益生菌预防婴幼儿抗生素相关性腹泻及对肠道菌群的影响

【目的】探讨益生菌对婴幼儿期感染性疾病患儿抗生素应用中腹泻的预防作用及肠道菌群的变化。【方法】89例应用抗生素治疗的下呼吸道感染患儿随机分成两组,一组(益生菌组)同时服用双歧杆菌三联活菌,另一组不用任何微生态制剂为对照组,比较两组腹泻的发生率。分别在抗生素给药前及给药后第3、6 d采集粪便,用荧光定量PCR的方法检测肠道菌群的变化。【结果】44例益生菌组患腹泻5例(发生率为11.3%),45例对照组患儿患腹泻21例(发生率为46.6%)。益生菌组患儿腹泻平均时间(1.30±0.24)d,对照组患儿腹泻平均病程(2.10±0.33)d。抗生素治疗过程中,肠道菌群出现明显改变,益生菌组抗生素治疗后双歧杆菌、乳酸杆菌及大肠杆菌数量较稳定,明显高于对照组(P<0.01)。【结论】益生菌能通过稳定肠道菌群而预防婴幼儿抗生素相关性腹泻。     

双歧杆菌拮抗肠道致病菌的体外实验

双歧杆菌是肠道的一种重要的生理菌。急性腹泻患者发病时,肠道菌群发生变化,双歧杆菌数量显著减少,而脱水患者更有甚之。使用双歧杆菌活菌制剂治疗后,原菌群平衡恢复。最常见的急性腹泻是感染性腹泻,而感染性腹泻常见病原多为致病性大肠杆菌、沙门氏菌、志贺氏菌、空肠弯曲菌及轮状病毒等等。本文研究双歧杆菌体外拮抗肠道致病菌的作用。     

双歧杆菌对严重烧伤患者美罗培南应用后肠菌群的调节

目的探讨双歧杆菌对烧伤患者大剂量应用美罗培南后,紊乱肠菌群调整作用.方法严重烧伤患者23例应用美罗培南(6 g/d)7 d后, 随机分为治疗组(n=11)和对照组(n=12);双盲法给予双歧杆菌悬液和生理盐水(100 ml/d),疗程5 d;分别于美罗培南应用前及用后0、1、3、5 d,常规方法检测粪便中双歧杆菌、真菌、大肠埃希菌量.结果美罗培南应用7 d,肠道菌群中双歧杆菌量骤减近100倍,真菌数激增100倍;双歧杆菌治疗1 d,肠道双歧杆菌数增加100倍,3 d后真菌量减少约25倍;对照组在停用美罗培南后5 d 肠道菌群始基本恢复;腹泻患者口服双歧杆菌后3 d肠道菌群恢复,对照组5 d恢复.结论长期大剂量应用美罗培南可导致肠道菌群紊乱,停药后外源性补充双歧杆菌能较快恢复肠道生态,治愈抗菌药物相关性腹泻.     

肠道双歧杆菌与婴幼儿腹泻

双歧杆菌是人类肠道菌群中重要的生理菌和优势菌,它具有抗感染、调节肠道菌群以及促进婴幼儿生产长发育等功能。研究双歧杆菌在婴幼儿腹泻粪便中的数量变化,对深入了解腹泻机理及其生态学防治可提供有意义的依据。 一、材料与方法 1.调查对象:腹泻组56例选自包头市区各大医院儿科门诊,年龄为5岁以下的腹     

嗜酸乳杆菌NCFM和乳双歧杆菌HN019联用对小鼠肠道菌群的调节作用

目的探究嗜酸乳杆菌NCFM和乳双歧杆菌HN019联用对Balb/c小鼠肠道菌群的调节作用。方法使用低、中、高剂量的嗜酸乳杆菌NCFM和乳双歧杆菌HN019混合菌粉灌胃雄性Balb/c小鼠14 d,收集0、7、14 d小鼠粪便,梯度稀释后平板培养计数粪便中双歧杆菌、乳杆菌、肠杆菌、肠球菌、产气荚膜梭菌的数量以及双歧杆菌与肠杆菌的比值(B/E值)。结果益生菌低剂量组小鼠第7天肠道双歧杆菌、乳杆菌数量显著高于基质对照组(P0.05);低、中剂量组小鼠第7天肠道产气荚膜梭菌数量显著低于干预前(P0.05);高剂量组小鼠肠道B/E值显著高于空白对照组和基质对照组(P0.05)。结论嗜酸乳杆菌NCFM和乳双歧杆菌HN019联用对Balb/c小鼠肠道菌群具有很好的调节作用。     

