口服Cocktail A乳酸菌制剂对人肠道乳酸菌群影响的研究

目的评价口服Cocktail A乳酸菌制剂后人肠道乳酸菌群的变化。方法用需氧和厌氧定量培养方法分离并鉴定烧伤病房中30例腹泻患者给予Cocktail A乳酸菌制剂治疗前后肠道中的细菌,并以正常健康体检者的粪便培养鉴定结果作为对照。同时对未鉴定出的细菌用16S rRNA基因进行鉴定。结果腹泻患者肠道中的菌群与健康体检者肠道中的菌群相比,乳酸菌的数量和种类少,而口服乳酸菌制剂治疗后肠道中的植物乳杆菌、明串珠球菌、戊糖片球菌、副酪蛋白乳杆菌大量增加。结论口服Cocktail A乳酸菌制剂能调节肠道的菌群失调。     

严重烧伤伴腹泻患者口服双歧杆菌制剂的疗效观察及护理

目的：观察双歧杆菌制剂治疗严重烧伤病人腹泻的作用。方法：选取烧伤后腹泻病人26例，从腹泻当天开始喂服双歧杆菌活菌制剂，于喂服前及喂服后第3天及第6天采集粪便做粪便菌群分析。另选10名健康成年人粪便标本为对照组。结果：严重烧伤后粪便菌群总菌量较正常显下降，肠杆菌轻度下降，双歧杆菌下降近1000倍，酵母样真菌显升高，说明肠道菌群发生紊乱。用双歧杆菌制剂治疗6d后腹泻均停止，肠道菌群趋向正常，与对照组和治疗前比较均存在显性差异（P＜0．05或P＜0．01）。结论：口服双歧杆菌制剂能调整肠道菌群紊乱，起到治疗腹泻的作用。注意饭后给药，低温（4℃）存放药物。     

双歧杆菌四联活菌辅助治疗对高尿酸血症的临床分析

目的 研究高尿酸血症（HUA）患者肠道菌群变化,观察双歧杆菌四联活菌制剂干预对HUA治疗效果及肠道菌群影响。方法 将100例高尿酸血症患者随机分为实验组A组和标准组B组各50例,另选择同期健康体检者50例作为对照组C组。 A、B组患者均予非布司他治疗,B组加服双歧杆菌四联活菌片,疗程为2周。测定各组治疗前后的血尿酸及粪便结果。结果 治疗前,A、B组粪便中双歧杆菌、乳酸杆菌及粪肠球菌含量明显低于正常对照组,而大肠杆菌含量明显增多（P<0.05）。治疗后A、B患者血尿酸水平明显下降,其中A组明显低于B组（P<0.05）,A组患者粪便内细菌分解尿酸量较治疗前明显升高,且与B组具有统计学意义（P<0.05）,A组粪便中双歧杆菌、乳酸杆菌及粪肠球菌含量较治疗前明显增多,且与B组存在明显统计学意义（P<0.05）。 结论 HUA治疗过程中添加双歧杆菌活菌制剂辅助治疗可明显降低血尿酸,可能与肠道细菌尿酸处理能力增强有关。     

乳酸菌对高脂血症小鼠血脂和肠道菌的影响

目的:研究功能乳酸菌制剂的降血脂作用及对肠道菌的影响。方法:建立小白鼠高脂血症动物模型;模型小鼠30只,随机分为:生理盐水组、复合乳酸菌组和辛伐他汀组,每组10只。采取灌胃处理,分别灌服生理盐水、复合乳酸菌制剂(等比例混合的植物乳杆菌、嗜酸乳杆菌和干酪乳杆菌)和降血脂药物辛伐他汀。结果:与生理盐水比较,乳酸菌和辛伐他汀药物处理显著降低了小鼠血清胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(HDL-C)含量(P0.05);乳酸菌处理和药物处理间TC、TG和HDL-C无显著差异。与降血脂药物相比,乳酸菌处理显著增加小鼠粪便乳酸菌数量(P0.05),降低了大肠杆菌(P0.05)和肠球菌数量(P0.01)。结论:乳酸菌制剂具有降低血脂、增加肠道有益菌数量、降低肠道有害菌数量的作用。     

乳酸菌与肿瘤防治

双歧杆菌乳杆菌是人和动物肠道中占绝对优势的生理性细菌这些细菌都能发酵糖类，并产生大量到，因此称之为 到菌。双歧杆菌等乳酸菌与机体共同构成一个整体，对维护肠道微生态平衡和健康具有重要意义。     

