国产微生态制剂金双歧片治疗急性腹泻的随机对照研究

金双歧是一种由双歧杆菌、乳杆菌和嗜热链球菌组成的三联活菌制剂 ,它能有效地调整肠道菌群 ,抑制肠道病原微生物的定植和生长。为考察金双歧片的临床疗效和安全性 ,本研究以培菲康胶囊 (上海信宜制药厂生产的一种活菌制剂 )为对照药 ,进行了双盲双模拟随机对照试验。结果表明 ,金双歧治疗急性腹泻时 ,对各种症状、体征及化验检查异常均有较好的治疗作用 ,临床有效率为 86 1% ,与培菲康治疗组相似 ( 91 6 % ,P >0 0 5 )。经治疗后两组病原菌均被清除。金双歧治疗组 2例恶心 ,培菲康治疗组有 3例恶心 ,均能耐受至疗程结束后 2天自行消失 ,未发现其它不良反应 ,不良反应发生率为 5 6 %和 8 3 %。表明金双歧是一种治疗急性腹泻安全有效的药物     

菌群失调引起真菌性小儿腹泻的菌种分布特点及微生态调节剂的应用

目的：了解因菌群失调引起的真菌性小儿腹泻的菌种分布特点，探索更安全、有效的治疗手段。方法：将120例0．6岁腹泻患儿的粪便直接涂片革兰氏染色镜检。对有菌群比例失调，同时查见较多真菌孢子和菌丝者，进行真菌分离鉴定，并采用微生态调节剂治疗。结果：120例0-6岁腹泻患儿粪便检出菌群比例失调者69例，其中查见真菌孢子厦茸丝者45例，真菌分布白色假丝酵母菌占44．4％，热带假丝酵母菌占26．7％，克柔氏假丝酵母菌占15．6％，近平滑假丝酵母菌占4．4％，季也蒙假丝酵母菌占4．4％。用微生态调节剂治疗菌群失调引起的小儿真菌性腹泻总治愈率为93．3％。结论：菌群失调引起的慢性迁延性小儿真菌性腹泻以白色假丝酵母菌感染为主，应用微生态制剂治疗方法简单、安全、有效。     

双歧三联活菌对肝硬化患者肠道菌群、血氨和血浆内毒素的影响

正常情况下肠道菌群保持平衡状态,细菌的种类和数量相对稳定。肝硬化患者存在着肠道菌群失调,表现为厌氧菌减少,需氧菌及兼性厌氧菌数量增多,可导致内毒素血症,肝功能损害及肠功能紊乱等[1]。随着对微生态制剂研究的进展,发现微生态制剂具有生物化学屏障、营养和改善肝脏和肠道功能、增强免疫、抗肿瘤作用等。本研究对肝硬化患者在常规保肝治疗的基础上辅助应用双歧三联活菌制剂进行治疗,     

双歧杆菌四联活菌片联合复方谷氨酰胺肠溶胶囊治疗老年人肠道菌群失调相关性腹泻的临床观察

目的观察双歧杆菌四联活菌片（商品名：思连康）联合复方谷氨酰胺肠溶胶囊对老年人肠道菌群失调相关性腹泻的临床疗效。方法肠道菌群失调相关性腹泻老年住院患者68例,根据随机数字表法按入院先后顺序随机分为治疗组和对照组各34例,治疗组服用双歧杆菌四联活菌片1 g加复方谷氨酰胺肠溶胶囊0.4 g,均3次/天;对照组仅服用双歧杆菌四联活菌片1 g,3次/天,比较两组总有效率及粪检结果。结果治疗组显效28例、有效5例、无效1例,总有效率为97.05%;对照组显效16例、有效10例、无效8例,总有效率为76.47%,两组总有效率比较差异有统计学意义（P〈0.05）;两组粪检杆球比例倒置、细菌计数减少、真菌感染等差异均有统计学意义（P〈0.05）。结论双歧杆菌四联活菌片联合复方谷氨酰胺肠溶胶囊治疗老年人肠道菌群失调相关性腹泻,疗效确切,安全可靠。     