长期过量饮用不同品质浓香型白酒对大鼠肠道正常菌群影响的研究

目的应用实时荧光定量PCR法研究大鼠肠道正常菌群的变化,揭示长期过量饮用高浓度不同品质浓香型白酒对大鼠肠道正常菌群的影响。方法采用48.0%乙醇溶液作为对照组,以12周灌胃的方式分别给予SD大鼠两种不同浓香型白酒,收集大鼠粪便,提取细菌基因组DNA。应用实时荧光定量PCR法分别测定双歧杆菌、乳酸杆菌、产气荚膜梭菌群、拟杆菌、肠杆菌、拟杆菌门菌、硬壁菌门菌、肠球菌及全肠道菌群的数量,采用SPSS 16.0软件进行统计学分析。结果各组大鼠粪便样品中乳酸杆菌、拟杆菌、肠杆菌、拟杆菌门菌、硬壁菌门菌、肠球菌及全肠道菌群的数量有统计学差异(P0.05),硬壁菌门菌/拟杆菌含量比值仅乙醇组低于空白组,而产气荚膜梭菌群及双歧杆菌的数量差异无统计学意义(P0.05)。结论长期过量饮用酒精会导致肠道益生菌减少,饮用白酒与相同度数乙醇对肠道菌群的影响存在差异,高品质白酒对机体肠道菌群影响更小,更利于维护肠道微生态平衡。     

成都地区中老年人肠道双歧杆菌构成初探

目的本研究旨在初探成都地区中老年人肠道双歧杆菌的种群分布的特点。方法收集成都地区2014年3~5月间45~74岁的正常健康中老年人的粪便标本60例,根据细菌的16Sr RNA基因序列设计双歧杆菌属及种的特异性引物,应用实时荧光定量PCR(Real-time quantitative PCR)反应对粪便标本中的双歧杆菌属及其人体最常见的8个种水平的进行定性定量分析。结果受试标本的双歧杆菌检出率是100%,平均检出4种以上双歧杆菌,检出3~6种的占70%以上;受试标本中的双歧杆菌数量平均值是8.2(以Log10为单位)、青春双歧杆菌(P0.05)和角双歧杆菌(P0.1)随年龄的增高,数量减少,其余6种双歧杆菌并没有随着年龄的增高出现统计学上的差异。婴儿双歧杆菌、短双歧杆菌的菌量随BMI的增高先增加后减少(P0.05)。角双歧杆菌的数量(P0.01)在不同性别表现不同。结论成都地区健康中老年人的肠道双歧杆菌数量显著地偏低,但是其菌种数却维持在较高的水平,和肠道双歧杆菌数量相比,肠道双歧杆菌数量菌种构成的多样性可能和中老年人健康有着更重要的关系。     

培菲康联合马来酸曲美布汀治疗肠易激综合征的临床疗效及肠道益生菌群变化分析

[目的]评价培菲康治疗肠易激综合(IBS)的疗效。[方法]以罗马Ⅲ肠易激综合征诊断标准选取IBS患者200例,随机分为对照组和治疗组,其中对照组100例予以马来酸曲美布汀治疗4周,治疗组100例予以培菲康联合曲美布丁治疗4周;治疗完成后通过对患者症状评定评价疗效,比较治疗前后患者粪便中双歧杆菌和乳杆菌数量的变化。[结果]治疗组在治疗4周后症状好转明显优于对照组,其中腹痛或腹部不适、腹胀症状及排便形态明显好转。治疗后治疗组粪便中双歧杆菌及乳杆菌含量均高于治疗前(P﹤0.05)。在无论是腹泻型还是便秘型IBS患者中,治疗有效者治疗后粪便中双歧杆菌和乳杆菌含量都要多于对照组(P﹤0.05),治疗组两型病例治疗后肠道双歧杆菌和乳杆菌并无显著性差异。对照组治疗后总有效率为67%,治疗组治疗后总有效率为93%,两组患者治疗后总有效率比较差异有统计学意义(P﹤0.05)。[结论]培菲康联合马来酸曲美布汀治疗治疗IBS疗效满意,可增加肠道益生菌的数量,不良反应少,优于单用马来酸曲美布汀,值得临床推广和应用。     

