传统药物联合酪酸梭菌对溃疡性结肠炎患者肠屏障功能及疗效的影响  

Efficacy of Clostridium butyricum combined with conventional therapy in treatment of patients with ulcerative colitis

作　　者：施嫣红[1] 汤茂春[1] 黄林生[1] 王俊珊[1] 刘占举[1] SHI Yan-hong;TANG Mao-chun;HUANG Lin-sheng;WANG Jun-shan;LIU Zhan-ju(Dept.of Gastroenterology,Tenth People's Hospital,Tongji University School of Medicine,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院消化内科,上海200072

出　　处：《同济大学学报（医学版）》2020年第4期443-448,共6页Journal of Tongji University(Medical Science)

基　　金：上海市卫生和计划生育委员会资助项目(201640159);北京医卫健康公益基金项目(YWJKJJHKYJJ-A712)。

摘　　要：目的观察传统药物联合酪酸梭菌对溃疡性结肠炎患者的肠屏障功能及临床疗效的影响。方法将82例轻度至中度溃疡性结肠炎患者随机分为观察组(42例)及对照组(40例)。对照组给予传统药物美沙拉嗪片1.0 g,每日4次,或加用泼尼松0.75 mg/(kg·d),口服。观察组在传统药物基础上口服酪酸梭菌0.2g/次,每日3次。总疗程12周。评估两组治疗前后的肠屏障功能,临床活动指数、内镜评分、病理评分、临床综合疗效及不良反应。结果治疗12周后,两组血清内毒素及血浆D-乳酸水平均比治疗前明显改善(P<0.05),观察组的改善优于对照组,而且观察组的血清内毒素水平6周后比对照组内毒素水平的改善更明显(P<0.05)。治疗后12周,两组患者临床活动指数Mayo评分、内镜评分及病理评分显著低于治疗前(P<0.01),且观察组的Mayo评分显著低于对照组(P<0.05);观察组比对照组能更有效地改善患者的内镜评分及病理评分(P<0.05);观察组临床总有效例数显著高于对照组(P<0.05)。两组不良反应率差异比较无统计学意义(P>0.05)。结论酪酸梭菌联合传统药物治疗可有效改善轻中度溃疡性结肠炎患者的肠黏膜屏障功能、临床活动指数、内镜下及病理评分,提高临床疗效,且副反应少。Objective To assess the efficacy of Clostridium butyricum(CB)with conventional therapy in treatment of patients with ulcerative colitis(UC).Methods Eighty-two patients with mild or moderate UC were divided into study group(n=42)and control group(n=40)randomly.All patients were treated with sulfasalazine 1.0 g qid and/prednisone 0.75 mg/(kg·d)for 12 weeks;patients in study group were given additional Clostridium butyricum 0.2 g tid.The intestinal barrier function,clinical efficacy,disease activity index,endoscopic findings and pathological results were evaluated at the beginning and at the end of treatment.Results After 12 weeks of treatment,the levels of serum endotoxin and plasma D-lactate in the two groups were significantly improved(P<0.05),the improvement was more significant in the study group compared to control group(P<0.05).The level of serum endotoxin after 6 weeks of treatment in the study group decreased more significantly than that in the control group(P<0.05).At 12 weeks,Mayo scores,endoscopic score and pathological score of the two groups were significantly lower than those before treatment(P<0.01),and the Mayo score of the treatment group was significantly lower than that of the control group(P<0.05);the endoscopic score and pathological score of the study group were more markedly improved than those of the control group(P<0.05,respectively).The effective rate in the study group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion Clostridium butyricum combined with conventional therapy can effectively improve the intestinal barrier function and clinical efficacy of patients with mild or moderate ulcerative colitis.

关 键 词：溃疡性结肠炎 传统药物 酪酸梭菌 肠黏膜屏障 疗效 

分 类 号：R574.62[医药卫生—消化系统]