肠易激综合征患者肠道菌群分析及应用益生菌疗效观察

目的了解益生菌治疗肠易激综合征的疗效及治疗前后患者肠道菌群变化。方法选取符合罗马Ⅲ标准的IBS患者26例及年龄、性别相匹配的对照组25人,采用细菌培养法对肠道五种常见菌群进行定量检测,肠易激综合征(IBS)患者给予益生菌治疗,比较治疗前后患者粪便中五种常见菌群数量的变化,同时根据患者治疗前后肠道症状评分评价疗效。结果与健康对照组相比,IBS患者粪便中肠杆菌明显增加(P<0.05);双歧杆菌及乳杆菌差异数量均少于正常人群(P<0.01,P<0.05);B/E值显著低于健康对照组(P<0.01);而肠球菌和拟杆菌差异无统计学意义;治疗后粪便中双歧杆菌及乳杆菌含量均高于治疗前(P<0.01,P<0.05);B/E值增加(B/E>1)但较治疗前差异无统计学意义;肠杆菌、肠球菌、拟杆菌治疗前后差异无统计学意义。服用益生菌制剂4周后,26例IBS患者中16例有效,10例无效,有效率为62%;症状总积分显著降低(P<0.01)。结论 IBS患者存在肠道菌群异常,肠道定植抗力减弱;益生菌制剂能够增加IBS患者肠道有益菌数量,改善肠道症状。     

异基因造血干细胞移植过程中患者艰难梭菌感染与肠道微生态失调关系的临床研究

本研究探讨异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation,allo-HSCT）过程中患者艰难梭菌相关性腹泻（clostridium difficile associated diarrhea,CDAD）与肠道微生态的关系,了解肠道微生态失衡的临床特征,寻找有效防治措施,保护肠道菌群,减少细菌易位及感染的发生。对44例allo-HSCT后腹泻患者采用艰难梭菌毒素A＆B检测试剂盒进行毒素检测,采用厌氧培养方法进行艰难梭菌的分离、鉴定。对患者粪便标本进行肠道微生态研究;采用光冈复合式法对目的菌群（双歧杆菌、乳酸杆菌、类杆菌、消化链球菌、产气荚膜梭菌、肠杆菌、肠球菌、酵母菌）进行定性定量分析。结果表明：44例腹泻患者中共检测出12例艰难梭菌阳性,阳性率为27.27%;CDAD的发生与使用抗生素或化疗药物有关;CDAD患者的肠道微生态发生了明显变化,表现为乳酸杆菌、双歧杆菌、类杆菌、肠杆菌等细菌数量明显下降;对CDAD用万古霉素、甲硝唑等药物并配合给予益生菌治疗效果好,但有一定复发率（16.67%）。结论：allo-HSCT并发CDAD与肠道微生态的改变有关,应用敏感抗生素治疗的同时应积极扶植肠道菌群,这样的治疗有利于改善病情和减少复发。     

婴幼儿病毒性腹泻肠道微生态变化特点分析

目的 分析婴幼儿病毒性腹泻与肠道微生态变化的关系.方法 300例病毒性腹泻婴幼儿(腹泻组),随机分为微生态制剂治疗组(微生态制剂组)和常规收敛剂治疗组(收敛剂组);50例健康婴幼儿作为对照组;采集粪便标本进行细菌涂片革兰染色检查.结果 腹泻组婴幼儿粪便中细菌分布与对照组差异有统计学意义(P<0.05);微生态制剂组患儿腹泻持续天数少于收敛剂组(P<0.05).结论 病毒性腹泻婴幼儿肠道菌群以革兰阳性球菌为主,存在菌群失调,应用微生态制剂可缩短治疗周期.     

NEC患儿肠道菌群的优势菌属及益生菌制剂疗效分析

目的探讨新生儿坏死性小肠结肠炎(NEC)患儿肠道菌群的优势菌属及益生菌制剂的疗效。方法选取2018年2月至2020年2月于该院治疗的30例NEC患儿作为观察组,同时选取于该院体检的健康儿童30例作为对照组。比较观察组和对照组儿童肠道菌群的丰富度并分析两组儿童肠道菌群的优势菌属。采用随机数字表法,将观察组患儿分为A组及B组;A组患儿采用酪酸梭菌二联活菌散剂联合奥曲肽治疗,B组患儿仅采用奥曲肽治疗;两组患儿均治疗1周,比较两组患儿的治疗效果以及肠道菌群的差异。结果观察组肠道菌群丰富度显著低于对照组(P0.05),两组儿童的肠道细菌优势菌属条带相似度接近100%。观察组患儿双歧杆菌及大肠埃希菌呈下降趋势。经1周治疗,A组治疗总有效率显著高于B组(P0.05);治疗后,A、B两组患儿的粪便乳酸杆菌、双歧杆菌、肠球菌、真杆菌菌落数均有所升高(P0.05),且A组患儿乳酸杆菌、双歧杆菌、肠球菌、真杆菌菌落数明显高于B组。结论 NEC患儿肠道菌群中的双歧杆菌以及大肠埃希菌呈下降趋势,可通过采用益生菌制剂进行辅助治疗。     

