Ringel-Kulka Tamar, McRorie Johnson, Ringel Yehuda
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
The Procter & Gamble Company, Mason, Ohio, USA.
Am J Gastroenterol. 2017 Jan;112(1):145-151. doi: 10.1038/ajg.2016.511. Epub 2016 Nov 15.
Bifidobacterium infantis 35624 is a probiotic that is used often in patients with irritable bowel syndrome (IBS). Non-patients with bowel symptoms may differ from patients with IBS in the impact of their bowel symptoms on illness severity, healthcare and treatment seeking behavior. The aim of this study is to assess the efficacy of B. infantis 35624 (10 c.f.u. per day) for the relief of abdominal discomfort and bloating in a non-patient population.
A double-blind, randomized, placebo-controlled, parallel study with a 2-week placebo run-in phase followed by a 4-week intervention phase was conducted at ten clinical centers (USA). Subjects were recruited from the general population by advertisement. The study randomized 302 subjects who experienced abdominal discomfort and bloating ≥2-times per week for at least three months but have not seen a physician or received prescribed medication for their symptoms in the past 12 months. Subjects were assessed for pre- to post-intervention changes in symptom severity (on a 6-point Likert scale; 0=none, 5=very severe) and frequency (symptoms-free days).
A total of 275 subjects (mean age 42 years, 79% female, 74% Caucasian) provided evaluable data. Overall mean severity scores at baseline were 2.4 for abdominal discomfort and 2.5 for bloating with no significant differences between the placebo and probiotic groups. Both groups showed significant (P<0.05) improvement in abdominal discomfort and bloating scores over the 4-week intervention period. Mean severity symptom scores at the end of intervention showed no significant differences between the probiotic and the placebo groups in either abdominal discomfort or bloating (P>0.3). The frequency of abdominal bloating-free days was greater in the B. infantis 35624 group compared to the placebo group (P<0.05). Both regimens were well tolerated.
Unlike previous clinical studies in patients with IBS, B. infantis 35624 did not show a significant improvement in the mean severity of symptoms of abdominal discomfort and bloating in a non-patient population. This may be explained by the high placebo effect and the lower impact of functional bowel symptoms in the non-patient population.
婴儿双歧杆菌35624是一种常用于肠易激综合征(IBS)患者的益生菌。没有肠道症状的人与IBS患者在肠道症状对疾病严重程度、医疗保健及寻求治疗行为的影响方面可能存在差异。本研究的目的是评估婴儿双歧杆菌35624(每天10 c.f.u.)对非患者人群腹部不适和腹胀缓解的疗效。
在美国的十个临床中心进行了一项双盲、随机、安慰剂对照的平行研究,先有一个为期2周的安慰剂导入期,随后是为期4周的干预期。通过广告从普通人群中招募受试者。该研究将302名每周经历腹部不适和腹胀至少2次、持续至少三个月但在过去12个月内未看过医生或未因这些症状接受过处方药治疗的受试者随机分组。评估受试者干预前后症状严重程度(采用6分李克特量表;0 = 无,5 = 非常严重)和频率(无症状天数)的变化。
共有275名受试者(平均年龄42岁,79%为女性,74%为白种人)提供了可评估数据。基线时腹部不适的总体平均严重程度评分为2.4,腹胀为2.5,安慰剂组和益生菌组之间无显著差异。在4周的干预期内,两组的腹部不适和腹胀评分均有显著改善(P < 0.05)。干预结束时,益生菌组和安慰剂组在腹部不适或腹胀方面的平均严重程度症状评分均无显著差异(P > 0.3)。婴儿双歧杆菌35624组的无腹胀天数频率高于安慰剂组(P < 0.05)。两种治疗方案耐受性均良好。
与先前针对IBS患者的临床研究不同,婴儿双歧杆菌35624在非患者人群中并未显示出腹部不适和腹胀症状的平均严重程度有显著改善。这可能是由于安慰剂效应较高以及非患者人群中功能性肠道症状的影响较低所致。