不同益生菌制剂治疗活动期轻、中度溃疡性结肠炎的疗效比较

Comparison of the Therapeutic Effects of Different Probiotics Preparations on Mild to Moderate Ulcerative Colitis in Active Stage

目的探讨不同益生菌制剂治疗活动期轻、中度溃疡性结肠炎(ulcerative colitis,UC)的疗效。方法选取河北医科大学第三医院收治的224例活动期轻中度UC患者,按照随机数字表法分为对照组、乐托尔组、米雅组、亿活组、整肠生组、培菲康组和金双歧组,每组各32例。对照组患者给予常规治疗,后6组患者在对照组的基础上,分别给予对应的益生菌治疗,比较各组患者的临床疗效。利用改良Mayo评分和改良Baron内镜评分评估各组患者治疗前后的肠道功能。检测各组患者治疗前后的肠道菌群情况和血清D-乳酸(D-lactic acid,D-LA)和内毒素脂多糖(lipopolysaccharide,LPS)水平。结果治疗后,对照组、乐托尔组、米雅组、亿活组、整肠生组、培菲康组和金双歧组患者的总有效率为71.88%、84.38%、81.25%、84.38%、81.25%、90.63%和93.75%。其中,培菲康组和金双歧组的总有效率高于对照组,差异均有统计学意义(P均<0.05);治疗后,乐托尔组、米雅组、亿活组、整肠生组、培菲康组和金双歧组患者的改良Mayo评分、改良Baron内镜评分、血清D-LA和LPS水平以及肠球菌和肠杆菌菌落数均显著低于对照组,肠道双歧杆菌和乳酸杆菌菌落数均显著高于对照组,差异均有统计学意义(P均<0.05)。结论益生菌能够有效地改善UC患者的临床症状,调节肠道菌群平衡,改善肠黏膜屏障功能,且多联益生菌的疗效优于单菌。

Objective To explore the therapeutic effects of different probiotics preparations on mild to moderate ulcerative colitis(UC)in active stage.Methods A total of 224 patients with mild to moderate UC in active stage admitted to the Third Hospital of Hebei Medical University were randomly divided into control group,Lacteol Fort group,Miya group,Yihuo group,Zhengchangsheng group,Bifikang group and Jinshuangqi group,with 32 cases in each group.The patients in the control group was given routine treatment,and the patients in the last six groups were given probiotic preparations treatment on the basis of the control group,and the clinical efficacy of the patients in each group was compared.The modified Mayo score and modified Baron endoscopic score were used to evaluate the intestinal function of patients in each group before and after treatment.The intestinal flora and serum levels of D-lactic acid(D-LA)and endotoxin lipopolysaccharide(LPS)were detected in each group before and after treatment.Results After treatment,the total effective rate of the control group,Lacteol Fort group,Miya group,Yihuo group,Zhengchangsheng group,Bifikang group and Jinshuangqi group was 71.88%,84.38%,81.25%,84.38%,81.25%,90.63%and 93.75%.Among them,the total effective rate of Bifikang group and Jinshuangqi group was higher than that of control group,and the difference were statistically significant(P<0.05).After treatment,the modified Mayo score,modified Baron endoscopic score,serum D-LA and LPS levels,as well as the colony counts of enterococcus and enterobacter in the Lacteol Fort group,Miya group,Yihuo group,Zhengchangsheng group,Bifikang group and Jinshuangqi group were significantly lower than those in the control group,and the colony counts of bifidobacterium and lactobacillus were significantly higher than those of the control group(P<O.05).Conclusion Probiotics can effectively improve the clinical symptoms of UC patients,regulate the balance of intestinal flora and improve the intestinal mucosal barrier function,and the therapeutic effects of multiple probiotics is better than that of single probiotics.