功能性腹泻与肠道菌群失调

功能性腹泻(functional diarrhea,FD) 临床较为常见,主要表现为排便频次的增多及粪便性状的改变,至少75% 不伴有腹痛。其发病率仅位居肠易激综合征之后,中国的发病率显著低于西方国家,但在亚洲相对较高。FD 的病 因及发病机制复杂,肠道菌群失调被认为是其主要致病因素之一。因此,调节肠道菌群失调、恢复肠道微生态平衡 是治疗功能性腹泻的有效途径。国内外多项研究表明,应用微生态制剂可有效调节肠道菌群失调,并能明显缓解功 能性腹泻的症状。     

老年性便秘与肠道菌群失调的相关性及药物干预性研究

目的研究老年性便秘与肠道菌群失调的相关性,以及老年便秘患者服用微生态制剂干预后肠道菌群改善的情况。方法从肠道菌群失调的角度,采用横断面调查研究老年性便秘及非便秘老年人群的肠道菌群的差异,并应用队列研究试验设计方案,用微生态制剂进行生物学干预试验。结果老年便秘人群肠道中肠杆菌、肠球菌、梭杆菌数量增多,乳酸杆菌、双歧杆菌、类杆菌数量减少。经过微生态制剂治疗后肠杆菌、肠球菌、梭杆菌数量有所下降,乳酸杆菌、双歧杆菌、类杆菌数量有所增高。结论老年性便秘患者肠道菌群分布与非便秘者比较有差异,且微生态制剂干预对便秘患者肠道菌群失调有一定疗效。     

微生态制剂对肠易激综合征的治疗作用

肠易激综合征（irritable bowel syndrome，IBS）的病因至今仍未完全阐明，但已有诸多证据表明，50％-80％的IBS患者存在有肠道菌群失调。尽管IBS与肠道菌群失调之间是否有因果关系，目前尚不清楚，但是，现有的研究资料显示，菌群失调参与了IBS的病理生理过程，IBS的某些临床表现与肠道菌群失调直接相关，而且，应用微生态制剂纠正肠道菌群失调后，可使IBS的临床症状得到改善。本文就微生态制剂对肠易激综合征的治疗作用进行综述。     

整肠生临床应用有奖征文活动通知

正整肠生作为中国第一批原研微生态制剂,上市26年来,其在治疗腹泻病、各种原因引起的肠道菌群失调方面已经得到临床医生及患者的认可。为了总结整肠生的临床应用经验,加强学术交流合作,推进国内微生态领域的发展,东北制药集团沈阳第一制药有限公司联合《中国实用内科杂志》举办整肠生临床应用有奖征文活动,诚邀广大临床医生参加。征文内容:     

肠道菌群调节剂的研究进展

肠道菌群失调可致人体许多疾病。保持肠道微生态平衡是维持人体健康所必需的。微生态调节剂指益生菌及其代谢产物和生长促进物质制成的制剂。它包括：益生菌、益生元、合生素三部分。微生态制剂临床应用广泛，对急性腹泻，如病毒性肠炎，旅游者腹泻、抗生素相关性肠炎等有肯定疗效，对慢性腹泻肠易激综合征有很好疗效，对炎症性肠病，囊袋炎治疗评价尚需进一步临床观察，微生态制剂发展方向有筛选新的益生菌菌种，开发复合制剂，构建基因工程菌菌种等。本文对肠道菌群调节剂的近期研究进展进行综述。     

肠道菌群失调与慢性便秘的研究进展

慢性便秘患者存在肠道菌群失调,肠道菌群失调与慢性便秘的发生存在相关性,肠道微生态制剂对慢性便秘具有一定的治疗作用。该文就慢性便秘患者的肠道菌群改变、肠道菌群失调与慢性便秘的发生以及基于肠道微生态的治疗等方面的国内外研究进展作一综述。     

感染性腹泻的微生态疗法

0 引言从微生态学观点来说,胃肠道受到外界因素的影响导致内部的微生态失调将导致腹泻.对于感染性腹泻的防治,目前仍以抗生素治疗为主.但应用抗生素治疗的弊端已愈来愈引起人们的重视,微生态制剂的兴起是治疗感染性腹泻的又一重要手段,它具有调节肠道菌群失调及改善肠道生态环境的作用,对急、慢性腹泻和抗生素引起的肠道菌群失调有良好的预防和治疗作用.微生态防治的本质是以扶植正常菌群,拮抗致病或条件致病菌,调整和恢复微生态平衡为日的的一种预防和治疗方法.1 肠道的微生态平衡正常情况下,由正常微生物群、宿主和外环境构成的生态系统是相互平衡的.从出生到死亡人体与正常菌群之间保持着和谐的共生关系.新生儿刚出生时肠道是无菌的,出生后2h 左右开     

