口服丽珠肠乐（回春生）胶囊治疗婴儿菌群失调的体会

口服丽珠肠乐（回春生）胶囊治疗婴儿菌群失调的体会郑州市儿童医院内科郑州４６００５３冀玉英,王光松,侯广军笔者１９９２年５月至１９ｑ３年５月用口服回春生胶囊治疗婴儿菌群失调,疗效较好。１．临床资料随机抽样将此间住院患者中发生菌群失调的１２８例,分为二组...     

金双歧治疗肠易激综合征患者疗效观察

目的 探讨金双歧活菌制剂治疗肠易激综合征（IBS）患者的临床疗效和对菌群失调的调整作用。方法 64例患者随机分成2组.治疗组35例,口服金双歧活菌制剂（每粒含活菌0.5亿）,4片/次,2次/d,连服1个月;对照组29例,口服安慰剂胶囊,疗程同治疗组.评价标准系采用积分法。结果 治疗组治疗效果与对照组相比差异有显著性（P＜0.05）。患者治疗后肠道中双歧杆菌、类杆菌和肠杆菌数量明显上升。结论 金双歧活菌制剂能纠正肠道菌群失调,对IBS患者有良好的治疗作用。     

双歧杆菌制品（回春生）对肝硬化患者治疗作用的观察

双歧杆菌制品（回春生）对肝硬化患者治疗作用的观察辽河油田沈阳采油厂医院１１０３１６李兆平,陆新志双歧杆菌是人体内重要的生理性有益菌。本文就回春生（双歧杆菌活菌制品）改善肝硬化患者临床有关症状的疗效进行了初步观察,其结果报告如下。１临床资料选择肝硬化患...     

双歧杆菌三联活菌胶囊对胆囊切除术后腹泻患者肠道菌群及sIgA水平的影响

目的探讨双歧杆菌三联活菌胶囊对胆囊切除术后腹泻患者肠道菌群及sIgA水平的影响。方法选取胆囊切除术后腹泻患者68例,分为观察组和对照组。两组患者均予以低脂饮食和止泻药等常规治疗。观察组患者予以口服双歧杆菌三联活菌胶囊420 mg,3次/d,连用4周。对照组除不口服双歧三联活菌肠溶胶囊外余治疗基本同观察组。观察两组患者治疗前后肠道菌群和sIgA水平的变化,并比较其临床疗效。结果治疗4周后,观察组患者双歧杆菌和乳酸杆菌数量较前明显上升,肠杆菌和肠球菌较前明显减少（P〈0.05）,而对照组治疗前后肠道菌群数量均无明显变化（P〉0.05）;两组患者肠道sIgA水平较前明显上升（P〈0.05或P〈0.01）,且观察组上升值明显大于对照组（P〈0.05）;同时观察组患者临床总有效率明显高于对照组（χ2=5.31,P〈0.05）。结论双歧杆菌三联活菌胶囊治疗胆囊切除术后腹泻的疗效确切,能调节患者肠道菌群失调,从而重建肠道微生态平衡,提高肠道免疫力,改善和保护肠道功能。     

双歧杆菌活菌制剂治疗腹泻的临床疗效观察

腹泻是临床上常见症状,过去常规用抗生素及止泻药治疗效果不佳,现认为肠道菌群失调是腹泻的主要原因,为进一步证实这一理论,我们用回春生胶囊即双歧杆菌活菌制剂治疗腹泻３２例,用多酶片为对照组治疗２０例,效果满意,现报道如下：１材料与方法１１病例选择５２例...     

丽珠肠乐（回春生）对肝硬化的疗效观察

丽珠肠乐（回春生）为双歧杆菌活菌制剂,给７３例肝硬化失代期病人口服２２～６７天。治疗前后分别检测血内毒素含量及肝功能,观察其疗效。结果表明本制剂对肝硬化的疗效明显,总有效率为７９．４５％,其中内毒素水平治疗后明显下降,与治疗前比较,Ｐ＜０．０１,有效率为８７．６７％。肝功能各指标有不同程度的改善,有效率７８．０８％。说明回春生是当代最新的微生态调节剂。     

