维生素D联合粪菌移植治疗腹泻型肠易激综合征的疗效与疾病转归研究  

Study on Efficacy and Disease Outcome of Vitamin D Combined with Fecal Microbiota Transplantation in Patients with Diarrhea-Type Irritable Bowel Syndrome

作　　者：杨博[1] 缪婷婷[1] 洪文[1] 刘亚坡 路明[1] YANG Bo;MIAO Tingting;HONG Wen;LIU Yapo;LU Ming(Dept.of Proctology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院肛肠科,乌鲁木齐830054

出　　处：《中国医院用药评价与分析》2025年第1期37-40,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：新疆维吾尔自治区自然科学基金面上项目(No.2022D01C233)。

摘　　要：目的:探讨维生素D联合粪菌移植治疗腹泻型肠易激综合征(IBS-D)的疗效及对疾病转归的影响。方法:选取2022年5月至2023年10月该院收治的IBS-D患者122例,采用随机数字表法分为对照组和研究组,每组61例。在常规治疗基础上,对照组患者给予粪菌移植治疗,研究组患者给予维生素D联合粪菌移植治疗。比较两组患者的临床疗效、肠道菌群、内脏敏感性指标及3个月复发率。结果:对照组58例、研究组59例患者完成研究。研究组患者的治疗总有效率高于对照组[94.9%(56/59)vs.81.0%(47/58)],差异有统计学意义(P<0.05)。治疗后,研究组患者IBS症状严重程度量表各维度评分及总分低于对照组,粪便双歧杆菌、乳杆菌含量高于对照组,肠球菌含量低于对照组,直肠初始感觉阈值、初始排便冲动阈值和最大耐受容量增加,血清5-羟色胺、P物质水平低于对照组,差异均有统计学意义(P<0.05)。两组治疗有效的患者中,研究组患者的复发率低于对照组[5.4%(3/56)vs.19.1%(9/47)],差异有统计学意义(P<0.05)。结论:维生素D联合粪菌移植能够提高IBS-D患者的临床疗效,减少疾病复发,而且能够调节肠道菌群和降低内脏高敏性。OBJECTIVE:To explore the efficacy and disease outcome of vitamin D combined with fecal microbiota transplantation in patients with diarrhea-type irritable bowel syndrome(IBS-D).METHODS:A total of 122 patients with IBS-D admitted into the hospital from May 2022 to Oct.2023 were extracted to be divided into the control group and study group by the random number table method,with 61 cases in each group.On the basis of routine treatment,the control group received fecal microbiota transplantation,while the study group was given vitamin D combined with fecal microbiota transplantation.Clinical efficacy,gut microbiot,visceral sensitivity indices and recurrence rates in 3 months between two groups were compared.RESULTS:Totally 58 cases in the control group and 59 cases in the study group completed the study.The total effective rate of study group was higher than that of control group[94.9%(56/59)vs.81.0%(47/58)],the difference was statistically significant(P<0.05).After treatment,severity scale scores of IBS and total scores in the study group were lower than those in the control group,Bifidobacterium faecalis and Lactobacillus were higher than those in the control group,Enterococcus were lower than those in the control group,initial rectal sensation threshold,initial defecation impulse threshold and maximum tolerance capacity increased,serum 5-hydroxytryptamine and substance P levels were lower than those in the control group,the differences were statistically significant(P<0.05).Among the two groups of patients with effective treatment,the recurrence rate of study group was lower than that of control group[5.4%(3/56)vs.19.1%(9/47)],with statistically significant differences(P<0.05).CONCLUSIONS:Vitamin D combined with fecal microbiota transplantation can improve clinical efficacy of patients with IBS-D,reduce the disease recurrence,regulate the gut microbiota and reduce the visceral hypersensitivity.

关 键 词：维生素D 粪菌移植 腹泻型肠易激综合征 肠道菌群 内脏高敏性 复发 

分 类 号：R977.24[医药卫生—药品]