双歧杆菌联合匹维溴铵对肠易激综合征患者临床疗效和肠道菌群及免疫功能的影响

Effects of bifidobacterium combined with piverium bromide on clinical efficacy,intestinal flora and immune function in patients with irritable bowel syndrome

目的探讨双歧杆菌联合匹维溴铵治疗肠易激综合征(IBS)患者的临床疗效。方法选取2021-05-01-2023-05-31信阳市第二人民医院收治的150例IBS-D患者,随机数字表法分为匹维溴铵组和双歧杆菌联合组,各75例,匹维溴铵组给予匹维溴铵(口服给药,50 mg/次,3次/d)治疗,双歧杆菌联合组给予双歧杆菌三联活菌胶囊(口服给药,3粒/次,2次/d)联合治疗匹维溴铵治疗。对比2组临床疗效,采用Bristol大便性状分型量表评估患者的大便性状评分,记录大便次数,菌群培养后,革兰染色鉴定双歧杆菌、大肠杆菌、乳杆菌及粪肠球菌阳性个数,免疫单扩散法检测患者免疫球蛋白(Ig)M、IgG、IgA。结果治疗后,双歧杆菌联合组总有效率为94.67%,高于匹维溴铵组的84.00%,差异有统计学意义,χ^(2)=4.478,P=0.034;双歧杆菌联合组大便次数为(1.52±0.64)次/d,少于匹维溴铵组的(1.85±0.67)次/d,大便性状评分为(3.09±0.92)分,高于匹维溴铵组的(2.29±0.87)分,差异均有统计学意义,F值分别为5.280、14.963,均P<0.05;双歧杆菌联合组双歧杆菌、乳杆菌数目分别为(9.78±1.30)CFU/g、(9.35±0.98)CFU/g,多于匹维溴铵组的(8.69±0.89)CFU/g、(8.47±1.25)CFU/g,大肠杆菌、粪肠球菌数目分别为(6.29±0.87)CFU/g、(6.13±0.89)CFU/g,少于匹维溴铵组的(7.34±0.90)CFU/g、(6.89±1.05)CFU/g,差异均有统计学意义,F值分别为17.896、11.421、26.454、11.902,均P<0.001;双歧杆菌联合组IgM、IgG、IgA分别为(1.60±0.18)g/L、(15.08±1.14)g/L、(1.85±0.27)g/L,高于匹维溴铵组的(1.41±0.24)g/L、(13.89±1.27)g/L、(1.49±0.20)g/L,差异均有统计学意义,F值分别为17.040、19.815、43.789,均P<0.001。结论双歧杆菌联合匹维溴铵治疗IBS患者的疗效确切,可有效减少大便次数,改善大便性状,改善肠道菌群失调状态,提升免疫功能,有助于患者病情恢复。

Objective To investigate the clinical efficacy of bifidobacterium combined with pivilium bromide in the treatment of irritable bowel syndrome(IBS).Methods A total of15o IBS patients admitted to the Second People's Hospital of Xin-yang City from May 1,2021 to May 31,2023 were selected and divided into pivillium bromide group and bifidobacterium combined group by random number table method,with 75 cases in each group.The pivillium bromide group was given pivillium bromide(oral administration,5o mg/time,3 times/day),and the bifidobacterium combination group was given bifidobacterium triple viable capsule(oral administration,3 capsules/time,2 times/day)combined with pivillium bromide treatment.The clinical efficacy was compared between the two groups.Stool trait score was evaluated by Bristol stool form scale,stool frequency was recorded,and positive numbers of bifidobacterium,Escherichia coli,Lactobacillus and Enterococcus faecalis were identified by Gram staining after bacterial population culture.Immunoglobulin(Ig)M,IgG and IgA were detected by immune single diffusion method.Results After treatment,the total effective rate of bifidobacterium combined group was 94.67%,which was higher than that of piverium bromide group 84.00%,the difference was statistically significant(χ^(2)=4.478,P=0.034).After treatment,the stool frequency in bifidobacterium combination group was(1.52±0.64)times/d,which was less than that in piviterium bromide group(1.85±0.67)times/d,and the stool trait score was(3.09±0.92)points,which was higher than that in piviterium bromide group(2.29±0.87)points,the differences were statistically significant(F=5.280,F=14.963,All P<0.05);after treatment,the numbers of bifidobacterium and Lactobacillus in bifidobacterium combination group were(9.78±1.30)CFU/g and(9.35±0.98)CFU/g,respectively,which were higher than those in piverium bromide group(8.69±0.89)CFU/g and(8.47±1.25)CFU/g,the numbers of Escherichia coli and Enterococcus faecalis were(6.29±0.87)CFU/g and(6.13±0.89)CFU/g,respectively,which were lower than those in piverium bromide group(7.34±0.90)CFU/g and(6.89±1.05)CFU/g,the differences were statistically significant(F values were 17.896,11.421,26.454,11.902,all P<0.001);after treatment,IgM,IgG and IgA in bifidobacterium combination group were(1.60±0.18)g/L,(15.08±1.14)g/L and(1.85±0.27)g/L,respectively,which were higher than those in piverium bromide group(1.41±0.24)g/L,(13.89±1.27)g/L and(1.49±0.20)g/L,the differences were statistically significant(F values were 17.040,19.815,43.789,all P<0.oo1).Conclusion Bifidobacterium combined with piverium bromide is effective in the treatment of IBS patients,which can effectively reduce stool frequency,improve stool characteristics,improve intestinal flora disorder,enhance immune function,and contribute to the recovery of patients disease.