益生菌对病毒性腹泻患者菌群结构及黏膜屏障功能变化的影响  

Effects of probiotics on gut microbiota and the functional change of mucosal barrier in patients with viral diarrhea

作　　者：刘跃平[1] 石涵[1] 李红[1] 李青松[1] 林刚[1] LIU Yue-ping;SHI Han;LI Hong;LI Qing-song;LIN Gang(Department of Digestive Medicine, Taizhou Central Hospital, Taizhou, Zhejiang 318000, China)

机构地区：[1]台州市中心医院消化内科,浙江台州318000

出　　处：《中国预防医学杂志》2018年第6期448-451,共4页Chinese Preventive Medicine

摘　　要：目的分析益生菌对病毒性腹泻患者肠道菌群结构和肠道黏膜屏障功能的影响。方法选择2015年5月至2016年5月在台州市中心医院诊断为病毒性腹泻的患者80例,根据患者是否使用益生菌治疗分为试验组和对照组,试验组在病毒性常规治疗的基础上给予益生菌治疗,对照组患者给予病毒性腹泻的常规治疗,并以同期20例健康体检者作为健康对照组。结果治疗前试验组和对照组患者大肠埃希菌、双歧杆菌、乳酸杆菌和肠球菌含量对比差异无统计学意义(t=1.104、0.232、0.893、0.428,P>0.05),治疗后试验组患者双歧杆菌和乳酸杆菌含量分别为(7.42±1.56)lgCFU/g和(8.36±1.58)lgCFU/g,高于治疗前(t=9.972、8.181,P<0.05)和对照组治疗后(t=2.819、6.492,P<0.05),而大肠埃希菌和肠球菌含量低于治疗前(t=6.942、4.335,P<0.05)和对照组治疗后(t=2.992、2.408,P<0.05),治疗前试验组和对照组患者血清LPS、DAO、D-乳糖含量比较差异有统计学意义(t=0.586、0.116、0.351,P<0.05),治疗后试验组患者LPS、DAO、D-乳糖水平分别为(20.54±6.37)pg/ml、(4.38±1.20)U/ml和(6.36±1.64)mg/L,低于治疗前(t=11.809、6.356、4.853,P<0.05)和对照组治疗后(t=5.587、4.874、2.427,P<0.05),治疗后试验组有效24例、显效14例、无效2例,有效率为95.00%,与对照组相比差异有统计学意义(χ2=4.112,P<0.05)。结论肠道益生菌有助于改善病毒性腹泻患者肠道菌群和肠道粘膜功能,值得临床推广运用。Objective To explore the effects of probiotics on gut microbial flora and intestinal mucosal barrier function in patients with viral diarrhea. Methods 80 cases with confirmed viral diarrhea from April 2015 to April 2016 were enrolled into our study and were divided into experimental group and control group.Patients in experimental group were given probiotics besides conventional treatment for viral diarrhea,while patients in control group were only received traditional treatment.At same time,20 healthy individuals were also recruited as healthy controls. Results There were no significant differences before treatment between two groups in terms of the bacterial burdens of Escherichia Coli,Bifidobacterium,lactobacillus and Enterococci（P〈0.05）,however,after treatment,the amount of both Bifidobacterium（7.42±1.56）lgCFU/g and lactobacillus（8.36±1.58）lgCFU/g significantly increased and were much higher in patients who received probiotics compared with those who did not（t=2.819,6.492,P〈0.05）,while,the bacterial burden of E.Coli and Enterococci decreased after treatment and were both lower compared to the control group（t=2.992,2.408,P〈0.05）.Before treatment,the differences of serum levels of LPS,DAO and D-lactose were not significant among patients in experimental group,control group and healthy controls,however after treatment,the serum levels of LPS,DAO and D-lactose all significantly decreased（t=11.809,6.356,4.853,P〈0.05）and were all significantly lower in patients with probiotics treatment compared with controls（t=5.587,4.874,2.427,P〈0.05）.The treatment effective rate was greatly higher among patients in experimental group than those in control group（95.00%vs 80.00%;χ2=4.112,P〈0.05）. Conclusions Use of probiotics can help to improve the gut microbial flora and intestinal mucosal function in patients with viral diarrhea,which is worthy of clinical application.

关 键 词：病毒性腹泻 肠道菌群 肠道黏膜屏障 益生菌 双歧杆菌 乳酸杆菌 

分 类 号：R574.4[医药卫生—消化系统]