微生态制剂在炎症性肠病中的应用

炎症性肠病(inflammatory bowel disease, IBD) 是病因尚不十分明确的慢性非特异性肠道炎症性疾病。肠道菌 群失调是炎症性肠病发生的重要原因,其通过多种途径调控IBD 的发生和发展。微生态制剂可通过调节肠道菌群 中有益菌和致病菌的数量和比例,起到缓解IBD 病情的作用。微生态制剂形式多样,包括益生菌、抗生素和粪菌移 植。不同种类的微生态制剂对炎症性肠病的疗效差异较大,因此微生态制剂既是目前的研究热点也是难点。     

肠道菌群调节在消化系统疾病治疗中的应用

肠道微生态系统对机体正常功能的发挥起至关重要的作用。肠道菌群失调参与人体各系统多种疾病的发病过程,益生菌制剂和粪便菌群移植技术因能有效调节肠道菌群且无明显不良反应而成为当今疾病治疗研究的热点课题。本文就肠道菌群调节在消化系统疾病治疗中的应用情况作一综述。     

协和乐托尔临床应用有奖征文启事

微生态制剂的研究和应用越来越广 ,微生态死菌制剂的优势更是受到医患双方的肯定。协和药业有限公司的乐托尔 ○R为中国的微生态领域率先提出了死菌概念 ,乐托尔 ○R产品有散剂和胶囊两种剂型 ,分别适用于儿童和成人。主要成份是嗜酸性乳酸杆菌的死菌体及其培养基。现经过全国乃至世界多家医院临床应用 ,发现它不仅是目前治疗各类急慢性腹泻的首选药物 ,并且还具有双向调节肠道菌群 ,增强肠道免疫力 ,对便秘及多种药物尤其抗生素引起的肠道菌群失调效果显著。为进一步总结交流乐托尔 ○R临床应用经验 ,协和药业有限公司特举办下述有奖征文…     

益生菌制剂在消化系统中的应用

益生菌制剂可以恢复肠道菌群平衡和黏膜屏障功能,从而治疗相关疾病,其安全性和有效性已在临床上得到验证。现就近年来益生菌制剂在抗生素相关性腹泻、溃疡性结肠炎、腹泻型肠易激综合征、功能性便秘和慢性肝病等常见消化道疾病中的临床应用作一概述,为更好地开发和医用益生菌制剂奠定基础。     

肠道菌群失调在慢性肝病发病中的作用研究进展

肠道菌群是肠道屏障的重要组成部分,在健康状态下肠道菌群与机体之间处于平衡状态。当某种原因引起机体内外环境发生变化破坏了该平衡状态时,即出现肠道菌群失调。肠道菌群失调可以促进各种慢性肝脏疾病的发生与发展。应用益生菌治疗能够改善肠道菌群失调,从而为治疗慢性肝脏疾病带来更好的疗效。     

肠道微生态改变在炎症性肠病中的作用

炎症性肠病（IBD）主要包括溃疡性结肠炎（UC）和克罗恩病（CD），其病因和发病机制尚未明确。目前认为IBD的病因为肠道微环境（肠道菌群）、宿主遗传易感性和黏膜免疫因素三者间的相互作用。近年来．随着微生态学的发展，肠道菌群与IBD发病的关系日益受到关注。本文就IBD时肠道菌群的变化、肠道微生态改变对IBD的影响以及微生态制剂对IBD的治疗作用作一综述。     

结直肠癌根治术后肠道菌群、miR-10a表达变化及微生态肠内营养干预作用

背景 直肠癌根治术为治疗直肠癌的重要方法,但手术引起的肠道菌群失调、基因表达变化均不利于预后改善,积极探索术后肠道菌群、相关基因表达变化情况对指导干预措施的制定具有重要指导价值.目的 探讨结直肠癌根治术后肠道菌群、微小RNA-10a(microRNA-10a,miR-10a)表达变化情况,并分析微生态肠内营养干预的作用...     

Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate

Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation(FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, Pub Med was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation. More than three hundred articles published up to 2015 were selected and reviewed. Randomized placebo-controlled trials and meta-analysis were firstly included, mainly for probiotics. A meta-analysis was not performed because of the heterogeneity of these studies. Most of relevant data derived from studies on probiotics, reporting some efficacy in ulcerative colitis and in pouchitis, while disappointing results are available for Crohn's disease. Probiotic supplementation may significantly reduce rates of rotavirus diarrhea. Efficacy of probiotics in NSAID enteropathy and irritable bowel syndrome is still controversial. Finally, FMT has been recently recognized as an efficacious treatment for recurrent Clostridium difficile infection. Modulation of intestinal flora represents a very interesting therapeutic target, although it still deserves some doubts and limitations. Future studies should be encouraged to provide new understanding about its therapeutical role.     

