Jafari Seyed-Ali, Mehdizadeh-Hakkak Atieh, Kianifar Hamid-Reza, Hebrani Paria, Ahanchian Hamid, Abbasnejad Elaheh
Department of Pediatric Gastroenterology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Cystic Fibrosis Clinic, Dr. Sheikh Pediatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Pediatr. 2013 Dec;23(6):669-74.
Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota and dysregulated immune mediators due to massive exposure to antibiotics. Probiotics as immunomodulatory and anti-inflammatory substances are considered to improve both clinical and biochemical intestinal and pulmonary function in CF patients. We decided to investigate the effects of probiotics on quality of life and pulmonary exacerbations in children with cystic fibrosis.
In a prospective, randomized, controlled clinical trial, 37 CF patients (2-12 years old) were randomly divided into two groups. 20 patients of probiotic group took probiotics (2×10(9)CFU/d) for one month while 17 patients of control group took placebo capsules. Quality of life was determined using PedsQL™4.0 questionnaire at the beginning, then three and six months after completing the treatment period. Rate of pulmonary exacerbation in probiotic group patients was also evaluated during three months after intervention and compared to the same three months of the previous year. Results were analyzed using SPSS (11.5). P<0.05 was considered statistically significant.
Significant improvement was observed in the mean total score of parent reported quality of life among probiotic group patients in comparison with placebo group at 3(rd) month (P=0.01), but this was not significant at 6(th) month of probiotic treatment. Rate of pulmonary exacerbation was significantly reduced among probiotic group (P<0.01).
Probiotics are considered as useful nutritional supplements on reducing number of pulmonary exacerbations and improving quality of life in patients with cystic fibrosis. Effects of probiotics seem to be temporary and probably continuous ingestion might have more stable improving effects on quality of life.
由于大量使用抗生素，囊性纤维化（CF）患者通常存在肠道微生物群异常和免疫介质失调的情况。益生菌作为免疫调节和抗炎物质，被认为可改善CF患者的临床及生化肠道和肺功能。我们决定研究益生菌对囊性纤维化儿童生活质量和肺部加重发作的影响。
在一项前瞻性、随机、对照临床试验中，37例CF患者（2至12岁）被随机分为两组。益生菌组的20例患者服用益生菌（2×10⁹CFU/天），为期1个月，而对照组的17例患者服用安慰剂胶囊。在治疗期开始时、结束后的3个月和6个月，使用儿童生活质量量表（PedsQL™4.0）问卷来确定生活质量。还对益生菌组患者在干预后的3个月内的肺部加重发作率进行评估，并与上一年的相同三个月进行比较。使用SPSS（11.5）对结果进行分析。P<0.05被认为具有统计学意义。
与安慰剂组相比，益生菌组患者在第3个月时家长报告的生活质量平均总分有显著改善（P = 0.01），但在益生菌治疗的第6个月时不显著。益生菌组的肺部加重发作率显著降低（P<0.01）。
益生菌被认为是减少囊性纤维化患者肺部加重发作次数和改善生活质量的有用营养补充剂。益生菌的作用似乎是暂时的，持续摄入可能对生活质量有更稳定的改善作用。
