双歧杆菌三联活菌胶囊对动脉粥样硬化患者血脂、颈动脉斑块和肠道菌群的影响

目的 探讨双歧杆菌三联活菌胶囊辅助治疗颈动脉粥样硬化患者及其对患者血脂、颈动脉斑块和肠道菌群的影响。方法 选择2017年1月至2017年10月在我院门诊治疗的颈动脉粥样硬化患者84例，随机分为观察组和对照组各42例。对照组患者均予以瑞舒伐他汀（10 mg/次，1次/d）+肠溶阿司匹林片（100 mg/次，1次/d）口服治疗，并根据病情酌情给予降压、降糖等治疗。观察组患者在对照组基础上加用双歧杆菌三联活菌胶囊630 mg/次，3次/d，温水口服。两组患者疗程均为6个月。观察两组患者治疗前后血脂指标[总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）]水平、颈动脉斑块指标[颈动脉斑块内‒中膜厚度（IMT）及斑块面积）及肠道菌群数量（双歧杆菌、乳杆菌和大肠埃希菌）的变化。结果 治疗6个月后，两组患者TC、TG和LDL-C水平较治疗前均明显下降，HDL-C水平较治疗前均有明显上升（P<0.05），且观察组变化幅度较对照组更明显（P<0.05）；两组患者颈动脉IMT及斑块面积较治疗前均明显下降（P<0.05），且观察组下降幅度幅度较对照组更明显（P<0.05）；两组患者肠道双歧杆菌和乳杆菌数量较治疗前明显上升，大肠埃希菌数量较治疗前明显下降（P<0.05或P<0.01），且观察组变化幅度幅度较对照组更明显（P<0.05）。结论 双歧杆菌三联活菌胶囊对颈动脉粥样硬化患者具有良好的协同降脂作用，并能延缓和逆转颈动脉粥样硬化，降低IMT及斑块面积。其作用机制可能与其能纠正肠道菌群紊乱，增加肠道有益菌数量，减少致病菌数量密切相关。

Influence of Bifid-triple Viable capsules on blood lipids, carotid plaque and intestinal flora of patients with carotid atherosclerosis

Objective To discuss the influence of Bifid-Triple Viable capsules on blood lipids, carotid plaque and intestinal flora of patients with carotid atherosclerosis. Methods 84 outpatients with carotid atherosclerosis, who accepted treatment in our hospital from January 2017 to October 2017, were randomly divided into Observation group or Control group , 42 cases in each group. The patients in control group were given Rosuvastatin 10mg qd and Enteric Aspirin tablets 100mg qd orally, as well as hypotension and antidiabetes drugs based on their conditions. The patients in observation group were additionally given Bifid-Triple Viable capsules 630mg tid orally on the basis of the treatment given to Control group. All patients were treated for 6 months. The changes of blood fat indexes [total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterin (LDL-C)], carotid plaque indexes [intima-media thickness (IMT) and plaque area of carotid plaque] and the quantities of intestinal flora (Bifidobacteria, Lactobacilli and Escherichia coli) were observed before and after treatment. Results After 6 months’ treatment, the levels of TC, TG and LDL-C in both groups were obviously declined while the HDL-C levels were obviously rose (P<0.05), and the changing rates in observation group were much higher than those in control group (P<0.05). The IMT and area of carotid plaque of patients were obviously declined (P<0.05), and the declining rates in observation group were much higher than those in control group (P<0.05). The quantities of Bifidobacteria and Lactobacilli in both groups were obviously rose while that of Escherichia coli were obviously declined (P<0.05 or P<0.01), and the changing rates in observation group were much higher than those in control group (P<0.05). Conclusion Bifid-Triple Viable capsules have favorable synergetic lipid-decreasing effect, which can defer and reverse the progression of carotid atherosclerosis and reduce IMT and plaque area. The mechanisms of action may be related to its effect of adjusting the disorder of intestinal flora balance, increasing the quantities of beneficial bacteria and reducing those of pathogenic bacteria.