布拉氏酵母菌散联合美沙拉嗪治疗溃疡性结肠炎的疗效及对患者肠黏膜屏障功能和肠道菌群的影响

Efficacy of Saccharomyces Boulardii Sachets Combined with Mesalazine in Treatment of Ulcerative Colitis and Its Effect on Intestinal Mucosal Barrier Function and Intestinal Flora

目的:探讨布拉氏酵母菌散联合美沙拉嗪治疗溃疡性结肠炎的疗效及对患者肠黏膜屏障功能和肠道菌群的影响。方法:将107例溃疡性结肠炎患者分为观察组54例和对照组53例,观察组患者给予口服布拉氏酵母菌散和美沙拉嗪肠溶片治疗,对照组患者仅口服美沙拉嗪肠溶片治疗,2组患者治疗时间均为8周。观察并比较2组患者的疗效,治疗前后的症状评分、改良Baron内镜评分、以及肠黏膜屏障功能指标和肠道菌群数量。结果:观察组患者总有效率高于对照组(P<0.05)。治疗前2组患者临床症状及改良Baron内镜评分比较差异无统计学意义(P>0.05),治疗后观察组患者腹痛、腹泻、便血及改良Baron内镜评分均显著降低,且观察组低于对照组(P<0.05)。治疗前2组患者肠黏膜屏障功能指标比较差异无统计学意义(P>0.05),治疗后2组患者血清二胺氧化酶(DAO)、内皮素(ET)、D-乳酸(D-LA)、以及尿中乳果糖与甘露醇比值(L/M)均降低,且观察组低于对照组(P<0.05)。治疗前2组患者肠道菌群数量比较差异无统计学意义(P>0.05),治疗后2组患者大肠杆菌数量均降低,且观察组低于对照组(P<0.05);治疗后2组乳酸杆菌和双歧杆菌数量均增加,且观察组高于对照组(P<0.05)。治疗期间,2组患者均无明显不良反应。结论:布拉氏酵母菌散联合美沙拉嗪治疗溃疡性结肠炎疗效显著,不但可以减轻患者的临床症状,而且还具有改善患者肠黏膜屏障功能和调节肠道菌群的作用。

Objective To investigate the efficacy of saccharomyces boulardii sachets combined with me-salazine in the treatment of ulcerative colitis and the effect on intestinal mucosal barrier function and intes-tinal flora.Methods Total 107 patients with ulcerative colitis were divided into observation group(54 cases)and control group(53 cases).The observation group was treated with oral saccharomyces boulardii sachets and mesalazine enteric-coated tablets,while the control group was treated with oral mesalazine en-teric-coated tablets only.The treatment time of both groups was 8 weeks.The efficacy,symptom score,modified Baron endoscopy score,intestinal mucosal barrier function index and the number of intestinal flora of the two groups were observed and compared.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).Before treatment,there was no significant differ-ence in the scores of clinical symptoms and modified Baron endoscopy between the two groups(P>0.05).After treatment,scores of abdominal pain,diarrhea,hematochezia and modified Baron endoscopy in the observation group were significantly reduced,which were lower in the observation group than in the control group(P<0.05).Before treatment,there was no significant difference in functional indexes of in-testinal mucosal barrier between the two groups(P>0.05).After treatment,serum diamine oxidase(DAO),endothelin(ET),D-lactate(D-LA),and urinary lactulose to mannitol ratio(L/M)were de-creased,which were lower in the observation group than in the control group(P<0.05).Before treat-ment,there was no significant difference in the number of intestinal flora between the two groups(P>0.05),and after treatment,the number of Escherichia coli in the observation group was lower than that in the control group(P<0.05).After treatment,the number of lactobacillus and bifidobacterium increased in both groups,which was higher in the observation group than in the control group(P<0.05).During treatment,there were no obvious adverse reactions in both groups.Conclusion Saccharomyces boulardii sachets combined with mesalazine are effective in the treatment of ulcerative colitis,which can not only re-duce the clinical symptoms of patients,but also improve the function of intestinal mucosal barrier and regu-late intestinal flora.