胆囊切除术后腹泻患者应用双歧三联活菌胶囊改善其肠道微生态紊乱的效果评价

目的 探讨双歧三联活菌胶囊对胆囊切除术后腹泻（PCD）患者的临床疗效及对肠道菌群的影响。方法 选取胆囊切除术后腹泻患者80例，随机分为观察组和对照组，每组40例。对照组患者给予常规治疗，观察组患者在对照组的基础上给予双歧三联活菌胶囊口服治疗（420 mg/次，3次/d），连用4周。比较两组患者治疗后的临床疗效及不良反应，并检测两组患者治疗前后肠道菌群组成及血清D-乳酸和5-HT的水平。结果 治疗后，观察组患者的总有效率为92.50%，显著高于对照组的70.00%（χ2 =6.646，P＜0.05），两组患者均无明显不良反应。与对照组患者相比，观察组双歧杆菌和乳酸杆菌数量显著增加（logCFU/g：9.88±1.01 vs 7.35±0.72，8.96±0.69 vs 7.61±0.58，t=12.9004、9.4722，P<0.01），大肠埃希菌和肠球菌数量下降（logCFU/g：7.86±0.81 vs 8.41±0.80，8.06±0.69 vs 8.56±0.78，t=‒2.9626、‒3.0366，P<0.01)。观察组患者血清D-乳酸和5-HT的水平明显低于对照组[（5.69±0.76）μg/mL vs （8.12±0.92）μg/mL，（1.24±0.21）ng/mg vs （1.68±0.19）ng/mg，t=‒12.8790、‒9.8264，P＜0.01]。结论 双歧三联活菌胶囊治疗胆囊切除术后腹泻患者疗效确切，可降低患者血清D-乳酸和5-HT的水平，纠正患者肠道微生态失衡。

Effect of Bifid Triple Viable Capsules on intestinal microbial disorders in patients with postcholecystectomy diarrhea

Objective To discuss the effect of Bifid Triple Viable Capsules on intestinal microbial disorders in patients with postcholecystectomy diarrhea (PCD). Methods 80 patients with PCD were selected and divided into two groups randomly, observation group and control group, with 40 patients in each group. The control group was administrated with the routine treatment and the observation group with given Bifid Triple Viable Capsules with strength of 420 mg, tid, lasting for 4 weeks. The clinical efficacy and adverse effect were investigated, and intestinal microbial quantity and the levels of D-lactic acid and 5-HT were detected. Results The total efficacy rate in the treatment group was 92.50%, which was much higher than that in the control group (70.00%)(χ2=6.646, P＜0.05). Both of two groups had no serious adverse effect. Compared with the control group, the amount of Bifidobacteria and Lactobacilli in observation group were increased obviously (logCFU/g: 9.88±1.01 vs 7.35±0.72, 8.96±0.69 vs 7.61±0.58, t=12.9004 or 9.4722, P<0.01), while Enterobacteria and Enterococci decreased obviously(logCFU/g: 7.86±0.81 vs 8.41±0.80, 8.06±0.69 vs 8.56±0.78, t=-2.9626 or -3.0366, P<0.01). The levels of D-lactic acid and 5-HT in the treatment group were much lower than those in the control group after treatment [(5.69±0.76)μg/mL vs (8.12±0.92)μg/mL, (1.24±0.21)ng/mg vs (1.68±0.19)ng/mg, t=-12.8790 or -9.8264, P＜0.01].