文章摘要
郭凡菱,黄红英,陈晋超,贺明元,宗玮,德吉措姆,马万援,刘安平.双歧杆菌治疗质子泵抑制剂致老年胃食管反流病患者肠道菌群紊乱的效果及对胃肠激素的影响[J].中国临床保健杂志,2020,23(6):815-819.
双歧杆菌治疗质子泵抑制剂致老年胃食管反流病患者肠道菌群紊乱的效果及对胃肠激素的影响
Effect of Bifidobacterium on intestinal flora disorder induced by proton pump inhibitor in elderly patients with gastroesophageal reflux disease and its effect on gastrointestinal hormones
投稿时间:2020-04-20  
DOI:10.3969/J.issn.1672-6790.2020.06.023
中文关键词: 胃食管反流  胃肠道微生物组  质子泵抑制剂  双歧杆菌  胃肠激素类
英文关键词: Gastroesophageal reflux  Gastrointestinal microbiome  Proton pump inhibitors  Bifidobacteriales  Gastrointestinal hormones 〖FL
基金项目:青海省卫生计划委员会科研项目(2017-wjzdx-43)
作者单位E-mail
郭凡菱 青海省中医院,制剂中心,西宁 810000 hongying88661@163.com 
黄红英 青海省中医院药剂科,西宁 810000 hongying88661@163.com 
陈晋超 青海省中医院外一科,西宁 810000 hongying88661@163.com 
贺明元 青海省中医院风湿科,西宁 810000 hongying88661@163.com 
宗玮 青海省中医院心肾科,西宁 810000 hongying88661@163.com 
德吉措姆 青海省中医院肛肠科,西宁 810000 hongying88661@163.com 
马万援 青海省中医院脾胃科,西宁 810000 hongying88661@163.com 
刘安平 青海西宁市食品药品检验检测中心 hongying88661@163.com 
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中文摘要:
      目的 探究双歧杆菌对质子泵抑制剂(PPIs)药物致老年胃食管反流病(GERD)患者肠道菌群紊乱和胃肠激素水平的影响。方法 选择2017年2月至2019年3月青海省中医院消化内科收治的78例长期服用PPIs的老年GERD患者纳入GERD组,30例同期查体的健康老年人作为研究对象(非GERD组),采用随机数字表法将GERD组患者分为观察组及对照组,观察组患者在常规使用PPIs基础上联合双歧杆菌三联活菌胶囊治疗,对照组维持PPIs药物治疗。比较GERD患者及非GERD组受试者肠道菌群数量差异及胃泌素(GAS)、胃动素(MOT)、5-羟色胺(5-HT)、血管活性肠肽(VIP)胃肠激素水平差异,分析观察组及对照组干预前后肠道菌群数量、胃肠激素水平及营养指标变化及差异。结果 ①GERD组患者双歧杆菌、乳酸杆菌数量显著低于非GERD组,肠球菌、葡萄球菌数量显著高于非GERD组(P<0.05);GERD患者血清GAS、5-HT、VIP等胃肠激素水平显著高于非GERD组,MOT水平显著低于非GERD组,差异有统计学意义(P<0.05)。②与基线时间点比较,观察组双歧杆菌、乳酸杆菌数量明显增加(P<0.05),大肠埃希菌、葡萄球菌数量明显降低(P<0.05),两组治疗后双歧杆菌、乳酸杆菌、大肠埃希菌、葡萄球菌数量比较差异有统计学意义(P<0.05)。③治疗后观察组MOT水平均显著高于对照组(P<0.05);GAS、5-HT、VIP等激素水平显著低于对照组(P<0.05)。④治疗后观察组血红蛋白、白蛋白等营养功能指标显著优于对照组(P<0.05)。结论 长期使用PPIs老年GERD患者存在肠道菌群失调现象,口服双歧杆菌三联活菌胶囊可纠正肠道菌群失调,改善胃肠道功能及机体营养水平。
英文摘要:
      Objective To explore the effects of bifidobacterium on intestinal flora disorders induced by proton pump inhibitors (PPIs) and gastrointestinal hormones levels in elderly patients with gastroesophageal reflux disease (GERD).Methods During the period from February 2017 to March 2019,78 elderly GERD patients who took PPIs for a long time were admitted to gastroenterology department of the hospital and 30 healthy elderly people who underwent physical examination during the same period were enrolled as study objects.They were included in GERD group and non-GERD group,respectively.The patients in GERD group were divided into observation group and control group by random number table method.On basis of PPIs treatment,observation group was treated with bifidobacterium triple viable capsules,while control group was treated with PPIs only.The differences in number of intestinal flora and levels of gastrointestinal hormones such as gastroin (GAS),motilin (MOT),serotonin (5-HT),vasoactive intestinal peptide (VIP) were compared between GERD group and non-GERDgroup.The changes and differences in number of intestinal flora,levels of gastrointestinal hormones and nutritional indexes before and after intervention betwenobservation and group control group were analyzed.Results ①The number of bifidobacterium and lactobacillus in GERD group was significantly less than that in non-GERDgroup,while the numbers of enterococcus and staphylococcus were significantly more than those in non-GERD group (P<0.05).The levels of serum GAS,5-HT,VIP in GERD patients were significantly higher than those in non-GERD groups,while the MOT level was significantly lower than that in non-GERD groups,the difference was statistically significant (P<0.05).②Compared with those at baseline time point,the numbers of bifidobacterium and lactobacillus in observation group were significantly increased (P<0.05),while numbers of escherichia coli and staphylococcus were significantly decreased (P<0.05).After treatment,there were significant differences in number of bifidobacterium,lactobacillus,escherichia coli and staphylococcus between the two groups (P<0.05).③After treatment,level of MOT in observation group was significantly higher than that in control group (P<0.05),while levels of GAS,5-HT,VIP were significantly lower than those in control group (P<0.05).④After treatment,nutritional function indexes such as hemoglobin and albumin in observation group were significantly better than those in control group (P<0.05).Conclusion There is intestinal flora imbalance in elderly GERD patients who have taken PPIs for a long time.Oral bifidobacterium triple viable capsules can correct intestinal flora imbalance,improve gastrointestinal function and body nutrition level.
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