益生菌联合常规疗法对艾滋病相关性腹泻的疗效及对肠道菌群的影响

Effect of probiotics combined with conventional therapy on AIDS-related diarrhea and its influence on intestinal microecology

目的探讨益生菌联合常规疗法治疗艾滋病相关性腹泻的效果,为该类患者的治疗提供参考。方法选取2020年6月至2023年6月在泉州地区诊治的97例艾滋病相关性腹泻患者,按治疗方法划分成常规组(n=47)和试验组(n=50)。常规组患者采用常规疗法治疗,试验组患者采用益生菌联合常规疗法进行治疗。观察两组患者疗效。结果试验组患者治疗2周后Bristol粪便性状评分量表、Hart腹泻量表评分[(13.45±2.29)分、(8.26±1.68)分]均低于常规组[(18.16±3.65)分、(12.82±2.03)分](t=7.662、12.082,均P<0.05)。治疗2周后,试验组患者肠道肠球菌、肠杆菌数量[(5.03±0.84)lg CFU/g、(6.39±0.86)lg CFU/g]低于常规组[(6.25±1.07)lg CFU/g、(7.25±1.02)lg CFU/g],乳杆菌、双歧杆菌数量[(8.20±1.48)lg CFU/g、(8.12±1.43)lg CFU/g]高于常规组[(6.42±1.17)lg CFU/g、(6.69±1.22)lg CFU/g](t=6.266、4.499、6.544、5.282,均P<0.05)。试验组患者治疗2周后巨噬细胞炎性蛋白-2(MIP-2)、IL-6、IL-10水平及CD3^(+)细胞、CD4^(+)细胞、CD8^(+)细胞计数[(70.59±4.24)μg/L、(9.69±1.30)pg/mL、(84.63±7.84)ng/L、(52.45±7.29)个/mm^(3)、(33.59±7.04)个/mm^(3)、(22.26±3.68)个/mm^(3)]均优于常规组[(82.25±5.58)μg/L、(13.48±1.91)pg/mL、(73.52±6.56)ng/L、(47.16±6.65)个/mm^(3)、(26.75±5.93)个/mm^(3)、(27.82±4.03)个/mm^(3)](t=11.631、11.485、7.544、3.726、5.159、7.102,均P<0.05)。结论益生菌联合常规疗法对艾滋病相关性腹泻的疗效显著,能调节患者肠道菌群,减轻炎症反应,改善免疫功能,促进临床症状缓解。

Objective To observe the effect of probiotics combined with conventional therapy on AIDS-related diarrhea,providing a reference for the treatment.Methods A total of 97 cases of AIDS-related diarrhea diagnosed and treated in our hospital from June 2020 to June 2023 were divided into conventional group(n=47)and experimental group(n=50)according to treatment methods.The former group received conventional therapy while the latter received probiotics combined with conventional therapy.The efficacy in the two groups was observed.Results After two weeks of treatment,the scores of Bristol fecal trait scale and Hart diarrhea scale in experimental group[(13.45±2.29)score,(8.26±1.68)score]were lower than those in conventional group[(18.16±3.65)score,(12.82±2.03)score](t=7.662,12.082,all P<0.05);the counts of Enterococcus and Enterobacter in experimental group[(5.03±0.84)lg CFU/g,(6.39±0.86)lg CFU/g]were lower than those in conventional group[(6.25±1.07)lg CFU/g,(7.25±1.02)lg CFU/g],while those of Lactobacillus and Bifidobacterium in experimental group[(8.20±1.48)lg CFU/g,(8.12±1.43)lg CFU/g]were higher than those in conventional group[(6.42±1.17)lg CFU/g,(6.69±1.22)lg CFU/g](t=6.266,4.499,6.544,5.282,all P<0.05);the levels of MIP-2,IL-6,IL-10 and the counts of CD3^(+)cell,CD4^(+)cell and CD8^(+)cell in experimental group[(70.59±4.24)μg/L,(9.69±1.30)pg/mL,(84.63±7.84)ng/L,(52.45±7.29)units/mm^(3),(33.59±7.04)units/mm^(3),(22.26±3.68)units/mm^(3)]were superior to those in conventional group[(82.25±5.58)μg/L,(13.48±1.91)pg/mL,(73.52±6.56)ng/L,(47.16±6.65)units/mm^(3),(26.75±5.93)units/mm^(3),(27.82±4.03)units/mm^(3)](t=11.631,11.485,7.544,3.726,5.159,7.102;all P<0.05).Conclusion Probiotics combined with conventional therapy are effective in the treatment of AIDS-related diarrhea,which can regulate intestinal microecology,reduce inflammation,improve immune function and promote the remission of clinical symptoms.