低糖饮食对老年肠易激综合征影响的机制研究  

Mechanism of the effect of low-sugar diet on elderly irritable bowel syndrome

作　　者：许义红[1] 念其滨[1] 邱洪[1] 陈立[2] 张帆 XU Yi-hong;NIAN Qi-bin;QIU Hong;CHEN Li;ZHANG Fan(Department of Pharmacy,Fujian Provincial Hospital,Fuzhou,Fujian 350003,China;不详)

机构地区：[1]福建省级机关医院药剂科,福建福州350003 [2]福建省立医院药学部 [3]福州药品检验所

出　　处：《中国微生态学杂志》2021年第12期1391-1397,共7页Chinese Journal of Microecology

摘　　要：目的低糖饮食对老年肠易激综合征的影响机制研究。方法从2020年11月至2021年4月,招募我院和省立医院收治的52名肠易激综合征患者,采用自愿入组方式,根据入组结果将其分为低糖饮食组(n=27)和对照组(n=25)。给予对照组常规饮食联合枸橼酸莫沙必利分散片治疗,低糖饮食组在对照组治疗的基础上采用低糖饮食联合乳果糖口服溶液治疗。4周以后对两组患者的转归进行IBS-SSS严重程度评分比较。观察两组患者临床疾病活动情况、炎症标志物水平变化、患者饮食摄入情况、肠道微生物组组成变化情况和粪便中短链脂肪酸浓度等。结果与对照组相比,低糖饮食组患者临床评分、疼痛程度、腹胀程度、生活质量及症状缓解均显著降低(均P<0.05)。对照组和低糖饮食组患者疼痛天数、大便次数和粪便性状差异均无统计学意义(P>0.05)。两组基因数、微生物种类数、门水平分布、多样性指数和Bray-Curtis指数差异均无统计学意义(P>0.05)。两组中有33种微生物的丰度受到饮食的显著影响(P<0.05)。两组双歧杆菌的相对丰度差异无统计学意义(P>0.05);低糖饮食组长双歧杆菌、青春双歧杆菌和普拉梭菌丰度明显低于对照组(P<0.05),齿双歧杆菌丰度升高。34个KO组的丰度在低糖饮食组和对照组之间差异具有统计学意义(P<0.05)。与对照组相比,低糖饮食组显著增加的基因涉及纤维素二糖运输系统和丙酸的生产,而低丰度的基因涉及有乳糖和半乳糖降解途径、谷氨酸运输系统和Zn/Mn运输系统。两组CD4;和CD8;T细胞数量没有显著差异(P>0.05)。结论低糖饮食通过改变肠道菌群的数量的功能改善老年肠易激综合征症状,为临床实践提供指导、为监控患者预后提供积极的理论依据。Objective To explore the mechanism of the effect of low-sugar diet on irritable bowel syndrome(IBM) in the elderlies. Methods Fifty-two patients with IBM admitted to our hospital and provincial hospital from November 2020 to April 2021 were enrolled and voluntarily divided into low-sugar diet group based on the enrollment results(n=27)or control group(n=25).The control group was given a regular diet combined with mosapride citrate dispersible tablets, while the low-sugar diet group was treated with a low-sugar diet combined with lactulose oral solution on the basis of the treatment for control group.After 4 weeks, the outcomes of patients were compared in terms of IBS-SSS severity score.The clinical disease activities of patients were compared between groups.The changes in the levels of inflammatory markers, dietary intake, microbial composition and functional changes, and the concentrations of short-chain fatty acids were observed. Results Compared with the control group, the clinical score, pain degree, abdominal distension, quality of life and symptom relief of patients in the low-sugar diet group significantly reduced(P<0.05).There were no significant differences between the two groups in the days of pain, stool frequency and stool characteristics(P>0.05), nor in the number of genes, number of microorganisms, Phyla distribution, Shannon index and Bray-Curtis index(P>0.05).The abundances of 33 microorganisms in the two groups were significantly affected by diet(P<0.05).There was no significant difference in the relative abundance of total bifidobacteria between groups(P>0.05).The counts of Bifidobacterium longum and Bifidobacterium adolescentis in the low-sugar group were significantly lower than those in the control group(P<0.05).After given low-sugar diet, the abundance of Bifidobacterium dentata was higher, and that of total Clostridium prastilinoids was significantly lower than in the control group, respectively(P<0.05).The abundance of 34 KO(KEGG orthology)groups was significantly different between groups

关 键 词：低糖饮食 肠道菌群 肠易激综合征 

分 类 号：R378[医药卫生—病原生物学]