初乳对新生儿肠道双歧杆菌和肠杆菌的影响

目的 探讨初乳对新生儿肠道双歧杆菌和肠杆菌生长的作用。方法 采用厌氧菌培养技术，对５－７天的３２名初乳喂养儿和２４名人工喂养的儿的粪便做双歧杆菌和直菌定量培养。结果 初乳喂养儿粪便双歧杆菌的数量明显高于肠杆菌；人工喂养儿粪便直菌的数量高于双歧杆菌。结论 初乳对早期新生儿肠道菌群替发挥 发作用，它促进双歧杆菌生长，、抑帛杆菌生长。     

双歧杆菌乳杆菌三联活菌片联合莫沙必利治疗便秘型肠易激综合征的临床效果

目的 探讨双歧杆菌乳杆菌三联活菌片联合莫沙必利治疗便秘型肠易激综合征(IBS)的临床效果。方法 80例便秘型IBS患者随机分为两组,对照组采用莫沙必利治疗,观察组采用双歧杆菌乳杆菌三联活菌片联合莫沙必利治疗,比较两组的治疗效果和胃肠激素水平。结果 观察组的治疗总有效率为92.5%,显著高于对照组的70.0%(P<0.05)。治疗后,观察组的血清生长抑素、血管活性肠肽水平均显著低于对照组,血清胃动素水平显著高于对照组(P<0.05)。结论 双歧杆菌乳杆菌三联活菌片联合莫沙必利治疗便秘型IBS的效果显著,能有效改善患者的胃肠激素水平。     

益生菌颗粒对便秘和腹泻患者的临床研究

目的观察益生菌颗粒对便秘与腹泻患者的疗效和安全性。方法采用自身对照试验,77例便秘和87例慢性腹泻患者口服益生菌颗粒30d,记录并量化服用前、后患者的胃肠道症状和不良反应情况。结果口服益生菌颗粒30d后,便秘、腹泻患者有效率分别为为71.4%、77.0%,无不良反应。结论益生菌颗粒可明显改善腹泻和便秘的症状,且安全性高、耐受性好。     

莫沙必利联合聚乙二醇电解质散在便秘患者结肠镜检查肠道准备中的应用

目的 探讨莫沙必利联合聚乙二醇电解质散对慢性便秘患者结肠镜前清洁肠道的效果.方法 选择需行结肠镜检查的慢性便秘患者127例,随机分为观察组64例,口服莫沙必利10 mg和聚乙二醇电解质散;对照组63例,单服聚乙二醇电解质散行结肠镜检查前肠道准备.比较两组患者肠道清洁度、首次排便时间及不良反应.结果 观察组Boston肠道准备量表评分（8.32±0.86）分,对照组（7.69±0.95）分,两组差异有统计学意义（t=3.918,P＜ 0.05）.观察组服药后首次排便时间（45.69±13.57） min,对照组（54.63±11.78） min,两组差异有统计学意义（t=3.966,P＜0.05）.服药后,观察组出现恶心呕吐5例,腹胀11例;对照组恶心呕吐13例,腹胀23例.两组差异有统计学意义（x2=4.29,6.04,P＜0.05）.结论 莫沙必利联合聚乙二醇电解质散可提高肠道清洁质量,缩短首次排便时间,减少不良反应.     

紫菜粉对小鼠肠道排便功能的影响

目的研究不同紫菜粉含量的饲料的润肠通便、抑制肠道有害菌以及对粪便挥发性成分的影响。方法以小鼠为实验对象,随机分为空白组、低、高剂量3组,给予含不同紫菜粉的配合饲料30d,测小鼠体重、粪便持水量、粒数、重量、排首黑便时间、pH、大肠杆菌含量以及挥发性成分。结果在连续喂食30d后,紫菜组小鼠粪便持水量、排便粒数、重量都显著增加(P<0.05),首黑便时间缩短,其中以5%的喂食量效果较好。另外,粪便pH值随紫菜添加量的增加而升高,大肠杆菌的含量也呈浓度趋势减少,包括醇类、酚类、烃类、酮类等的挥发性臭气化合物含量下降,同样以5%的功效较好。结论动物实验表明紫菜粉中的膳食纤维具有通便、改善肠道功能和减少粪便臭味的作用。     

