便秘型肠易激综合征患者肠道菌群变化特点及双歧杆菌四联活菌片的疗效观察

The changes of gut microbiota in patients with constipation-predominant irritable bowel syndrome and efficacy of Bifidobacterium Tetravaccine Tablets

目的研究便秘型肠易激综合征(IBS-C)患者肠道菌群变化特点,并进一步分析双歧杆菌四联活菌片对其的干预效果。方法选取2020年2月至2021年11月于我院消化内科就诊的162例IBS-C患者为研究组;选择同期113例健康体检者作为对照组。采用16S rDNA高通量测序法检测受试者肠道菌群的构成,分析菌群多样性,比较双歧杆菌四联活菌片干预前后IBS-C患者肠道菌群变化特点及便秘症状相关指标变化情况。结果研究组患者肠道菌群Ace指数(P=0.001)、Chao指数(P<0.001)、Shannon指数(P=0.020)、Sobs指数(P<0.001)均显著低于对照组。在门水平上,研究组患者肠道厚壁菌门和变形菌门的丰度均显著高于对照组,而拟杆菌门丰度均显著低于对照组。双歧杆菌四联活菌片干预后,患者肠道厚壁菌门和变形菌门丰度均显著下降,拟杆菌门丰度显著提高。在属水平上,研究组患者肠道乳杆菌属和双歧杆菌属丰度均显著低于对照组。双歧杆菌四联活菌片干预后,患者肠道乳杆菌属、双歧杆菌属、粪杆菌属丰度均显著上升。干预后IBS-C患者的便秘症状积分(P<0.001)、GIQLI评分(P<0.001)、WC评分(P<0.001)、PAC-QOL评分(P=0.005)均较干预前差异显著,排便次数也显著增加(P<0.001)。结论IBS-C患者肠道菌群显著紊乱,双歧杆菌四联活菌片能在一定程度上调节患者肠道菌群失衡,同时能够改善胃肠道功能,缓解便秘。

Objective To observe the changes of gut microbiota in patients with constipation-Predominant irritable bowel syndrome(IBS-C),and analyze the effect of Bifidobacterium Tetravaccine Tablets(BTTs)intervention.Methods A total of 162 IBS-C patients admitted to our hospital from February 2020 to November 2021 were selected as the subjects,and 113 healthy subjects in the same period were selected as the control group.16S rDNA high-throughput sequencing method was used to detect the composition of gut microbiota and analyze the diversity of gut microbiota of all the subjects.The changes of gut microbiota and constipation-related indicators in patients with IBS-C were analyzed after 8 weeks of intervention with BTTs.Results The Ace index(P=0.001),Chao index(P<0.001),Shannon index(P=0.020)and Sobs index(P<0.001)of gut microbiota in the observation group were significantly lower than those in the control group.At the phylum level,the abundance of Firmicutes and Proteobacteria in the observation group was significantly higher than that in the control group,while the abundance of Bacteroidetes was significantly lower than that in the control group.After the intervention of BTTs,the abundance of Firmicutes and Proteobacteria decreased significantly,while the abundances of Bacteroidetes increased significantly.The abundance of Lactobacillus and Bifidobacterium in the observation group was significantly lower than that in the control group.The abundance of Lactobacillus,Bifidobacterium and Faecalibaculum increased significantly after the intervention of BTTs.After intervention,the constipation symptom score,gastrointestinal quality of life index(GIQLI)score,Wexner constipation(WC)score and patient assessment of constipation quality of life(PAC-QOL)score of IBS-C patients significantly increased compared with those before intervention,and the frequency of defecation also significantly increased(P<0.05).Conclusion The gut microbiota of IBS-C patients is obviously disordered.Bifidobacterium Tetravaccine Tablet can regulate the imbalance of gut microbiota to a certain extent,and improve gastrointestinal function and constipation symptoms.