口服双歧杆菌活菌散剂治疗急慢性腹泻的随机对照双盲双模拟多中心临床研究

目的 评价口服双歧杆菌活菌散剂治疗肠道菌群失调所致的急慢性腹泻的疗效和安全性.方法 采用阳性药物平行对照、分层区组随机、双盲双模拟、多中心临床试验设计方法.其中急性腹泻136例,慢性腹泻125例;每次口服双歧杆菌活菌散剂1包(1.0 g,含双歧杆菌活菌1.0亿个)或丽珠肠乐胶囊2粒,每日2次;急性腹泻疗程3 d,慢性腹泻疗程14 d,观察治疗后临床症状和大便常规的恢复情况,慢性腹泻中39例进行肠道菌群分析.结果 疗程结束时急性腹泻总有效率:口服双歧杆菌活菌散剂组为89.6%,丽珠肠乐胶囊组为91.2%,2组疗效相似,差异无显著性(P＞0.05);慢性腹泻总有效率:口服双歧杆菌活菌散剂组为88.1%,丽珠肠乐胶囊组为79.0%,2组疗效相似,差异无显著性(P＞0.05);慢性腹泻组中39例治疗前后进行的肠道菌群分析表明,2组双歧杆菌、拟杆菌和真杆菌治疗后比治疗前均有显著增加(P=0.00～0.02),但治疗前后增加值2组间比较差异无显著性(P＞0.05).安全性研究未发现不良反应.结论 口服双歧杆菌活菌散剂能有效治疗急慢性腹泻,疗效和安全性与丽珠肠乐胶囊相当.     

双歧杆菌三联活菌胶囊对化疗相关性腹泻患者肠黏膜屏障功能的保护作用

目的探讨双歧杆菌三联活菌胶囊对化疗相关性腹泻患者肠黏膜屏障功能的保护作用。方法选取78例化疗相关性腹泻患者,采用随机数字表将患者分为观察组（n=39例）和对照组（n=39例）。两组患者均常规予以补液,维持水电解质平衡及口服思密达3g,3次／d。观察组患者在此基础上加用双歧杆菌三联活菌胶囊420mg,3次／d。对照组除不使用双歧杆菌三联活菌胶囊外余治疗同观察组。观察两组患者治疗前和治疗3d后血清内毒素和和D-乳酸水平的变化,并比较其临床效果。结果治疗3d后,两组患者内毒素和和D-乳酸水平均有明显下降（P〈0．05或P〈0．01）,且观察组下降值明显大于对照组（P〈0．05）;同时观察组患者临床总有效率为92．31％,明显优于对照组的74．36％（x^2=4．52,P〈0．05）。结论双歧杆菌三联活菌胶囊治疗化疗相关性腹泻具有较好的临床效果,其作用机制可能是通过降低血清内毒素和D-乳酸水平,保护和改善改善肠黏膜屏障功能,从而恢复患者的肠功能。     

双歧杆菌三联活菌肠溶胶囊治疗婴儿支气管肺炎并症状性腹泻疗效观察

目的观察双歧杆菌三联活菌肠溶胶囊（贝飞达）治疗婴儿支气管肺炎并症状性腹泻的疗效。方法156例婴儿支气管肺炎并症状性腹泻患儿随机分为2组,对照组72例按支气管肺炎常规抗感染及对症治疗,治疗组84例在此基础上加用双歧杆菌三联活菌。结果治疗组有效率为82．2％,显著高于对照组（58．3％）,2组间差异有非常显著性（χ^2=10．7,P〈0．01）。结论双歧杆菌三联活菌治疗婴儿支气管肺炎并症状性腹泻疗效显著。     

灭活双歧杆菌调整小鼠抗生素相关性菌群失调

目的：观察灭活的双歧杆菌及其耗尽培养上清液（SCS）对小鼠肠道生理菌群的影响。方法：应用腹腔注射青霉素造成肠菌群失调动物模型,分别以灭活的双歧杆菌菌液,耗尽培养上清液以及活菌菌液对菌群失调小鼠进行灌胃治疗。结果：活菌组、死菌组及SCS组同自然恢复组的肠道生理菌群相比差异均有显著性,死菌组与SCS组相比,差异也有显著性。结论：灭活的双歧杆菌及其SCS对小鼠肠道菌群失调的恢复具有调整作用,尤其对双歧杆菌和乳酸杆菌有更明显的扶持作用。     