乳果糖口服液联合聚乙二醇电解质散剂在便秘患者行结肠镜检查前肠道准备中的应用

目的：分析研究乳果糖口服液联合聚乙二醇电解质散剂在便秘患者行结肠镜检查前肠道准备中的应用。方法抽取2015年1月～2016年6月我院接受结肠镜检查的106例便秘患者,随机分为两组,各53例。对照组口服聚乙二醇电解质散剂;观察组在此基础上联合使用乳果糖口服液。对两组患者首次排便时间、肠道清洁时间、排便次数及肠道清洁效果、不良反应进行统计分析。结果观察组肠道准备情况、清洁效果均显著优于对照组,差异有统计学意义（P＜0.05）;观察组不良反应发生率为7.55%,与对照组5.66%相比,差异无统计学意义（P＞0.05）。结论乳果糖口服液联合聚乙二醇电解质散剂用于便秘患者结肠镜检查前肠道准备中,可有效缩短肠道清洁时间、提高肠道清洁效果,且具有一定安全性,值得推广运用。     

Lactobacillus rhamnosus GG and Bifidobacterium animalis MB5 induce intestinal but not systemic antigen-specific hyporesponsiveness in ovalbumin-immunized rats

Probiotics may modulate the host immune response by mechanisms not yet fully understood. We evaluated the modulation of intestinal and systemic antigen-specific immune response by Lactobacillus rhamnosus GG (LGG) or Bifidobacterium animalis MB5 in tolerized and immunized rats. Three groups of rats received orally LGG, B. animalis, or PBS (control) for 28 d. Each group was divided into two subgroups of tolerized or immunized rats receiving orally ovalbumin (OVA; 7 mg) or PBS on d 7, 9, and 11. All rats were immunized with OVA (300 μg) on d 14 and 21. In tolerized rats, the OVA-induced proliferative response of mesenteric lymph nodes (MLN) and spleen cells did not differ from control, indicating that the two probiotics maintained the tolerance. LGG and B. animalis in immunized rats reduced the OVA-induced proliferative response in MLN (P < 0.01) but not in spleen, whereas the proliferative response to anti-CD3 and concanavalin A of MLN and spleen cells as well as the delayed-type hypersensitivity reaction were not affected by probiotic treatment, indicating OVA-specific hyporesponsiveness restricted to intestinal immunity. This hyporesponsiveness was associated with CD4+CD25+Foxp3+ T cell expansion (P < 0.01) and increased IL-10 and TGFβ after LGG (P < 0.05), and increased apoptosis after B. animalis (P < 0.001) in MLN. In conclusion, we report a novel activity of LGG and B. animalis in inducing OVA-specific hyporesponsiveness in MLN of OVA-immunized rats that can be useful for a therapeutic strategy to prevent undesirable reactions to immunogenic antigens in the gut.     

美常安联合乳果糖治疗慢性功能性便秘的疗效观察

目的评价美常安联合乳果糖治疗慢性功能性便秘的疗效。方法采用随机、双盲、平行的方法将慢性功能性便秘患者83例分为三组,A组(n=31)口服美常安+乳果糖,B组(n=27)口服美常安,C组(n=25)口服乳果糖,疗程4 w。结果治疗4 w后,三组总有效率分别为96.8%,44.4%,72.0%。A组显著高于B和C两组(p<0.05)。结论美常安联合乳果糖治疗慢性功能性便秘优于单用一种药物,且效果明显,安全、有效,值得临床推广应用。     

Effects of infant formula containing a mixture of galacto- and fructo-oligosaccharides or viable Bifidobacterium animalis on the intestinal microflora during the first 4 months of life

Adding prebiotics or probiotics to infant formula to improve the intestinal flora of formula-fed infants is considered to be a major innovation. Several companies have brought relevant formulations onto the market. However, comparative data on the effects of pre- and probiotics on the intestinal microflora of infants are not available. The present study aimed to compare the effects of infant formula containing a mixture of galacto- and fructo-oligosaccharides or viable Bifidobacterium animalis on the composition and metabolic activity of the intestinal microflora. Before birth, infants were randomised and double blindly allocated to one of three formulas. The prebiotic (GOS/FOS) group (n 19) received regular infant formula supplemented with a mixture of galacto-oligosaccharides and fructo-oligosaccharides (6 g/l). The probiotic (Bb-12) group (n 19) received the same formula supplemented with 6.0x10(10) viable cells of B. animalis per litre. The standard group (n 19) received non-supplemented regular formula. A group of sixty-three breast-fed infants was included as a reference group. Faecal samples were taken at postnatal day 5 and 10, and week 4, 8, 12 and 16. Compared with the groups fed Bb-12 and standard formula, the GOS/FOS formula group showed higher faecal acetate ratio (69.7 % (sem 2.7), 69.9 % (sem 3.9) and 82.2 % (sem 5.3); P<0.05) and lactate concentration (11.3 (sem 7.9), 3.1 (sem 2.3) and 34.7 (sem 10.7) mmol/kg faeces) and lower pH (6.6 (sem 0.2), 7.1 (sem 0.2) and 5.6 (sem 0.2); P<0.05) at 16 weeks. Differences in percentage of bifidobacteria between the GOS/FOS (59.2 % (sem 7.7)), Bb-12 (52.7 % (sem 8.0)) and the standard (51.8 % (sem 6.4)) groups were not statistically significant at 16 weeks. Feeding infants GOS/FOS formula resulted in a similar effect on metabolic activity of the flora as in breast-fed infants. In the Bb-12 group, composition and metabolic activity of the flora were more similar to those of the standard group.     

