RESUMO
Objective To understand the distribution of intestinal microflora in different types of IBS,and to observe the effect of intestinal microecological intervention. Methods According to the inclusion criteria,the patients were divided into diarrhea group (IBS-D group) and constipation group (IBS-C group),and the normal control group was also set up. The start of the three groups took gastroscopy examinination and took duodenal fluid for intesti-nal bacteria culture and counting,and electronic colonoscopy to retrieve the terminal ileum fluid for bacteria culture and count. Diarrhea and constipation type IBS patients were given Bifidobacterium triple viable capsules,2 capsules each time,3 times a day,treatment for 4 weeks. After treatment for 4 weeks,took electronic gastroscopy to retrieve the duodenal fluid for bacteria culture and counting,and took electronic colonoscopy examination to retrieve the intestinal fluid for terminal colon intestinal bacteria culture and count. Before and after treatment,IBS patients filled in intestinal symptoms rating scale and the intestinal symptoms were graded. After the test,compared the distribution differences of different segments of bacterial flora with diarrhea type IBS,constipation IBS and normal people. And the differences of intestinal flora bacterial distribution and IBS sympotoms were compared among the three groups after the Bifidobacterium triple viable capsules treatment. Results In the duodenal fluid of the three groups, the culture rate of Escherichia coli,Bacteroides,Bifidobacterium,Enterococcus,Lactobacillus was low,the difference was not statistically significant (all P>0. 05). Compared with the normal group,Enterobacter cultured in terminal ileum intestinal in the IBS-D group increased,Bifidobacterium and Lactobacillus decreased significantly[(2. 17 ± 0. 26)Log10 CFU/g vs (3. 26 ± 0. 44)Log10 CFU/g,(1. 46 ± 0. 25)Log10 CFU/g vs (2. 22 ± 0. 25)Log10 CFU/g] (t=4. 42,8. 98,all P<0. 05), the Bacteroides in the IBS-C group increased significantly (t=14. 27,P<0. 05). After the use of Bifidobacterium triple viable capsule oral treatment,the number of Bifidobacterium in duodenal fluid was increased,but the difference was not statistically significant. The terminal ileum intestinal bifidobacteria culture in the IBS -D group increased significantly (t=4. 42,P=0. 00),Enterobacter decreased significantly (t=20. 30,P<0. 05),the quasi bacterial content in the IBS-C group decreased (t=14. 27,P<0. 05). After 4 weeks of Bifidobacterium triple viable capsule treatment,21 cases were effective in the IBS-D group,the total effective rate was 70. 00%. 13 cases were effective in the IBS-C group,the total effective rate was 43. 33%. The total symptoms scores of the IBS-D group decreased significantly (t=10. 36,P<0. 05). Conclusion IBS type of diarrhea and constipation both have intestinal flora disorder,mainly in ileum. The results showed that the effect of intestinal microecological treatment is obvious in diarrhea and constipation type IBS,especially in diarrhea type IBS.
RESUMO
Objective To understand the distribution of intestinal microflora in different types of IBS,and to observe the effect of intestinal microecological intervention. Methods According to the inclusion criteria,the patients were divided into diarrhea group (IBS-D group) and constipation group (IBS-C group),and the normal control group was also set up. The start of the three groups took gastroscopy examinination and took duodenal fluid for intesti-nal bacteria culture and counting,and electronic colonoscopy to retrieve the terminal ileum fluid for bacteria culture and count. Diarrhea and constipation type IBS patients were given Bifidobacterium triple viable capsules,2 capsules each time,3 times a day,treatment for 4 weeks. After treatment for 4 weeks,took electronic gastroscopy to retrieve the duodenal fluid for bacteria culture and counting,and took electronic colonoscopy examination to retrieve the intestinal fluid for terminal colon intestinal bacteria culture and count. Before and after treatment,IBS patients filled in intestinal symptoms rating scale and the intestinal symptoms were graded. After the test,compared the distribution differences of different segments of bacterial flora with diarrhea type IBS,constipation IBS and normal people. And the differences of intestinal flora bacterial distribution and IBS sympotoms were compared among the three groups after the Bifidobacterium triple viable capsules treatment. Results In the duodenal fluid of the three groups, the culture rate of Escherichia coli,Bacteroides,Bifidobacterium,Enterococcus,Lactobacillus was low,the difference was not statistically significant (all P>0. 05). Compared with the normal group,Enterobacter cultured in terminal ileum intestinal in the IBS-D group increased,Bifidobacterium and Lactobacillus decreased significantly[(2. 17 ± 0. 26)Log10 CFU/g vs (3. 26 ± 0. 44)Log10 CFU/g,(1. 46 ± 0. 25)Log10 CFU/g vs (2. 22 ± 0. 25)Log10 CFU/g] (t=4. 42,8. 98,all P<0. 05), the Bacteroides in the IBS-C group increased significantly (t=14. 27,P<0. 05). After the use of Bifidobacterium triple viable capsule oral treatment,the number of Bifidobacterium in duodenal fluid was increased,but the difference was not statistically significant. The terminal ileum intestinal bifidobacteria culture in the IBS -D group increased significantly (t=4. 42,P=0. 00),Enterobacter decreased significantly (t=20. 30,P<0. 05),the quasi bacterial content in the IBS-C group decreased (t=14. 27,P<0. 05). After 4 weeks of Bifidobacterium triple viable capsule treatment,21 cases were effective in the IBS-D group,the total effective rate was 70. 00%. 13 cases were effective in the IBS-C group,the total effective rate was 43. 33%. The total symptoms scores of the IBS-D group decreased significantly (t=10. 36,P<0. 05). Conclusion IBS type of diarrhea and constipation both have intestinal flora disorder,mainly in ileum. The results showed that the effect of intestinal microecological treatment is obvious in diarrhea and constipation type IBS,especially in diarrhea type IBS.