肠道菌群与肠易激综合征相关研究进展

肠易激综合征(irritable bowel syndrome,IBS)是一种功能性肠病,目前已有研究表明IBS的致病机制、症状的产生和持续时间可能与肠道菌群失调有关,且不同IBS亚型患者体内的肠道菌群种类有差异。IBS的发病机制尚不完全清楚,临床表现存在较大的个体差异。IBS的诊断和治疗尚未形成统一的标准。但已经有较多研究提示IBS可能与胃肠道动力、内脏高敏感性、肠道免疫反应和模式识别受体等密切相关,并且可以通过益生菌、益生元、抗生素、粪菌移植和饮食习惯等调节肠道菌群的失调,从而改善IBS的症状。这也为未来治疗IBS提供了新的思路。本文就肠道菌群的概况、IBS患者肠道菌群的特点、肠道菌群失衡导致IBS发病的可能机制以及IBS肠道菌群的相关治疗方法的研究进展作一综述。     

肠易激综合征患者服用酪酸菌制剂前后肠道菌群状况

治疗ＩＢＳ,观察酪酸菌制剂的临床疗效及肠道菌群状况。从门诊随机选择２１例男性,９例女性。检测大便常见菌群和病原菌,采用Ｍｉｌｅｓ－Ｍｉｓｒｏ介绍的滴注法操作。每次培养时均选上述细菌标准菌株一同培养作质控。治疗前总厌氧菌、双歧杆菌和乳酸杆菌下降,而有潜在致病性的梭菌明显下降。无致病菌生长。治疗后腹泻次数明显减少。总有效率为８３４％,双歧杆菌和乳酸杆菌升高明显。结论：ＩＢＳ易致肠菌失调,酪酸菌能抑制肠道内腐败菌、病原菌,并能促进双歧杆菌、乳酸菌等肠道内的有益菌发育。     

Proteomic analysis of colonic mucosa in a rat model of irritable bowel syndrome

Irritable bowel syndrome (IBS) is one of the most common functional disorders of the gastrointestinal tract. It is characterized by abdominal pain and changes in bowel habits. Various studies have investigated the pathophysiologic processes underlying IBS, but the mechanism remains poorly understood. In the present study, we established an IBS model and identified differentially expressed proteins in colon tissue of IBS rats compared with healthy controls by 2‐D gel electrophoresis, MALDI‐TOF‐MS, and Western blot analysis. Our results showed that 13 of the 1396 protein spots on 2‐D gel were differently expressed between the IBS and control groups. Ontological analysis of these proteins revealed primary roles in catalytic activity (protein disulfide‐isomerase A3, glyoxalase I, cathepsin S, α‐enolase), structural support (cytokeratin 8), antioxidant activity (peroxiredoxin‐6), protein binding (transgelin, serpin peptidase inhibitor B5), and signal transduction (40S ribosomal protein SA). Protein disulfide‐isomerase A3 and cytokeratin 8 overexpression in IBS were confirmed by Western blot. The findings indicate that multiple proteins are involved in IBS processes that influence intestinal tract immunity, inflammation, and nerve regulation. Our study provides useful candidate genes and proteins for further investigation.     

小檗碱对肠易激综合征大鼠肠道菌群的影响

目的通过口服小檗碱(Berberine,BBR)治疗大鼠肠易激综合征(IBS),初步研究小檗碱对IBS大鼠肠道菌群的影响。方法用避水应激试验制作大鼠IBS模型,分别给予模型大鼠小剂量(25mg/kg)小檗碱、大剂量(100mg/kg)小檗碱和利福昔明干预治疗10d,检测大鼠肠道菌群丰度、生物多样性及菌群结构组成的变化。结果避水应激试验造模后模型组大鼠排便次数增多、腹外斜肌EMG明显升高,肠道可见微炎症表现。小檗碱干预后,IBS大鼠排便增多情况、内脏高敏感性和肠道微炎症情况均显著改善,其中大剂量小檗碱组优于小剂量组。经小檗碱干预后,大鼠肠道菌群多样性显著降低,大剂量小檗碱抑菌作用强于小剂量小檗碱。大剂量小檗碱可显著提高IBS大鼠肠道乳杆菌科细菌的比例,同时降低肠杆菌科细菌的比例。结论小檗碱可以显著降低IBS大鼠内脏高敏感性,改善肠道微炎症,减少IBS大鼠排便增多症状。小檗碱可以调节肠道菌群丰度和多样性,且剂量越大,抑菌作用越明显。肠道乳杆菌科细菌在小檗碱治疗肠易激综合征的过程中可能起一定作用。     