粪便涂片观察菌群失调的临床意义

近年来,临床上由肠道菌群失调而造成的腹泻病菌人越来越多,引起临床高度重视。粪便涂片染色观察肠道菌群中各种菌的比例情况,协助临床诊断各类菌群失调症和紊乱症。更好的指导临床用药,提高治疗效果。1材料与方法1.1标本来源来自2007上1月至2007年7月本院住院的50例腹泻或合并腹泻患者。其中:消化内科22例,消化外科8例,神经外科20例。1.2标本采集无菌操作的状态下,用一次性无菌塑料杯采集新鲜大便5-10g或5-10ml。1.3涂片染色将新鲜粪便涂在载玻片上,均匀推片,面积约1-1.5cm×2-2.5cm。干燥粪便标本先取0.1g加0.9ml生理盐水充分混匀后推片,(…     

补充微生态制剂对腰椎后路手术患者肠道菌群失调的影响

目的探讨微生态制剂金双歧对腰椎后路手术患者肠道菌群的影响。方法72例腰椎后路手术患者,出现肠道菌群失调症者42例作为实验组（A组）,未出现肠道菌群失调症的30例作为对照组（B组）。两组患者术前、术后检测血浆内毒素、血清肿瘤坏死因子or．（TNF—a）及白细胞介素6（IL-6）。肠道菌群失调症者术后另加用金双歧。术前、术后第1次自然排便（术后1—4d）时分别留取粪便标本,比较两组患者肠道主要菌群差异、双歧杆菌（B）／肠杆菌（E）值。结果术前、术后第2、7天A、B两组患者血浆内毒素水平分别为（1．82±0．12）、（2．29±0．15）、（1．91±0．08）ng／L和（1．91±0．21）、（2．35±0．16）、（2．26±0．24）ng／L。TNF—d分另0为（275±51）、（309±45）、（276士34）ng／I~和（269±48）、（318±67）、（297±53）ng／L;IL-6分另0为（1384-22）、（159±15）、（137±17）ng／L和（159±16）、（187±19）、（174±21）ng／L。经重复测量方差分析显示,血浆内毒素、TNF-a、IL-63个指标组间、交互作用差异均有统计学意义（P均〈0．05）,组内比较差异无统计学意义（P均〉0．05）。3个指标浓度均随着住院时间的延长而逐渐降低,术后第2、7天与术前比较差异均有统计学意义（P均〈0．05）,且术后第7天与术后第2天比较差异也有统计学意义（P均〈0．05）。术后第2天A组血浆内毒素、TNF．仪、IL-6与B组比较差异均有统计学意义（P均〈0．05）;术后第7天,A组内毒素、TNF-仪、IL-6开始缓慢下降,与B组比较差异均有统计学意义（P均〈0．05）。术后A组肠道的双歧杆菌、类杆菌数量及B／E值较B组均减少,分别为（9．17±0．54）lgefu／g与（10．01±0．75）lgcfu／g,（9．23±0．47）lgcfu／g与（10．09±0．81）lgcfu／g,1．01±0．16与1．20-1-0．11,差异均有统计学意义（P值分别为0．031、0．042、0．029）;而肠杆菌、肠球菌数量较B组增加,分别为（9．11±1．02）lgcfu／g与（8．81±0．89）lgcfu／g,（7．80±1．02）lgefu／g与（7．29±0．98）lgcfu／g,差异均有统计学意义（P值分别为0．037、0．043）;小梭菌、乳杆菌与B组比较差异均无统计学意义（P均〉0．05）。A组使用金双歧后与使用前比较均增加,差异均有统计学意义[双歧杆菌：（13．叭±0．87）lgcfu／g与（9．17±0．54）lgefu／g、类杆菌数量：（14．12±0．75）lgcfu／g与（9．23±0．47）lgcfu／g及B／E值：1．28±0．45与1．01±0．16,P值分别为0．045、0．034、0．038];肠杆菌、肠球菌、小梭菌、乳杆菌数量无明显变化,分别为（8．71±0．91）Igcfu／g与（9．11±1．02）lgcfu／g,（7．01±0．54）lgcfu／g与（7．80±1．02）lgcfu／g,（5．23±1．04）lgcfu／g与（5．15±0．89）lgcfu／g,（6．71±1.04）lgcfu／g与（6．53±0．86）lgcfu／g,差异均无统计学意义（P均〉0．05）。结论腰椎后路手术出现肠道菌群失调的患者常合并内毒素血症及炎症反应,肠道内双歧杆菌、类杆菌数量减少,肠杆菌、肠球菌等条件致病菌数量相对增加,肠道微生物定植抗力下降。补充微生态制剂金双歧能缓解机体的内毒素血症及炎症反应,改善腰椎后路手术后肠道菌群失调,有利于术后重建肠道内微生态的平衡。     

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.     

