溃疡性结肠炎的微生态学改变及双歧杆菌治疗作用分析

目的 研究溃疡性结肠炎肠道微生态改变, 并观察双歧杆菌制剂对溃疡性结肠炎的治疗效果。方法 选取2018年5月至2019年10月北京中医药大学孙思邈医院收治的60例活动期溃疡性肠炎患者(A组)、60例缓解期溃疡性肠炎患者(B组)及60例同期体检健康者(对照组)作为研究对象。比较3组新鲜粪便中菌群变化情况。采用随机数字表法将A组、B组分为A1亚组(30例)、A2亚组(30例)、B1亚组(30例)和B2亚组(30例)。给予A1亚组和B1亚组患者口服双歧杆菌活菌胶囊, 给予A2亚组和B2亚组患者口服柳氮磺吡啶。比较4组患者临床疗效、组织学疗效及肠道菌群改变情况。结果 A组和B组大肠杆菌属、肠球菌属菌群数均显著大于对照组, 拟杆菌属、梭菌属、乳酸杆菌属和双歧杆菌属菌群数均显著低于对照组(P＜0.05);与B组比较, A组大肠杆菌属菌群数显著增加, 拟杆菌属、梭菌属、乳酸杆菌属和双歧杆菌属菌群数显著减少(P＜0.05)。A1组临床总有效率和组织学总有效率分别显著高于A2组, B1组临床总有效率和组织学总有效率分别显著高于B2组(P＜0.05)。各组治疗后大肠杆菌属和肠球菌属菌群数显著低于治疗前, 但拟杆菌属、梭菌属、乳酸杆菌属和双歧杆菌属菌群数显著高于治疗前;A1组和B1组患者治疗后大肠杆菌属和肠球菌属菌群数分别显著低于A2组和B2组, 拟杆菌属、梭菌属、乳酸杆菌属和双歧杆菌属菌群数分别显著高于A2组和B2组(P＜0.05)。结论 溃疡性结肠炎患者肠道内条件致病菌增加, 有益菌减少。双歧杆菌治疗溃疡性结肠炎疗效显著, 能够有效改善肠道微生态平衡。

Microecological changes of ulcerative colitis and analysis of the therapeutic effect of Bifidobacterium

Objective To study the intestinal microecological changes in ulcerative colitis and observe the therapeutic effect of Bifidobacterium preparation on ulcerative colitis.Methods :From May 2018 to October 2019, 60 patients with active ulcerative enteritis (group A), 60 patients with remission ulcerative enteritis (group B) and 60 healthy persons (control group) were selected as the subjects.The changes of bacterial flora in fresh feces of the three groups were compared.Group A was divided into A1 subgroup (30 cases) and A2 subgroup (30 cases) by random number table method.Group B was divided into B1 subgroup (30 cases) and B2 subgroup (30 cases).Subgroups A1 and B1 were given Bifidobacterium capsules orally, and subgroups A2 and B2 were given sulfasalazine orally.All patients were treated continuously for one month.The clinical efficacy, histological efficacy and changes of intestinal flora of the four groups were compared.Results The number of E.coli and Enterococcus in group A and group B was significantly higher than that in control group, while the number of Bacteroides, Clostridium, Lactobacillus and Bifidobacterium in group A was significantly lower than that in control group(P＜0.05).Compared with group B, the number of E.coli in group A increased significantly, while the number of Bacteroides, Clostridium, Lactobacillus and Bifidobacterium decreased significantly(P＜0.05).The total clinical effective rate and the total histological effective rate group A1 were significantly higher than those in group A2.The total clinical effective rate and the total histological effective rate in group B1 were significantly higher than those in group B2(P＜0.05).The number of E.coli and Enterococcus in group A1, group A2, group B1 and group B2 after treatment was significantly lower than that before treatment, but the number of Bacteroides, Clostridium, Lactobacillus and Bifidobacterium was significantly higher than that before treatment.The number of E.coli and Enterococcus in group A1 and group B1 after treatment was significantly lower than that in group A2 and group B2, respectively.The number of Bacteroides, Clostridium, Lactobacillus and Bifidobacterium was significantly higher than that of group A2 and group B2(P＜0.05).Conclusion In patients with ulcerative colitis, intestinal conditioned pathogens increased and beneficial bacteria decreased.Bifidobacterium is effective in the treatment of ulcerative colitis and can effectively improve the intestinal microecological balance.