维吾尔族结肠癌患者肠道菌群的分布情况研究

目的:检测新疆维吾尔族结肠癌人群肠道菌群结构,探讨维吾尔族结肠癌患者肠道菌群结构差异,以求找到肠内与结肠癌有关系的菌群。方法:使用16Sr DNA-PCR-DGGE技术对维吾尔族结肠癌患者肠道菌群分布情况制作肠道菌群指纹图谱,从图谱中的条带进行切胶回收、进行克隆、测序,与Genebank数据库提供的序列进行比对做树状图分析,对新疆维吾尔族结肠癌患者肠道细菌种群多样性进行探讨。结果:通过实验得到了维吾尔族结肠癌患者肠道菌群结构特征的DNA指纹图谱、基因序列及树状图。测序结果显示,维吾尔族结肠癌患者肠道菌群中主要分布乳酸杆菌属,拟杆菌属和梭杆菌属以及很多差异性细菌的分布情况。从维吾尔族结肠癌患者肠道菌群的分布情况来看,优势菌乳酸杆菌量甚少,拟杆菌属,梭杆菌属数量较多。结论:肠道乳酸杆菌优势菌量的减少及拟杆菌属,梭杆菌属比例的改变可能与结肠癌患者发病有一定的关系。     

Composition and temporal stability of gastrointestinal microbiota in irritable bowel syndrome--a longitudinal study in IBS and control subjects

Irritable bowel syndrome (IBS) is a common intestinal disorder that includes continuous or recurrent intestinal pain and discomfort and altered bowel habits. The pathophysiology of IBS is incompletely understood, but it may involve an altered intestinal microbiota. The aim of the present study was to compare the composition and temporal stability of faecal microbiota of IBS patients and healthy controls by applying culture-based techniques and PCR-DGGE analysis. No difference in the prevalence or mean culturable manners of bacteroides, bifidobacteria, spore-forming bacteria, lactobacilli, enterococci or yeasts were observed between the IBS and the control groups, whereas slightly higher numbers of coliforms as well as an increased aerobe:anaerobe ratio was observed in the IBS group. PCR-DGGE revealed more temporal instability in the predominant bacterial population of IBS subjects than in controls. In 9 out of 21 IBS subjects and 5 out of 17 controls the PCR-DGGE profiles obtained from the samples of the same individual on different occasions (sampling points 0, 3 and 6 months) were clearly different. However, the instability in some of the IBS subjects could partly be explained by the antibiotic consumption during the study. The present study suggests that instability of intestinal microbiota may be involved in IBS. However, further studies are needed to associate the instability with specific IBS symptoms or with specific bacterial groups and species.     

Lower gastrointestinal disorders in patients with irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal system characterized by abdominal pain related to bowel emptying, defecation impairment and abdominal distention. The aim of the study was to objectify lower gastrointestinal system disturbances in IBS patients. Thirty IBS patients and 30 healthy subjects were included in the study. IBS patients were divided into two subgroups: IBS with predominant diarrhea (IBSd) and IBS with predominant constipation (IBSc). All study subjects underwent physical examination (including digitorectal examination), standard laboratory testing and anorectal manometry. Endoscopy was performed only in group of IBS patients. A statistically significant difference was recorded in most manometric parameters between healthy subjects and IBS patients, which was even more pronounced in IBSd patients. Study results showed that the intestinal motility disorder underlying IBS could be objectified by use of anorectal manometry.     