Utilization of resistant starch of native tapioca, corn and waxy corn starches and their retrograded preparations by Bifidobacterium

Anaerobic fermentation of native starches from tapioca, normal and waxy corn, and their laboratory modified preparations, by selected Bifidobacterium strains (Bifidobacterium pseudolongum KSI9, Bifidobacterium breve KN14, and Bifidobacterium animalis KS20a1) was carried out under in vitro conditions. The growth and acidifying properties of bifidobacteria and utilization of resistant starches were determined in relation to glucose in the control sample. The preparations obtained from normal and waxy corn starches were the best substrates for growth of B. breve KN14, even compared with glucose. The growth of B. animalis KS20a1 was comparable, both on native and modified starches, whereas the starch preparations better stimulated the growth and acidifying activity of B. pseudolongum KSI9, as compared with native starches. The resistant starch fractions of all preparations were generally utilized to a higher degree (64-85%) compared with native starches (56-79%). The results of the study indicate that tapioca and corn starches, both native and modified, could be substrates beneficial for the enhancement of Bifidobacterium intestinal populations.     

肠道子宫内膜异位症的临床特点及腹腔镜治疗21例分析

目的：探讨肠道子宫内膜异位症（bowel endometriosis，BE）的临床特点、诊断方法及腹腔镜手术治疗优势。方法：回顾性分析上海交通大学医学院附属仁济医院妇科肿瘤科自2014年2月—2018年1月收治的21例BE患者的临床表现、诊断方法及腹腔镜手术治疗优势及要点。结果：21例BE患者均有不同程度的肠道症状，如腹泻、便秘、排便痛等不适主诉。所有患者均接受腹腔镜手术治疗，其中7例（33.33%）行肠壁浆肌层病灶切除，14例（66.67%）行节段性肠切除吻合术。21例患者术后均无肠瘘、吻合口出血、吻合口瘘及吻合口狭窄等并发症。术后发生小肠梗阻1例（4.76%），尿潴留2例（9.52%），术后盆腔感染1例（4.76%）。术后患者痛经、性交痛、排便痛、下腹痛视觉模拟评分法（Visual Analogue Score，VAS）评分较术前均显著降低（P＜0.05），腹泻、便秘等不适主诉均较术前有所缓解。结论：BE的临床表现不典型，诊断困难。腹腔镜手术能有效缓解相关疼痛症状，是首选的手术方式。     

Dietary fiber and bowel function in tube-fed patients.

In tube-fed patients, dietary fiber is often used to manage constipation/diarrhea. Dietary fiber consists of water-soluble and insoluble plant compounds that are resistant to digestion by small-bowel enzymes but are fermented to varying degrees by colonic bacteria. Many physiologic effects of fiber may be related to the degree of fermentation. Few controlled studies of fiber-containing tube feedings have been performed. These studies have limitations and are nondefinitive as to whether fiber prevents or controls constipation/diarrhea. Constipation in tube-fed patients has not been shown to respond to mixed soluble/insoluble fiber in the few studies performed to date. Likewise, fiber may be of only limited benefit in controlling diarrhea in acute illness because of such factors as stress or medication. Fiber does play a role in maintaining gut integrity in all patients, whether they have diarrhea or not. Fiber may be recommended as part of a standard tube-feeding regimen to help assure gut mucosal integrity but not specifically to treat constipation/diarrhea. Further studies are necessary before the role of fiber in the management of constipation/diarrhea in tube-fed patients is determined.