Probiotics: history,definition, requirements and possible therapeutic applications

The ingestion of probiotics is associated with various beneficial effects on human health and modifies the physiological homeostasis of the intestinal flora. Probiotics are microorganisms with some particular characteristics: human origin, safety in human use, bile and acid resistance, survival in the intestine, at least temporary colonization of the human gut, adhesion to the mucosa and bacteriocine production. Thanks to these characteristics, probiotics block the invasion of human intestinal cells by the enteroinvasive bacteria. Furthermore, they should be able to stimulate and modulate the intestinal immune response, and to protect and stabilize the mucosal barrier. Finally, the efficacy of probiotics should be evident and documented with valid studies. All their properties should be maintained during processing and storage. Probiotics are usually used to protect the host from pathogens. With regard to this, they are useful in the prevention of antibiotic and traveler's diarrhea and they may play a role in the management of gastric Helicobacter pylori infection. Furthermore, their efficacy in the treatment of infectious diarrhea, in inflammatory bowel diseases, in pouchitis and in food allergy has been shown. Probiotics can improve the symptoms of irritable bowel syndrome and of lactose malabsorption. Finally, it has been suggested that such microorganisms may play a role in the prevention of carcinogenesis and of tumor growth.     

Functional diarrhea

Functional diarrhea occurs as part of the irritable bowel syndrome (IBS) and as an isolated symptom as functional (painless) diarrhea. Progress has been made in defining these disorders and in identifying new mechanisms involved in symptom production. A strong link exists between intestinal infection and IBS, as is the role of 5-hydroxytryptamine (5-HT). The importance of persistent subclinical inflammation is also emerging as a potential etiologic factor, particularly in post-infectious IBS. Although changes in the bacterial flora and bacterial overgrowth have been put forward as additional new contributors to symptom production, the case is not strong. These developments in pathogenesis have facilitated the introduction of new therapies. 5-HT₃ antagonists reduce bowel frequency and pain in women with diarrhea-predominant IBS, but their use is limited because of ischemic colitis. Prednisolone lacks efficacy, and early results with probiotics and herbal remedies are encouraging but require confirmation by larger trials.     

鼠李糖乳杆菌治疗肠易激综合征机制新进展

肠易激综合征(irritable bowel syndrome,IBS)是临床上常见的功能性胃肠病,其会影响患者的生活质量.因此探寻IBS的有效治疗方法具有重要意义.益生菌可改善IBS患者的症状并提高其生活质量,其中备受关注的是鼠李糖乳杆菌(Lactobacillus rhamnosus GG,LGG).LGG是目前被...     

Probiotics in gastroenterology: indications and future perspectives

Nowadays. there is a growing interest in probiotics as a safe way of changing the intestinal bacterial flora. Probiotics may have potential in several gastroenterological conditions, especially when the intestinal flora has been disturbed. Most scientific evidence is available for diarrhoea patients treated with Lactobacillus GG, Lactobacillus reuteri or Saccharomyces boulardii. Meta-analyses have shown an overall reduction in the risk of antibiotic-associated diarrhoea during treatment with probiotics, and benefits have also been demonstrated for patients with rota-virus-associated diarrhoea. Patients with inflammatory bowel disease, an inflammatory disorder characterized by a change in the intestinal flora, are another important target group for which probiotics may be beneficial. It has been claimed that in ulcerative colitis and Crohn disease patients, lactobacilli, S. boulardii and Escherichia coli reduce relapses. but most studies were not placebo-controlled. A reduction in relapses has also been demonstrated in pouchitis patients treated with a multispecies probiotic. Irritable bowel syndrome might be another clinical indication for probiotic therapy, but results of clinical trials performed in these patients are inconsistent. Additionally, probiotics may improve lactose absorption. Helicobacter pylori eradication and constipation. Finally, in animal models of colorectal cancer, treatment with probiotics reduces the prevalence of this disease, and in humans the amount of genotoxic substances in faeces has been reduced. In conclusion, the results of studies on the effects of probiotics in gastrointestinal conditions are encouraging. but well-designed placebo-controlled studies are warranted before recommendations for therapeutic or preventive use can be given. Many issues still have to be resolved, including optimal dose and duration of treatment, selection of and differences between the several available probiotic strains, and, importantly, their mechanisms of actions have to be elucidated.     

Probiotics and functional foods in gastrointestinal disorders

Probiotics are live microbial food supplements that benefit the host animal by improving intestinal microbial balance. When they are fed in yogurts, they can fall into the category of functional foods. Functional foods include these probiotics, prebiotics, and, to a certain extent, dietary fiber. Prebiotics are nondigestible food ingredients or supplements that alter the intestinal flora and stimulate the growth of healthy bacteria. Dietary fibers are part of plant foods that are nonstarch polysaccharides and are poorly digested or not digested by human enzymes. The physiologic process in which probiotics and functional foods affect the intestinal flora is through the balance of the intestinal microecology. This review looks at the four major components of intestinal microecology and describes the probiotics in use today and their clinical relevance. Although probiotics hold great promise and appear to be useful in some settings, more clinical study is needed to firmly establish the relevance of probiotic therapy.