Blastocystis Is Associated with Decrease of Fecal Microbiota Protective Bacteria: Comparative Analysis between Patients with Irritable Bowel Syndrome and Control Subjects

Blastocystis is a protistan parasite living in the digestive tract of many animals, including humans. This highly prevalent intestinal parasite is suspected to be linked to Irritable Bowel Syndrome (IBS), a chronic functional bowel disorder. Here, we first compared the prevalence of Blastocystis among 56 IBS patients (40 IBS with constipation (IBS-C), 9 IBS with diarrhea (IBS-D), 4 mixed IBS (IBS-M) and 3 unsubtyped IBS (IBS-U) according to the Rome III criteria) and 56 control (i.e. without any diagnosed chronic or acute gastrointestinal disorder) subjects. The highest prevalence of Blastocystis spp. was observed in the IBS group, but was only statistically significant in men (36.8% in the IBS group versus 4.8% in the control group). We then conducted a meta-analysis including epidemiological studies attempting to determine whether Blastocystis carriage could be linked to IBS, and highlighted that IBS patients had a relative risk of 2.34 to be infected by Blastocystis when compared to non-IBS subjects. We also looked for Dientamoeba fragilis, which is often associated with IBS, and identified this parasite only in some IBS patients (n = 6/56). Several studies provided evidence for a major role of the gut microbiota in the pathophysiology of IBS. Thus, we investigated the possible impact of Blastocystis carriage on the enteric bacterial community through quantification of 8 major bacterial groups from the enteric flora. Our data indicated that men with IBS-C had a significant decrease in Bifidobacterium sp. when infected by Blastocystis. Interestingly, in control subjects (i.e. without any gastrointestinal disorder) positive for Blastocystis, Faecalibacterium prausnitzii, which is known for its anti-inflammatory properties, was significantly decreased in men. Our results support the hypothesis that Blastocystis might be linked to the pathophysiology of IBS-C and intestinal flora imbalance.     

Lactobacillus paracasei subsp. paracasei LC01 positively modulates intestinal microflora in healthy young adults

Lactobacillus paracasei subsp. paracasei LC01 (LC01) can tolerate intestinal stresses and has antioxidant activity. To evaluate the effect of the bacterium on human intestinal microflora, a randomized, double-blind, placebo-controlled human trial was carried out. Fifty-two healthy adult volunteers were randomized equally to two groups. One group consumed 12% (wt/vol) skimmed milk supplemented with 10¹⁰ CFU of LC01 each day for the 4-week treatment period, and then consumed placebo in the next treatment period, separated by a 2-week washout. The other group followed the reverse order. Group-specific real-time PCR and biochemical analyses was used to determine the intestinal bacterial composition of fecal samples collected at the end of every period, and the concentration of short-chain fatty acids and ammonia. A significant inhibition in fecal Escherichia coli and increase in Lactobacillus, Bifidobacterium, and Roseburia intestinalis were observed after consumption of LC01. Acetic acid and butyric acid were significantly higher in the probiotic stage and fecal ammonia was significantly lower. The results indicated a modulation effect of LC01 on the intestinal microflora of young adults, suggesting a beneficial effect on bowel health. LC01 may have potential value as a probiotic.     

Otilonium Bromide treatment prevents nitrergic functional and morphological changes caused by chronic stress in the distal colon of a rat IBS model

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by periods of remission and exacerbation. Among the risk factors to develop IBS, psychosocial stress is widely acknowledged. The water avoidance stress repeatedly applied (rWAS) is considered effective to study IBS etio-pathogenesis. Otilonium bromide (OB), a drug with multiple mechanisms of action, is largely used to treat IBS patients. Orally administered, it concentrates in the large bowel and significantly ameliorates the IBS symptomatology. Presently, we tested whether rWAS rats developed neuro-muscular abnormalities in the distal colon and whether OB treatment prevented them. The investigation was focussed on the nitrergic neurotransmission by combining functional and morphological methodologies. The results confirm rWAS as reliable animal model to investigate the cellular mechanisms responsible for IBS: exposure to one-hour psychosocial stress for 10 days depressed muscle contractility and increased iNOS expression in myenteric neurons. OB treatment counteracted these effects. We hypothesize that these effects are due to the corticotropin-releasing factor (CRF) release, the main mediator of the psychosocial stress, followed by a CRF1receptor activation. OB, that was shown to prevent CRF1r activation, reasonably interrupted the cascade events that bring to the mechanical and immunohistochemical changes affecting rWAS rat colon.