酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症效果分析

目的探讨酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症近期疗效及对骨代谢、炎性因子和肠道菌群的影响。方法将80例炎症性肠病合并骨质疏松症患者随机分为对照组和观察组。除基础治疗外,对照组给予阿仑膦酸钠、观察组给予联合酪酸梭菌二联活菌胶囊治疗,持续3个月。比较两组临床疗效、骨密度(bone mineral density,BMD)、骨代谢指标、炎性因子及肠道菌群水平。结果与对照组相比,观察组治疗总有效率升高(95.0%vs 77.5%),腰椎、股骨颈及Ward三角区BMD水平升高;骨碱性磷酸酶(BALP)、骨钙素水平升高,1型胶原交联羧基末端肽(CTX)水平降低; IL-6、IL-17等炎性因子水平降低,粪便中大肠杆菌含量降低,双歧杆菌、乳酸杆菌含量增加,差异均有统计学意义(P均0.05)。结论酪酸梭菌联合阿仑膦酸钠治疗炎症性肠病合并骨质疏松症近期疗效好,能够增加BMD,改善骨代谢指标,减轻机体炎性反应,而且还能够调节肠道菌群,适于临床上应用。

Efficacy of Clostridium butyricum and Alendronate sodium in patients with inflammatory bowel disease complicated with osteoporosis

Objective To investigate the efficacy of clostridium butyricum and alendronate sodium in inflammatory bowel disease complicated with osteoporosis (IBDCO) patients and the effects on bone metabolism, inflammatory factors and intestinal flora. Methods 80 IBDCO patients were randomly divided into the control group and observation group. Besides conventional treatments, the control group was given alendronate sodium, while the other was additionally given lived combined clostridium butyricum and bifidobacterium capsules for 3 months. Curative efficacy, bone mineral density (BMD), bone metabolism indices, levels of inflammatory factors and intestinal flora were compared between two groups. Results Compared to the control group after 3 months, the observation group had higher efficacy (95.0% vs 77.5%), higher BMD of lumbar vertebra, femur neck and Wards triangle, higher levels of bone alkaline phosphatase, osteocalcin, lower level of C-terminal telopeptide of type-I collagen, lower levels of IL-6 and IL-17, lower content of bacillus coli and higher contents of bacillus bifida and lactobacillus in feces (all P<0.05). Conclusion Clostridium butyricum combined with alendronate sodium has high short-term curative efficacy for IBDCO patients, which can increase BMD, improve bone metabolism indices, alleviate inflammatory reaction and regulate intestinal flora. It is suitable for clinical application.