双歧杆菌四联活菌片联合锌制剂治疗小儿腹泻的临床效果

目的探究双歧杆菌四联活菌片联合锌制剂治疗小儿腹泻的临床效果。方法选取小儿腹泻患者80例,按随机数字表法分为2组。对照组40例,予以双歧杆菌四联活菌片治疗;观察组40例,予以双歧杆菌四联活菌片联合锌制剂治疗。对比2组治疗效果、肠道菌群情况及症状消失时间。结果与对照组比较,观察组治疗总有效率及乳酸杆菌、双歧杆菌、类杆菌数值均明显升高,肠杆菌、肠球菌数值均明显降低,临床症状消失时间明显缩短,差异均有统计学意义(均P<0.05)。结论双歧杆菌四联活菌片联合锌制剂可以改善肠道菌群情况,提高小儿腹泻的治疗效果,加快患儿恢复健康。     

肠道菌群在肝硬化中的作用

肠道微生物群落可以作为一个独立的机构来调节人体的代谢平衡,肠道菌群失调可能会影响到肝硬化的预后。文章就肝硬化患者肠道菌群的研究现状、发展趋势及肠道菌群失调在肝硬化的进展及其并发症发生中的意义、微生态制剂在治疗肝硬化中的主要作用进行综述。 更多还原     

微生态制剂在小儿胃肠功能障碍防治中的应用

【目的】分析微生态制剂在防治小儿胃肠功能障碍中的作用。【方法】10 2例危重症患儿随机分为金双岐组和常规治疗组并与体检健康儿童对照 ,金双岐组在常规治疗基础上给予金双歧 ,常规组仅给予常规治疗。两组分别于入院当日及治疗后 72h、正常对照组于清晨分别空腹采集静脉血检测细胞因子TNF 2 ,IL 1、IL 6的水平。分析两组胃肠功能障碍的发生率和病死率 ,并观察两组胃肠功能障碍者临床疗效。【结果】治疗前金双岐组与常规组部分细胞因子比较差异无显著性。治疗后金双岐组与常规组TNF 2 ,IL 1、IL 6比较 ,差异均有显著性 (P <0 .0 5 ) ,金双岐组同正常对照组比较 ,无显著性差异 (P >0 .0 5 )。而常规组同正常对照组比较差异有显著性 (P <0 .0 5 )。金双岐组与常规组胃肠功能障碍发生率及病死率比较有显著性差异(P <0 .0 5 )。胃肠功能障碍者临床疗效明显优于常规组 ,差异有显著性 (P <0 .0 1)。【结论】微生态制剂金双歧能调节胃肠道微生态环境 ,有效抑制细胞因子的释放 ,降低胃肠功能障碍的发生率及病死率 ,并能改善其预后。     

196例患儿便血内镜下诊治分析

目的探讨患儿便血的内镜检查及镜下治疗特点。方法回顾分析本院1999年7月至2008年7月间196例便血患儿的内镜检查结果及镜下治疗效果。结果 196例便血患儿中,结、直肠息肉118例;慢性结肠炎33例;克隆氏病1例;溃疡性结肠炎3例;肛周疾病16例;正常25例。98例结肠息肉患儿进行高频电凝电切,20例行息肉活检钳钳除,无并发症发生。结论便血是患儿内镜检查的主要适应证,对结、直肠息肉可行内镜下治疗,创伤小,安全可靠。     

18例伪膜性肠炎的内镜及临床分析

目的 探讨伪膜性肠炎（PMC）的临床表现、内镜特征及治疗。方法 对该院5年来的18例PMC进行了回顾性分析。结果 全部患者均在使用抗生素过程中出现以腹泻为主要临床表现。内镜检查轻度5例、中度7例、重度6例。所有患者停用抗生素，口服甲硝唑或万古霉素后，全部治愈。结论 在临床抗感染治疗过程中，应警惕PMC的发生。一旦出现腹泻应尽早做内镜检查、早诊断，早治疗。     

Accelerated Infliximab Induction for Severe Lower Gastrointestinal Bleeding in a Young Patient with Crohn’s Disease: A Case Report

