质子泵抑制剂与小肠细菌过度生长的相关性及双歧杆菌三联活菌胶囊疗效观察  

The efficacy of bifidobacterium triple viable capsules on the small intestinal bacterial overgrowth induced by proton pump inhibitors

作　　者：陈爱方[1] 田霞[1] 韩峥[1] 朱庆曦 谭洁[1] 刘蒙[1] CHEN Ai-fang;TIAN Xia;HAN Zheng;ZHUQing-xi;TAN Jie;LIU Meng(Department of Gastroenterology,Wuhan No.3 Hospital,430060 Wuhan,Hubei,China)

机构地区：[1]武汉大学附属同仁医院武汉市第三医院消化内科

出　　处：《临床消化病杂志》2019年第3期159-162,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨质子泵抑制剂(proton pump inhibitors,PPIs)与小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)发生的相关性,并初步研究双歧杆菌三联活菌胶囊对SIBO的治疗效果。[方法]选择2016-06-2018-06期间在我科就诊服用常规剂量PPI但不同疗程(分别为4周、8周、12周)的反流性食管炎患者80例为研究对象,通过乳果糖氢气呼气试验(LHBT)诊断SIBO。所有患者在受试前均完成LHBT检测,比较受试前及应用不同疗程PPI后患者SIBO的发生率,并将48例SIBO阳性者随机分成益生菌组(服用双歧杆菌三联活菌)及对照组(服用安慰剂淀粉),均为胶囊制剂,3次/d,每次2粒,疗程为28 d,比较2组患者治疗前后SIBO阳性转阴率、治疗有效率之间的差异。[结果]80例患者受试前SIBO发生率为13.75%(11/80),38例PPI应用4周患者SIBO发生率为42.11%(16/38),24例PPI应用8周患者SIBO发生率为70.83%(17/24),18例PPI应用12周患者SIBO发生率为83.33%(15/18),组间比较差异有统计学意义(P<0.05)。益生菌组、对照组SIBO阳性者转阴率分别为54.17%、16.67%,2组比较差异有统计学意义(P<0.05);益生菌组、对照组临床症状治疗有效率分别为83.33%、41.67%,2组比较差异有统计学意义(P<0.05)。[结论]长期应用PPI可导致SIBO的发生,且PPI使用时间与SIBO阳性率呈正相关,应用益生菌治疗可以纠正SIBO。[Objective]To explore the relationship between the use of proton pump inhibitors(PPIs) and small intestinal bacteria overgrowth(SIBO),and to investigate the treatment efficacy of bifidobacterium triple viable capsules on the SIBO.[Methods]From June 2016 to June 2018,80 patients with reflux esophagitis who took the standard doses of proton pump inhibitors for different course(4 week,8 week,12 week)were involved.The LHBT test was performed in all the patients before and after the treatment of PPI at deferent time point and the incidence of SIBO was compared.The patients with SIBO were divided into 2 groups randomly(probiotics group and placebo group)and separately treated with bifidobacterium triple viable or placebo three times per day for four weeks.After treatment,the difference of SIBO negative rate and treatment efficiency were compared.[Results]The incidence of SIBO in 80 cases before the treatment was 13.75%(11/80).The incidence of SIBO in 38 cases treated with PPI for 4 weeks was 42.11%(16/38).The incidence of SIBO in 24 cases treated with PPI for 8 weeks was 70.83%(17/24)and the incidence of SIBO in 18 cases treated with PPI for 12 weeks was 83.33%(15/18).There was a statistical difference among every group.The differences of reverse negative of SIBO between probiotics treatment group and placebo group had statistical significance(54.17% vs 16.67%,P<0.05).There was statistically significant difference of treatment efficiency between probiotics treatment group and placebo group(83.33% vs 41.67%,P<0.05).[Conclusion]Long term application of PPI can lead to the occurrence of SIBO,and there is a positive correlation between the treatment course of PPI and the occurrence of SIBO positive rate.The probiotics can play a positive role in correcting SIBO.

关 键 词：质子泵抑制剂 小肠细菌过度生长 双歧杆菌三联活菌胶囊 

分 类 号：R839[医药卫生—航空、航天与航海医学]