经肠镜导入益生菌对肠易激综合征治疗的可行性研究

目的 观察经肠镜导入益生菌对肠易激综合征（IBS）患者症状的影响及可能的不良反应。方法 选择福建医科大学附属第一医院就诊的IBS患者，入选患者均符合IBS罗马IV诊断标准并同意进入本研究。患者肠镜检查完成时于右半结肠单次喷洒33.6 mg/mL的双歧杆菌三联活菌‒生理盐水混悬液100 mL，第0、2和4周进行粪便Bristol分型、腹痛视觉评分（VAS）、结肠症状评分和IBS严重程度调查表评分（IBS-SSS）；第0、4周进行医院焦虑抑郁量表（HADS）测定。结果 入选患者中共有5例IBS便秘型（IBS-C）、13例IBS腹泻型（IBS-D）患者完成研究，年龄分别为（49.4±10.0）岁和（36.1±8.9）岁，男女比例分别为1∶0.66和3.3∶1，均无严重不良反应发生。IBS-C组患者症状指标均无显著改善（P>0.05），该组患者提前终止。IBS-D组患者综合疗效指数0.692，与第0周相比，第2和4周患者的粪便Bristol分型、腹痛VAS评分、症状总积分和IBS-SSS评分均显著下降（P0.05）。结论 经肠镜单次双歧杆菌三联活菌混悬液喷洒可安全有效地改善IBS-D患者的肠道症状，但对IBS-C患者无效。

Effect of colonscopic probiotics administration on symptoms of irritable bowel syndrome: A feasibility study

Objective To analyze the effect of colonscopic probiotics administration on the symptoms of irritable bowel syndrome (IBS) and potential adverse events. Methods The patients with IBS in our hospital were included according to IBS Roma IV diagnostic criteria after obtaining their informed consent. Suspension of Bifidobacterium, Lactobacillus acidophilus and Enterococcus faecalis (100 mL, 33.6 mg/mL) was sprayed into the right hemicolon during colonscopy. The Bristol stool scale, abdominal visual analogue score (VAS), colon symptom score and IBS severity scoring system (IBS-SSS) were used at 0, 2 and 4 weeks, while Hospital anxiety and depression scale (HADS) was used at 0 and 4 weeks to evaluate the symptom improvement. Results 5 cases of constipation predominant IBS (IBS-C) and 13 cases of diarrhea predominant IBS (IBS-D) were enrolled. The average age were (49.4±10.0) and (36.1±8.9) respectively, and the male/female ratios were 1:0.66 and 3.3:1, respectively. No improvements were observed in IBS-C patients. In IBS-D group, the composite efficacy index was 0.692, and the scores of stool characters, urgency, distension, Bristol stool scale, abdominal VAS and IBS-SSS were decreased at 2 and 4 weeks (P0.05). No adverse event was reported during the study. Conclusion A single-dose probiotics administration via colonscopy may improve the symptoms of IBS-D, but not for IBS-C.