肠道菌群调节联合肠内营养辅助治疗对老年急性重症胰腺炎的疗效观察
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摘要
目的:探讨双歧杆菌四联活菌片联合肠内营养辅助治疗对老年急性重症胰腺炎(SAP)的疗效及对肠黏膜屏障功能及肠道菌群的影响。方法:选取2016年2月～2018年2月我院收治的老年SAP患者83例为研究对象,根据随机数字表法将患者分为对照组(n=41)和研究组(n=42),对照组给予肠内营养治疗,研究组在对照组基础上联合双歧杆菌四联活菌片治疗,比较2组治疗后临床疗效、肠黏膜屏障功能及肠道菌群情况,记录不良反应。结果:研究组患者治疗14d后临床总有效率为92.86%,显著高于对照组的73.17%(P<0.05);治疗后2组患者血清内毒素、二胺氧化酶(DAO)水平均显著降低,且研究组显著低于对照组(均P<0.05);治疗后2组患者双歧杆菌、乳酸杆菌较治疗前升高,且研究组显著高于对照组(P<0.05),葡萄球菌、大肠杆菌较治疗前降低,且研究组显著低于对照组(P<0.05)。2组患者治疗期间未见药品不良反应。结论:双歧杆菌四联活菌片联合肠内营养辅助治疗老年SAP,疗效确切,可有效改善机体肠黏膜屏障功能及肠道菌群状态,且不会增加不良反应发生率,有临床应用价值。
Objective:To investigate the effect of bifidobacterium tetragenous viable bacteria tablets(BT)combined with enteral nutrition on intestinal mucosal barrier function and intestinal flora in eldly patients with acute severe pancreatitis(SAP).Methods:A total of 83 eldly patients with SAP admitted to our hospital from February 2016 to February 2018 were selected as the research subjects.The patients were randomly divided into control group(n=41)and research group(n=42).The control group was given enteral nutrition treatment,and the research group was treated with BT on the basis of the control group.The clinical effects of the two groups after 14 day-treatment were compared.The occurrence of adverse reactions were recorded.Results:The total effective rate of the research group was 92.86%,which was significantly higher than 73.17% of the control group(P<0.05).After 14 d of treatment,the levels of serum endotoxin and diamine oxidase(DAO)in both groups were decreased and the level in the research group was lower than that in the control group(P<0.05).After 14 d of treatment,the quantities of Bifidobacterium and Lactobacillus in both groups were higher than those before treatment,and the effect of research group were significantly better than that of the control group(P <0.05).There were no adverse reactions during treatment.Conclusion:BT combined with enteral nutrition in the treatment of eldly SAP patients has definite curative effect.It can effectively improve the intestinal mucosal barrier function and intestinal flora status,and does not increase the incidence of adverse reactions.It has certain clinical value.
Objective:To investigate the effect of bifidobacterium tetragenous viable bacteria tablets(BT)combined with enteral nutrition on intestinal mucosal barrier function and intestinal flora in eldly patients with acute severe pancreatitis(SAP).Methods:A total of 83 eldly patients with SAP admitted to our hospital from February 2016 to February 2018 were selected as the research subjects.The patients were randomly divided into control group(n=41)and research group(n=42).The control group was given enteral nutrition treatment,and the research group was treated with BT on the basis of the control group.The clinical effects of the two groups after 14 day-treatment were compared.The occurrence of adverse reactions were recorded.Results:The total effective rate of the research group was 92.86%,which was significantly higher than 73.17% of the control group(P<0.05).After 14 d of treatment,the levels of serum endotoxin and diamine oxidase(DAO)in both groups were decreased and the level in the research group was lower than that in the control group(P<0.05).After 14 d of treatment,the quantities of Bifidobacterium and Lactobacillus in both groups were higher than those before treatment,and the effect of research group were significantly better than that of the control group(P <0.05).There were no adverse reactions during treatment.Conclusion:BT combined with enteral nutrition in the treatment of eldly SAP patients has definite curative effect.It can effectively improve the intestinal mucosal barrier function and intestinal flora status,and does not increase the incidence of adverse reactions.It has certain clinical value.
引文
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[2]孙雯娟,张波,李大魁,等.益生菌制剂的发展现状与临床应用进展[J].中国医院药学杂志,2015,35(9):850-857.
[3]中华医学会外科学分会胰腺外科学组.急性胰腺炎诊治指南(2014)[J].中华肝胆外科杂志,2015,21(1):.1-4
[4]Wereszczynska-Siemiatkowska U,Swidnicka-Siergiejko A,Siemiatkowski A,et al.Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acute pancreatitis[J].Pancreas,2013,42(4):640-646.
[5]刘方旭,许乐.双歧杆菌四联活菌片治疗迁延性、慢性腹泻的随机对照临床研究[J].中华消化杂志,2016,36(12):822-825.
[6]袁涛,赵维纲,曹勇,等.双歧杆菌四联活菌片治疗2型糖尿病患者便秘的有效性及安全性[J].中华内科杂志,2018,57(4):252-257.
[7]Ying-Jie Sun,Hui-Juan Cao,Qiang Jin,et al.Effects of penehyclidine hydrochloride on rat intestinal barrier function during cardiopulmonary bypass[J].World J Gastroenterol,2011,17(16):2137-2142.