BACKGROUNDSevere lower gastrointestinal bleeding (SLGIB) is a rare complication of Crohn''s disease (CD). The treatment of these patients is a clinical challenge. Monoclonal anti-TNFα antibody (IFX) can induce relatively fast mucosal healing. It has been reported for the treatment of SLGIB, but there are few reports on accelerated IFX induction in CD patients with SLGIB.CASE SUMMARYA 16-year-old boy with a history of recurrent oral ulcers for nearly 1 year presented to the Gastroenterology Department of our hospital complaining of recurrent periumbilical pain for more than 1 mo and having bloody stool 4 times within 2 wk. Colonoscopy showed multiple areas of inflammation of the colon and a sigmoid colon ulcer with active bleeding. Hemostasis was immediately performed under endoscopy. The physical examination of the patient showed scattered small ulcers in the lower lip of the mouth and small cracks in the perianal area. Combined with his medical history, physical examination, laboratory examinations with high C-reactive protein (CRP), platelet count (PLT), erythrocyte sedimentation rate (ESR) and fecal calprotectin levels, imaging examinations and pathology, a diagnosis of CD was taken into consideration. According to the pediatric CD activity index 47.5, methylprednisolone (40 mg QD) was given intravenously. The abdominal pain disappeared, and CRP, PLT, and ESR levels decreased significantly after the treatment. Unfortunately, he had a large amount of bloody stool again after 1 wk of methylprednisolone treatment, and his hemoglobin level decreased quickly. Although infliximab (IFX) (5 mg/kg) was given as a combination therapy regimen, he still had bloody stool with his hemoglobin level decreasing from 112 g/L to 80 g/L in a short time, so-called SLGIB. With informed consent, accelerated IFX (5 mg/kg) induction was given 7 days after initial presentation. The bleeding then stopped. Eight weeks after the treatment, repeat colonoscopy showed mucosal healing; thus far, no recurrent bleeding has occurred, and the patient is symptom-free.CONCLUSIONThis case highlights the importance of accelerated IFX induction in SLGIB secondary to CD, especially after steroid hormone treatment.     

获得性免疫缺陷综合征患者临床及结肠黏膜病变特征的研究

目的 对26例获得性免疫缺陷综合征(AIDS)患者的结肠黏膜病变特征进行临床研究.方法 回顾性总结近10年来有结肠镜检查和组织病理学检查的26例AIDS患者的临床资料.结果 26例AIDS患者均有发热和腹泻等症状.其中以发热、咳嗽为首发症状者19例(73.1%),体温最高达39.5℃.以腹痛、腹泻为首发症状7例(26.9%),同时伴有不同程度的里急后重、水样或黏液便,大便3～10次/d;26例患者中有20例(76.9%)有程度不等的口腔溃疡、鹅口疮、咽痛、吞咽困难或胸骨后疼痛等症状,大便潜血和脓血便阳性率高,分别达69.2%(18/26)和57.7%(15/26);结肠镜检查:84.6%(22/26)患者有不同程度病变,其中慢性结肠炎11例,结肠溃疡10例,回盲部恶性淋巴瘤1例;病变部位以直肠及乙状结肠多见,病变波及直肠者,腹泻症状重;组织病理学检查无特异性;病原学检查:16例活检结肠黏膜组织中检出病原体7例(43.8%).结论 发热和腹泻是AIDS的常见症状;AIDS患者结肠病变多见,表现为慢性结肠炎和结肠溃疡,偶见肿瘤;病变波及直肠者,临床症状重;大便潜血阳性或脓血便,多提示肠道有病变.     

The efficacy of bifidum-containing preparations in enterogenous reactive arthritis

Analysis is made of the intestinal microflora in 43 patients suffering from reactive arthritides (ReA) that developed after intestinal infection. The overwhelming majority of the patients manifested a decrease of the level of the bifidoflora. The disorders of the intestinal microflora were related to the disease activity and standing. Bifidumbacterine was found to produce a significant beneficial effect on the course of ReA and to cause no serious side effects. According to the preliminary data, the efficacy of bifidumbacterin exceeded that of the known basic drug salazopyridazine, thus making it possible to apply the bifidum-containing drugs as basic agents in the treatment of ReA.     

Effect on the human normal microflora of oral antibiotics for treatment of urinary tract infections