儿童抗幽门螺旋杆菌感染治疗对肠道菌群影响的研究

目的探讨抗幽门螺旋杆菌 (helicobacter pylori,Hp)感染治疗对患儿肠道菌群的影响,为预防抗生素所致肠道不良反应提供实验依据。方法收集2013年12月～2014年7月在陕西省人民医院消化内科、儿科共60例患儿,对Hp阳性患儿使用克拉霉素片、阿莫西林／克拉维酸钾片和奥美拉唑肠溶胶囊抗Hp菌治疗10天后,留取新鲜粪便标本进行肠道菌群分析。分别称取患儿治疗前后的新鲜粪便1.0 g,进行肠道菌群培养,鉴定肠道菌群的菌种,将其数量和检出率等观察指标进行统计学分析。结果肠杆菌、肠球菌、双歧杆菌、类杆菌和乳杆菌在抗Hp感染治疗前后患儿肠道的检出率均为100%。治疗后双歧杆菌、乳杆菌数量下降,差异有统计学意义(t=44.745～49.19,P<0.01),其余肠杆菌、肠球菌、类杆菌、产气荚膜梭菌和酵母菌五类菌种治疗前后的数量差异无统计学意义(P>0.05)。治疗后患儿肠道微生物定植抗力值(B/E值)0.69±0.33,较治疗前1.18±0.44降低(t=7.715,P<0.05)。结论抗Hp感染治疗易引起患儿双歧杆菌和乳杆菌菌群紊乱,患儿肠道定植抗力降低。故抗菌药物治疗Hp感染时须注意及时补充以双歧杆菌和乳杆菌为主要成分的益生菌制剂。     

Lactobacillus prophylaxis for diarrhea due to enterotoxigenic Escherichia coli.

In vitro and animal experiments indicated that lactobacilli might prevent Escherichia coli from colonizing the intestine and may produce substances counteracting enterotoxin. Lactinex, a commercial preparation of dried Lactobacillus acidophilus and L. bulgaricus, is marketed for uncomplicated diarrhea. Preliminary experiments in nonfasting volunteers indicated that lactobacilli in this preparation colonized the small intestine for up to 6 h. To evaluate the protective efficacy of Lactinex, a double-blind randomized study was carried out in which 48 volunteers (23 receiving Lactinex and 25 receiving placebos) were challenged with E. coli strains that produced heat-stable or heat-labile enterotoxins or both. No significant differences between the two groups were noted with respect to attack rate, incubation period, duration of diarrhea, volume and number of liquid stools, and coproculture yields. These data suggest that this lactobacillus preparations does not prevent or alter the course of enterotoxigenic E. coli diarrhea in adults. Lack of efficacy occurred despite efforts to maximize small bowel colonization, including administration of Lactinex in milk and in a 6-hour-interval regimen during 36 h before and 96 h after challenge.     

Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea

Chronic diarrhea is a common bowel disorder; disturbance of intestinal microorganisms may play a role in its pathogenesis. This study assessed the clinical efficacy of lyophilized, heat-killed Lactobacillus acidophilus LB versus living lactobacilli in the treatment of chronic diarrhea. One hundred thirty-seven patients with chronic diarrhea were randomly allocated to receive either a 4-week course of 2 capsules of Lacteol Fort twice a day (Lacteol group, 69 patients) or a 4-week course of 5 chewable tablets of Lacidophilin three times a day (Lacidophilin group, 64 patients). The frequency of stools was recorded quantitatively, and semiquantitative parameters such as stool consistency, abdominal pain, distention, and feeling of incomplete evacuation were evaluated. At the second and fourth week of treatment, mean bowel frequency was significantly lower in the Lacteol group than in the Lacidophilin group (1.88 +/- 1.24 vs 2.64 +/- 1.12, 1.39 +/- 0.92 vs 2.19 +/- 1.05; P<.05). At the end of the treatment, the clinical symptoms were markedly improved in the Lacteol group, indicating that L. acidophilus LB is more effective than living lactobacilli in the treatment of chronic diarrhea.     

