合生元调整肠道微生态治疗腹泻型肠易激综合征的疗效观察

Therapeutic Effect of Synbiotics on Irritable Bowel Syndrome With Diarrhea via Regulating Intestinal Microbiota

背景:肠道微生态紊乱是腹泻型肠易激综合征(IBS-D)发病的重要因素,合生元可有效调节人体肠道微生态。目的:探讨合生元制剂对IBS-D患者临床症状和肠道菌群的影响。方法:纳入2022年7月—2023年5月云南省第一人民医院收治的75例IBS-D患者,随机分为试验组和对照组。除常规治疗外,试验组给予含有益生元和多种益生菌的合生元制剂,对照组给予安慰剂。比较两组治疗前后消化道症状评分、生活质量(QOL)评分、精神症状评分和肠道菌群组成。结果:治疗4周后,试验组腹部疼痛评分、自主排便次数、IBS评分、焦虑评分和抑郁评分明显降低(P<0.05),IBS-QOL评分明显升高(P<0.05),而粪便性状评分无明显差异(P>0.05)。与对照组相比,治疗后试验组肠道菌群组成、菌群多样性无明显差异(P>0.05),螺杆菌、志贺菌、紫单孢菌、瘤胃球菌科UCG-009丰度明显降低(P<0.05),双歧杆菌和乳杆菌丰度明显升高(P<0.05)。结论:合生元对IBS-D患者有良好的治疗效果,可改善肠道菌群,减轻消化道症状,同时可提高患者的生活质量,减轻焦虑、抑郁等精神症状。

Background:Intestinal microbiota disorder is an important factor in the development of irritable bowel syndrome with diarrhea(IBS⁃D),and synbiotics can effectively regulate the human intestinal microbiota.Aims:To investigate the effect of synbiotics on clinical symptoms and intestinal microflora in patients with IBS⁃D.Methods:Seventy⁃five patients with IBS⁃D from July 2022 to May 2023 at the First People′s Hospital of Yunnan Province were enrolled,and then were randomly divided into experimental group and control group.In addition to conventional treatment,patients in experimental group were given synbiotics preparation containing prebiotics and various probiotics,and patients in control group were given placebo.Gastrointestinal symptoms score,quality of life(QOL)score,psychiatric symptoms score,and the composition of intestinal flora were compared before and after the treatment.Results:After 4 weeks of treatment,abdominal pain score,number of spontaneous defecation,IBS score,anxiety score and depression score in experimental group were significantly decreased(P<0.05),while IBS⁃QOL score was significantly increased(P<0.05),and no significant difference in stool character score was found(P>0.05).No significant differences in composition of intestinal flora and diversity of intestinal flora were found between experimental group and control group(P>0.05).Compared with control group,abundances of Helicobacter,Shigella,Micromonospora,Ruminococcaceae UCG⁃009 were significantly decreased(P<0.05),abundances of Bifidobacterium and Lactobacillus were significantly increased(P<0.05).Conclusions:Synbiotics have a good therapeutic effect on IBS⁃D patients,which can improve the intestinal flora,improve gastrointestinal symptoms,improve the quality of life of patients,and improve anxiety,depression and other psychiatric symptoms.