Shcherbakova P L, Parfenov A I, Ruchkina I N, Fadeeva N A, Gubina A V, Melik-Agadzhanian N B, Poleva N I, Khomeriki S G, Chikunova B Z
Eksp Klin Gastroenterol. 2012(5):91-8.
to define the frequency of secondary lactase deficiency (SLD) in patients with postinfectious IBS and to develop therapy for the correction of mild SLD in adult patients.
In this study, 138 patients (the mean age - 33.9 +/- 9.09; F/M - 112/26) with postinfectious IBS were analyzed concerning lactase deficiency. All patients underwent intestinal endoscopy with biopsies from the mucosa of the descending duodenum in order to determine lactase deficiency twice before and after therapy. To diagnose small intestinal bacterial overgrowth (SIBO) all patients underwent lactulose breath test during 2 hours.
SLD was detected in 59.4% of patients with postinfectious IBS. Mild SLD was determined in 43.5% of patients, and severe SLD - in 15.9% of patients. SLD in all cases was accompanied by SIBO (the mean level of lactulose breath test was 101 +/- 37 ppm, N<20 ppm). In group patients who took the probiotic during 14 days in 70.8% of patients recovering of lactose metabolism in the small intestine and decreasing of the intensity of clinical symptoms were registered. The decrease of the lactulose breath test level (86.9 +/- 40.9 ppm; 17.4 +/- 6.6 ppm; p<0.01) and negative LQT (p<0.01) were registered in the first group. In group patients who took placebo during 14 days there was no positive effect in 68.4% of cases.
the probiotic Bifiform, composed of Bifidobacterium longum 10(7) and Enterococcus faecium 10(7), demonstrated efficiency in correction of mild SLD in patients with postinfectious IBS and can be used to prevent SIBO.
确定感染后肠易激综合征（IBS）患者继发性乳糖酶缺乏（SLD）的发生率，并开发针对成年患者轻度SLD的纠正疗法。
在本研究中，对138例感染后IBS患者（平均年龄33.9±9.09岁；女性/男性=112/26）的乳糖酶缺乏情况进行了分析。所有患者均接受了肠道内窥镜检查，并在十二指肠降部黏膜取活检，以便在治疗前后各进行两次乳糖酶缺乏的测定。为诊断小肠细菌过度生长（SIBO），所有患者均进行了2小时的乳果糖呼气试验。
在感染后IBS患者中，59.4%检测出SLD。43.5%的患者为轻度SLD，15.9%的患者为重度SLD。所有病例中的SLD均伴有SIBO（乳果糖呼气试验平均水平为101±37 ppm，正常<20 ppm）。在接受益生菌治疗14天的患者组中，70.8%的患者小肠乳糖代谢恢复，临床症状强度降低。第一组患者的乳果糖呼气试验水平降低（86.9±40.9 ppm；17.4±6.6 ppm；p<0.01），乳糖耐量试验转阴（p<0.01）。在接受安慰剂治疗14天的患者组中，68.4%的病例没有积极效果。
由长双歧杆菌10⁷和粪肠球菌10⁷组成的益生菌必孚（Bifiform），在纠正感染后IBS患者的轻度SLD方面显示出有效性，可用于预防SIBO。