Effect of supplements with lactic acid bacteria and oligofructose on the intestinal microflora during administration of cefpodoxime proxetil

Thirty healthy volunteers in three groups participated in a study of the effect on the intestinal microflora of oral supplementation with Bifidobacterium longum, Lactobacillus acidophilus and oligofructose, an indigestible oligosaccharide, during oral administration of cefpodoxime proxetil bd for 7 days. Those in group A also received an oral supplement with c.1011 cfu of B. longum BB 536 and L. acidophilus NCFB 1748 and 15 g oligofructose daily, those in group B received a supplement with oligofructose only and those in group C received placebo, for 21 days. In all three groups there was a marked decrease in aerobic microorganisms, involving mainly a rapid and almost complete disappearance of Escherichia coli (P: < 0.05) during antimicrobial administration and, thereafter, an overgrowth of enterococci (P: < 0.05). The number of intestinal yeasts also increased significantly (P: < 0.05) in groups A and B over the same period. There was a dramatic decrease in anaerobic microorganisms on day 4 of administration, mainly caused by loss of bifidobacteria (P: < 0.05) in all groups. The number of lactobacilli also decreased but was significantly higher in group A than in group C at the end of cefpodoxime proxetil administration. Clostridium difficile was found in only one person from group A, but six persons each in groups B and C. Of the bifidobacterial strains isolated from the faecal samples in group A, one was similar to the strain of B. longum administered, but most volunteers were colonized by several different strains of B. longum during the investigation period. The administered strain of L. acidophilus was recovered from six patients in group A.     

实时荧光定量PCR在测定艾滋病患者肠道菌群量变化中的应用及意义

目的:应用实时荧光定量PCR观察艾滋病患者肠道菌群量的变化,研究艾滋病对肠道微生态的影响及其在发病中的作用。方法:分别设计双歧杆菌属、乳酸杆菌属、大肠杆菌、粪肠球菌及屎肠球菌的特异性引物。收集艾滋病患者粪便标本30份及正常对照标本30份,提取细菌基因组DNA,应用实时荧光定量PCR反应测定5种细菌的数量。结果:艾滋病患者组双歧杆菌属、乳酸杆菌属的数量较正常对照组明显减少;大肠杆菌、粪肠球菌、屎肠球菌数量明显增多,差异有统计学意义(P<0.05)。结论:艾滋病患者肠道微生态发生了明显变化,提示艾滋病患者肠道微生态紊乱。     

清肠化湿汤治疗溃疡性结肠炎的临床效果及对患者肠黏膜损伤和肠道微生态的影响

目的 探究清肠化湿汤治疗溃疡性结肠炎患者的临床效果及对患者肠黏膜损伤和肠道微生态的影响.方法 选择2018年5月至2020年5月收治的100例溃疡性结肠炎患者作为研究对象,根据计算机随机化法将其分为对照组(n=50)和试验组(n=50).对照组采取基础治疗+美沙拉嗪,试验组则同时配合清肠化湿汤治疗.比较两组的临床疗效、...     

蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的效果及对患儿细胞因子水平的影响

目的探讨蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻的效果及对患儿细胞因子水平的影响。方法选取2014年5月至2019年5月我院收治的急性腹泻患儿98例,按照随机数字表法将其分为对照组与研究组,各49例。对照组应用蒙脱石散治疗,研究组应用蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗。比较两组治疗效果。结果研究组患儿的治疗总有效率高于对照组(P<0.05)。治疗后,研究组患儿的IL-6、IL-10及TNF-α水平均低于对照组与治疗前(P<0.05)。治疗后,研究组患儿的乳酸杆菌、双歧杆菌均多于对照组与治疗前,肠球菌及肠杆菌均少于对照组与治疗前(P<0.05)。结论蒙脱石散联合双歧杆菌乳杆菌三联活菌片治疗小儿急性腹泻可以调节患儿肠道内菌群平衡,缓解炎症反应,可在临床中进一步推广应用。     

Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial

OBJECTIVES: To assess the efficacy of Lactobacillus GG in preventing antibiotic-associated diarrhea (AAD) in adults and, secondarily, to assess the effect of coadministered Lactobacillus GG on the number of tests performed to determine the cause of diarrhea. PATIENTS AND METHODS: In this prospective, randomized, double-blind, placebo-controlled trial conducted from July 1998 to October 1999, 302 hospitalized patients receiving antibiotics were randomized to receive Lactobacillus GG, 20 x 10(9) CFU/d, or placebo for 14 days. Subjects recorded the number of stools and their consistency daily for 21 days. The primary outcome was the proportion of patients who developed diarrhea in the first 21 days after enrollment. Weekly telephone follow-up was also performed. Results were analyzed in an intention-to-treat fashion. RESULTS: Diarrhea developed in 39 (29.3%) of 133 patients randomized to receive Lactobacillus GG and in 40 (29.9%) of 134 patients randomized to receive placebo (P=.93). No additional difference in the rate of occurrence of diarrhea was found between treatment and placebo patients in a subgroup analysis of those treated with beta-lactam vs non-beta-lactam antibiotics. Too few patients had stool cultures, additional laboratory tests for diarrhea, or a positive diagnosis of Clostridium difficile infection to assess between-group differences. CONCLUSION: Lactobacillus GG in a dose of 20 x 10(9) CFU/d did not reduce the rate of occurrence of diarrhea in this sample of 267 adult patients taking antibiotics initially administered in the hospital setting.     

β-内酰胺类抗菌药物对社区获得性肺炎患儿肠道菌群多样性及肠道菌群代谢能力的影响

目的探讨β-内酰胺类抗菌药物对社区获得性肺炎(CAP)患儿肠道菌群多样性及肠道菌群代谢能力的影响。方法选择2018年1月至2019年12月在该院治疗的120例CAP患儿为研究对象,分别对治疗前及治疗后的菌群丰度、肠道菌群菌属以及肠道菌群代谢能力进行比较。结果与治疗前比较,治疗3 d后,患儿粪便中不动杆菌属、肠球菌属、颤螺菌属、埃格特菌属丰度均显著升高,奇异菌属、双歧杆菌属、Dorea、乳酸菌属、链球菌属、萨特菌属、韦荣球菌属的菌群丰度均显著下降,差异有统计学意义(P<0.05);治疗前后,不动杆菌属、肠球菌属、颤螺菌属、埃格特菌属、奇异菌属、双歧杆菌属、Dorea、乳酸菌属、链球菌属、萨特菌属、韦荣球菌属的优势条带相似度之间的差异无统计学意义(P>0.05);治疗后,患儿粪便中乙酸水平显著高于治疗前,异戊酸、戊酸、丙酸、异丁酸、丁酸水平显著低于治疗前(P<0.05)。结论CAP患儿长时间使用β-内酰胺类抗菌药物治疗后,患者的肠道菌群丰度显著下降,肠道代谢能力随之发生改变。     

多种乳酸杆菌粘附活性的研究

目的比较热灭活状态和活苗状态乳酸杆菌对宫颈癌细胞(Hela)的粘附活性。方法运用光镜分析乳酸杆菌活菌和热灭活两种生物状态对Hela细胞的粘附指数。结果两种生物状态的乳酸杆菌对Hela细胞的粘附具有显著性,而热灭活状态对Hela细胞的粘附指数显著高于活菌状态。结论经热灭活的乳酸杆菌对Hela细胞有较强粘附性。     

三种泻药在肠道准备中效果的对比研究

目的：采用新的方法对肠道准备用药进行重新评价,探讨一种有效的肠道准备用药及措施,以提高肠镜检查及治疗的成功率。方法2011年1月-2012年12月某院门诊或住院完成结肠镜检查的患者3965例,其中单纯结肠息肉患者762例,完成研究的患者为85例。按自身对照设计原则,85例患者均半年复查一次肠镜,共复查3次,每次复查前随机给予口服3种泻剂（20％甘露醇、50％硫酸镁、番泻叶）中的1种准备肠道,每例患者3次复查口服泻剂不重复。按肠道准备方法的不同,分为3组：A组（口服20％甘露醇组）、B组（口服50％硫酸镁组）、C组（口服番泻叶组）。对3组患者服药后的肠道清洁度采用波士顿大学医学中心提出的Boston肠道准备量表（ BBPS ）进行评分比较、分析。结果3组患者的左半结肠、横结肠、右半结肠及全结肠肠道清洁效果PPBS评分比较,差异均无统计学意义（ H分别为1．103,1．377,0．179,0．160;P＞0．05）。结论口服20％甘露醇、50％硫酸镁、番泻叶在肠道清洁效果上无差异,肠道清洁效果与用何种药物准备肠道无关。护理健康教育可能是肠道准备中影响肠道清洁效果的重要因素。