscopy Score and Intestinal Mucosal Barrier Function in Patients with Ulcerative Colitis

目的:探讨布拉氏酵母菌联合柳氮磺吡啶对溃疡性结肠炎(UC)患者Baron内镜评分及肠黏膜屏障功能的影响。方法:选取2020年1月至2022年1月该院收治的184例UC患者,随机分为对照组和研究组,每组92例。两组患者均行常规治疗,同时对照组患者给予柳氮磺吡啶治疗,研究组患者给予布拉氏酵母菌联合柳氮磺吡啶治疗,持续治疗1个月。比较两组患者的治疗效果、症状改善情况、复发情况、治疗前后Baron内镜评分、肠道菌群数量、肠黏膜屏障功能指标[二胺氧化酶(DAO)、内毒素脂多糖(LPS)和D-乳酸(DLA)]水平、外周血瘦素(LP)及辅助性T细胞17/调节性T细胞(Th17/Treg)水平。结果:研究组患者的总有效率为93.48%(86/92),明显高于对照组的82.61%(76/92),差异有统计学意义(P<0.05)。研究组患者退热时间,腹泻、腹痛和黏液脓血便消失时间明显短于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗后的双歧杆菌、乳杆菌数量高于对照组,肠杆菌数量、Baron内镜评分低于对照组;研究组患者治疗后的血清DAO、LPS和DLA水平均低于对照组;研究组患者治疗后的外周血LP、Th17和Th17/Treg水平均低于对照组,Treg水平均高于对照组,上述差异均有统计学意义(P<0.05)。研究组患者随访期间的复发率为2.13%(1/47),明显低于对照组的17.50%(7/40),差异有统计学意义(P<0.05)。结论:布拉氏酵母菌联合柳氮磺吡啶治疗UC患者的疗效显著,复发率低。

OBJECTIVE:To probe into the effects of Saccharomyces boulardii combined with sulfasalazine on Baron endoscopy score and intestinal mucosal barrier function in patients with ulcerative colitis.METHODS:A total of 184 ulcerative colitis patients admitted into our hospital from Jan.2020 to Jan.2022 were randomly divided into the control group and study group,with 92 cases in each group.Patients in both groups received conventional treatment,the control group received sulfasalazine treatment,while the study group was given S.boulardii combined with sulfasalazine,with continuous treatment for 1 month.The treatment effect,symptom improvement,recurrence,Baron endoscopy score before and after treatment,the number of intestinal flora,and intestinal mucosal barrier function indicators[diamine oxidase(DAO),endotoxin lipopolysaccharide(LPS),D-lactate(DLA)],peripheral blood leptin(LP),T helper 17/regulatory T cell(Th17/Treg)levels of two groups were compared.RESULTS:The total effective rate of the study group was 93.48%(86/92),significantly higher than that 82.61%(76/92)of the control group,the difference was statistically significant(P<0.05).The disappearance time of fever,diarrhea,abdominal pain and mucus,mucus pus and blood stool in the study group was significantly shorter than that in the control group,the differences were statistically significant(P<0.05).After treatment,the number of Bifidobacterium and Lactobacillus in the study group was higher than that in the control group,while the number of enterobacterium and Baron endoscopy score in the study group were lower than that in the control group;the levels of DAO,LPS and DLA in the study group were lower than those in the control group after treatment;the levels of LP,Th17 and Th17/Treg in peripheral blood of the study group were lower than those of the control group,and the levels of Treg were higher than those of the control group,with statistically significant differences(P<0.05).The recurrence rate of the study group was 2.13%(1/47),significantly lower than that of the control group(17.50%,7/40),the difference was statistically significant(P<0.05).CONCLUSIONS:The efficacy of f S.boulardii combined with sulfasalazine in the treatment of ulcerative colitis is significant with lower recurrence rate.