Oral administration of antibiotics for treatment of urinary tract infections (UTIs) can cause ecological disturbances in the normal intestinal microflora. Poorly absorbed drugs can reach the colon in active form, suppress susceptible microorganisms and disturb the ecological balance. Suppression of the normal microflora may lead to reduced colonization resistance with subsequent overgrowth of pre-existing, naturally resistant microorganisms, such as yeasts and Clostridium difficile. New colonization by resistant potential pathogens may also occur and may spread within the body or to other patients and cause severe infections. It is therefore important to learn more about the ecological effects of antibacterial agents on the human microflora. The impact on intestinal microorganisms of oral antibiotics used for the treatment of UTIs is reviewed here. Ampicillin, amoxycillin and co-amoxiclav suppress both the aerobic and anaerobic intestinal microflora with overgrowth of ampicillin-resistant Enterobacteriaceae. Pivmecillinam also affects the intestinal microflora, suppressing Escherichia coli, but does not have a major effect on the anaerobic microflora. Several orally administered cephalosporins, such as cefixime, cefpodoxime, cefprozil and ceftibuten, reduce the number of Enterobacteriaceae and increase the number of enterococci. Colonization with C. difficile has also been observed. Fluoroquinolones eliminate or strongly suppress intestinal Enterobacteriaceae, but affect enterococci and anaerobic bacteria only slightly. When antimicrobial agents are prescribed for the treatment of UTIs, not only the antimicrobial spectrum of the agent but also the potential ecological disturbances, including the risk of emergence of resistant strains, should be considered.     

Isolated vaginal metastasis from stage Ⅰ colon cancer: A case report

BACKGROUND Distant metastasis occasionally occurs in patients who have been diagnosed with colorectal cancer(CRC), but it occurs in a few patients with stage I CRC. The vagina as a metastasis site has also been reported, albeit rarely. Most reported cases of vaginal metastasis(VM) report their origin from advanced CRC. We encountered a patient who was diagnosed with isolated VM originating from stage I colon cancer(T2N0) and herein present the case of this patient.CASE SUMMARY A 63-year-old woman visited the outpatient clinic because of a positive result from a stool occult blood test. She underwent laparoscopic anterior resection and was pathologically diagnosed with stage I(T2N0) sigmoid colon cancer. Neither lymphovascular invasion nor perineural invasion was observed. Ten months following the surgery, isolated vaginal metastases were detected on gynecologic examination. The examination was performed due to vaginal spotting. A transvaginal wide excision was performed, and no other adjuvant treatment was provided after discussion with a multidisciplinary team and the patient.Subsequently, a new VM was discovered after 33 mo. An additional transvaginal excision was performed. To date, there has been no evidence of further disease progression. From the time of diagnosis of VM, the patient’s overall survival has been 54 mo.CONCLUSION VM can occur as a result of early-stage colorectal cancer. Surgeons should consider the possibility of VM following complaints of gynecologic symptoms following surgery.     

Roentgenologic changes of the colon inCampylobacter infection

A double-contrast examination of the colon was performed during diarrheal illness in 5 patients withCampylobacter infection. The findings in these 5 patients were aphthoid ulcers and stippled appearance. In 1 patient with stool culture positive forCampylobacter, double-contrast study of the colon 9 days later showed no abnormalities. In a 12-year-old boy lymphoid hyperplasia could be observed as well as the aphthoid ulcers. All the abnormalities were segmental, more often localized in the rectosigmoid. No changes were found in the ascending colon. Histopathologic studies of the biopsy specimens taken endoscopically in 3 patients showed a nonspecific inflammatory reaction.     

Push-and-pull enteroscopy using a single-balloon technique for difficult colonoscopy

BACKGROUND AND STUDY AIMS: Several factors predict difficult or incomplete colonoscopy with a standard colonoscope, including female gender, low body mass index, extensive diverticulosis, and prior pelvic surgery. PATIENTS AND METHODS: A push-and-pull enteroscopy device and a single-balloon technique was used in 14 patients (six men, eight women; mean age 62 +/- 15 years) after failure of ileocolonoscopy or endoscopic therapy using either a standard or a pediatric colonoscope. The original ileocolonoscopy had been performed to investigate colon polyps (n = 6), an obscure inflammatory process in the ileocecal region (n = 6), or iron deficiency anemia with a positive fecal occult stool test (n = 2). RESULTS: Ileocolonoscopy was successfully performed using this push-and-pull technique in all 14 patients without technical problems or complications. All the endoscopic therapeutic interventions that were required were also performed without complications, with the exception of one instance of bleeding. Multiple polyps were found in six patients; a colon cancer was found in one patient; appendicitis combined with a carcinoid tumour of the appendix was diagnosed in one patient; ileocolitis was observed in two patients; one patient with Crohn's disease had stenoses in the region of an anastomosis; and in three patients no relevant pathological finding was seen. CONCLUSION: It was possible to perform ileocolonoscopy with therapeutic interventions using this new thin push-and-pull enteroscopy device with a single-balloon technique in patients who had previously undergone incomplete colonoscopy using a standard colonoscope.