Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
Department of Food Bioscience and Technology, College of Life Science and Biotechnology, Korea University, Seoul, 02841, Republic of Korea.
Dig Dis Sci. 2018 Oct;63(10):2754-2764. doi: 10.1007/s10620-018-5139-8. Epub 2018 Jun 7.
BACKGROUND/AIMS: The efficacy of probiotics for improving clinical symptoms, altering the fecal microbiota, and regulating serum immune cytokine levels was investigated in patients with irritable bowel syndrome-constipation (IBS-C) or functional constipation (FC).
A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital between October 2016 and February 2017. Consecutive 18-75-year-old patients with diagnosis of IBS-C or FC (based on Rome IV criteria) consumed probiotics (3.0 × 10 CFU/g Streptococcus thermophilus MG510 and 1.0 × 10 CFU/g Lactobacillus plantarum LRCC5193) or a placebo daily for 4 weeks (weeks 1-4) and were followed up for a 4-week washout period without intervention (weeks 5-8). The primary outcomes of the study were Bristol Stool Form Scale and Complete Spontaneous Bowel Movements (CSBM). Efficacy was assessed by per protocol.
Stool consistency measured by the Bristol Stool Form Scale was significantly better in the probiotic group (n = 88) than in the placebo group (n = 83) at 4 and 8 weeks (3.7 ± 1.1 vs. 3.1 ± 1.1 at 8 weeks, P = 0.002). No significant difference was found in CSBM. The quality of life was significantly better in the probiotic group than in the placebo group at 4 weeks (P = 0.044) and 8 weeks (P = 0.049). The relative abundance of L. plantarum among the fecal microbiomes was significantly greater in the probiotic group than in the placebo group at 4 weeks (P = 0.029). However, the levels of other microbiomes and of serum cytokines (IL-10/IL-12 ratio and TNF-α) did not differ significantly between the two groups.
Probiotics significantly ameliorated stool consistency in patients with chronic constipation. In addition, the beneficial effect of L. plantarum on stool consistency remained after the probiotic supplementation was discontinued. The mechanism whereby probiotics benefit patients with chronic constipation should be clarified in further studies.
背景/目的：本研究旨在探讨益生菌对改善肠易激综合征便秘型（IBS-C）或功能性便秘（FC）患者的临床症状、改变粪便微生物群和调节血清免疫细胞因子水平的疗效。
本研究为一项于 2016 年 10 月至 2017 年 2 月在庆熙大学医院进行的随机、双盲、安慰剂对照试验。连续纳入符合罗马 IV 标准诊断为 IBS-C 或 FC 的 18-75 岁患者，每天服用益生菌（3.0×10^9 CFU/g 嗜热链球菌 MG510 和 1.0×10^9 CFU/g 植物乳杆菌 LRCC5193）或安慰剂，持续 4 周（第 1-4 周），并在无干预的 4 周洗脱期（第 5-8 周）进行随访。本研究的主要结局指标为布里斯托粪便量表和完全自发性排便（CSBM）。根据方案评估疗效。
在第 4 周和第 8 周，益生菌组（n=88）的粪便稠度明显优于安慰剂组（n=83）（第 8 周时 3.7±1.1 比 3.1±1.1，P=0.002）。CSBM 无显著差异。第 4 周（P=0.044）和第 8 周（P=0.049）时，益生菌组的生活质量明显优于安慰剂组。第 4 周时，益生菌组粪便微生物群中植物乳杆菌的相对丰度明显高于安慰剂组（P=0.029）。然而，两组间其他微生物群和血清细胞因子（IL-10/IL-12 比值和 TNF-α）的水平无显著差异。
益生菌可显著改善慢性便秘患者的粪便稠度。此外，益生菌补充停止后，植物乳杆菌对粪便稠度的有益作用仍然存在。在进一步的研究中，应明确益生菌治疗慢性便秘患者的作用机制。
