ABSTRACT
Objective To explore the corrective role of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on the bacteria overgrowth in small intestinal (SIBO)and assess the efficacy and possible mechanism of it in the treatment of diarrhea predominant irritable bowel syndrome (IBS-D).Methods From May to August 2013,IBS-D patients were collected.Screened by lactulose hydrogen breath test (LHBT),and a total of 60 SIBO positive patients were enrolled in the study and divided into experimental group and control group.Live combined Bacillus subtilis and Enterococcus faecium enteric were given to the experimental group and starch given to the control group,both were capsules,each 250 mg,three times per day,two capsules each time,and the treatment course was four weeks.Before and after administration a questionnaire was conducted in the study objects,including basic information (age,gender,disease type,family history and accompanied diseases) and the severe degree of the symptoms (abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust).Fasting peripheral venous blood was taken from the study individuals before and after administration.The level of interleukin (IL)-1β,IL-6,IL-10,IL-12 and tumor necrosis fator-α(TNF-α) in serum were detected by enzyme linked immunosorbent assay(ELISA).t-test was performed for measurement data comparison between two groups,and chi-square test was for count data comparison.Results Among 60 SIBO positive IBS-D patients,30 patients were in experimental group and 30 in control group.The SIBO negative conversion rate of experimental group and control group was 63.3 ％(19/30) and 30.0％ (9/30),the difference was statistically significant (x2 =6.696,P＜0.05).Before and after administration,in control group there were no significant differences in severe degree scoring of abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust or the level of TNF-α,IL-1β,IL-6,IL-10 and IL-12 (all P＞0.05).In experimental group,before and after administration there were statistically significant differences in severe degree scoring of abdominal floating (2.97 ± 1.45 vs 2.61±1.28),level of IL 1β ((1390.81±103.95) ng/L vs (1209.76±113.26) ng/L)and IL-10/IL-12 (4.94±0.74 vs 5.30±0.43),the differences were statistically significant (t=2.052,5.279 and 2.282,all P＜0.05).There were no signinficant differences in other items (all P＞0.05).Conclusions Lived combined Bacillus subtilis and Enterococcus faecium enteric coated capsules could alleviate the symptoms of abdominal floating.The possible mechanism may related with correcting SIBO,inhibiting low degree of inflammation reaction and regulating the inflammatory cytokines.