益生菌治疗长期口服奥氮平所致便秘的效果及其对肠道菌群结构影响

The effect of probiotics on long-term oral olanzapine induced constipation and its impact on intestinal flora structure

目的 探讨益生菌治疗长期口服奥氮平所致便秘的效果及其对肠道菌群结构影响。方法 选取2020年8月~2023年8月收治的70例长期口服奥氮平所致便秘的患者作为研究对象,按随机数字表法分为观察组(n=35)及对照组(n=35)。对照组采取麻仁软胶囊治疗,观察组在对照组基础上增加益生菌口服治疗,对比两组临床疗效、便秘改善情况及大便性状、肠道菌群结构、周排便次数与生活质量。结果 观察组治疗总有效率(91.43%)显著高于对照组(68.57%)(P <0.05);治疗后两组Wexner评分降低,但观察组低于对照组,差异有统计学意义(P <0.05);与治疗前相比,两组治疗后布里斯托粪便性状量表(BSFS)评分均升高,差异有统计学意义(P <0.05);治疗后观察组乳酸杆菌、双歧杆菌以及普氏栖粪杆菌水平高于对照组,大肠杆菌及粪肠球菌水平低于对照组,差异有统计学意义(P <0.05);治疗后两组周排便次数均增加,且观察组高于对照组(P <0.05);治疗后两组便秘患者生活质量自评量表(PAC-QOL)评分降低,且观察组低于对照组(P <0.05)。结论 益生菌可改善长期口服奥氮平所致的便秘,改善患者便秘症状、大便性状以及肠道菌群结构,增加患者周排便次数,改善患者生活质量。

Objective To investigate the effect of probiotics on long-term oral olanzapine induced constipation and its impact on intestinal flora structure.Methods 70 patients with constipation caused by long-term oral olanzapine treatment from August 2020 to August 2023 were selected as the study subjects and randomly divided into the observation group(n=35)and the control group(n=35)using a random number table method.The control group was treated with Maren soft capsule,and the observation group was received oral probiotics in addition to the control group.The clinical efficacy,improvement of constipation,stool characteristics,intestinal flora structure,weekly bowel movements,and quality of life of the two groups were compared.Results The total effective rate of the observation group(91.43%)was significantly higher than the control group(68.57%)(P<0.05).After treatment,the Wexner scores of both groups were decreased,and the observation group lower than the control group,with statistically significant difference(P<0.05).The Bristol Stool Profile Scale(BSFS)score of two groups after treatment were increased compared to before treatment,with statistically significant difference(P<0.05).After treatment,the levels of lactobacilli,bifidobacteria,and Pseudomonas aeruginosa in the observation group were higher than those in the control group,while the levels of Escherichia coli and Enterococcus faecalis were lower than those in the control group(P<0.05).After treatment,the frequency of bowel movements increased in both groups,which in the observation group was higher than that in the control group(P<0.05).After treatment,the PAC-QOL score decreased in both groups,which in the observation group was lower than that in the control group(P<0.05).Conclusion Probiotics can improve constipation caused by long-term oral olanzapine,improve constipation symptoms,stool characteristics,and intestinal flora structure in patients,increase the frequency of bowel movements per week,and improve their quality of life.