摘要
目的探讨溃疡性结肠炎(ulcerative colitis,UC)患者小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)情况以及口-盲肠传输时间(orocalcal transit time,OCTT);观察利福昔明和枯草杆菌二联活菌胶囊对SIBO的治疗效果。方法选择2019年6月至2021年10月就诊于解放军总医院第六医学中心消化内科的100例UC患者及50名健康志愿者纳入研究,检测其SIBO及OCTT。将存在SIBO的UC患者随机分为两组。对照组:应用枯草杆菌二联活菌胶囊(500 mg,3次/d,14 d);治疗组:除应用枯草杆菌二联活菌胶囊(500 mg,3次/d,14 d)外加用利福昔明(0.2 g,4次/d,14 d),治疗结束后观察两组的SIBO转阴率及炎症指标白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)缓解情况。结果(1)UC患者中SIBO阳性率为41.0%,高于健康对照组18.0%,两者差异有统计学意义(P<0.05);年龄、性别与SIBO的发生无关(P>0.05)。(2)UC患者的OCTT长于对照组[(128.8±20.3)min vs.(90.7±13.6)min,P<0.05],差异有统计学意义。(3)UC合并SIBO阳性患者的OCTT值长于SIBO阴性的患者[(150.5±22.6)min vs.(108.3±19.7)min,P<0.05],差异有统计学意义。(4)应用利福昔明和枯草杆菌二联活菌治疗后,65%的患者SIBO转为阴性,高于单用枯草杆菌二联活菌组23.8%,差异有统计学意义(P<0.05)。(5)应用利福昔明及枯草杆菌二联活菌胶囊组,炎症指标IL-6及CRP较治疗前降低:[IL-6(50.16±8.5)vs.(20.31±7.1),CRP(33.36±3.4)vs.(10.22±4.1),P<0.05],差异有统计学意义。结论UC患者的SIBO的发生率较高,OCTT明显延长,利福昔明联合枯草杆菌二联活菌可以有效的治疗UC患者的SIBO,缓解炎症提高临床疗效。
Objective To observe small intestinal bacterial overgrowth(SIBO)and oral cecal transit time(OCTT)in patients with ulcerative colitis,the therapeutic effect of rifaximin combined with Bacillus subtilis were investigated.Methods All of the people enrolled in the study(UC group=100 cases,healthy group=50 cases)were tested for SIBO and OCTT.UC patients with SIBO were randomly divided into two groups:control group:Bacillus subtilis(500 mg,3/d,14 d);Treatment group:Bacillus subtilis(500 mg,3/d,14 d)and Rifaximin(0.2 g,4/d,14 d).After treatment,interleukin-6(IL-6)and C-reactive protein(CRP)were observed.Results(1)SIBO in patients with ulcerative colitis was 41.0%,and that in healthy control group was 18.0%(P<0.05).The incidence of SIBO was not related to gender and age(P>0.05).(2)OCTT in patients with ulcerative colitis was(128.8±20.3)min,and in that control group was(90.7±13.6)min(P<0.05).(3)The OCTT of ulcerative colitis patients with SIBO was(150.5±22.6)min,and in that of patients without SIBO was(108.3±19.7)min(P<0.05).(4)65%of the patients in the treatment group turned negative and 23.8%of the patients in the control group turned negative(P<0.05).(5)In the treatment group:IL-6 and CRP were significantly lower:IL-6(50.16±8.5)vs.(20.31±7.1)and CRP(33.36±3.4)vs.(10.22±4.1)(P<0.05).Conclusions Patients with ulcerative colitis had a high probability of SIBO.Rrifaximin combined with Bacillus subtilis can effectively alleviate inflammation.
作者
于兰
闫志辉
罗哲
郑岩
崔立红
YU Lan;YAN Zhihui;LUO Zhe;ZHENG Yan;CUI Lihong(Department of Gastroenterology,the Sixth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《实用医学杂志》
CAS
北大核心
2023年第14期1815-1819,共5页
The Journal of Practical Medicine
基金
首都卫生发展科研专项项目(编号:2020-2-5113)。
