Shi Jin, Gao Feng, Zhang Jie
Digestive Department, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Gastroenterol Res Pract. 2020 Sep 17;2020:4181748. doi: 10.1155/2020/4181748. eCollection 2020.
Changes of the gut microbiota are related to the pathogenesis of functional bowel disorders (FBDs), and probiotic supplementation may be an effective treatment option. Therefore, we aimed to investigate the effect of combined live probiotics on the gastrointestinal symptoms of FBDs via altering the gut microbiota.
Patients with the gastrointestinal symptoms of FBDs attending the Outpatient Department, from July to November 2019, were recruited. After the bowel preparation with polyethylene glycol electrolyte powder and colonoscopy, patients with normal result of colonoscopy were randomly divided into the probiotics group and control group. Patients in the probiotics group were prescribed with combined live and enteric-coated capsules for 4 weeks. Small intestinal bacteria overgrowth (SIBO) was measured by lactulose hydrogen breath test, and the microbial DNA was extracted from the fecal samples and the bacteria were classified by 16S rDNA gene amplicon sequencing.
Twenty-five patients of each group were recruited, and there was no significant difference between the probiotics and control groups on baseline gastrointestinal symptom rating scale (GSRS), positive rate of SIBO, and relative abundances of the gut microbiota at the phylum level. After 4 weeks of treatment, the values of the probiotics and control groups were as follows: GSRS 1.4 ± 1.4 and 3.6 ± 1.6 and positive rate of SIBO 28.0% and 56.0%, respectively. The median relative abundances of the gut microbiota were 1.01% and 5.03% Actinobacteria and 43.80% and 35.17% Bacteroidetes at the phylum level; 0.76% and 3.29% , 0.13% and 0.89% , 0.03% and 0.01% , 0.18% and 0.36% , 0.10% and 0.16% , 1.31% and 2.44% , and 0.83% and 2.02% at the genus level ( < 0.05), respectively.
Combined live probiotic supplementation after the bowel preparation can alter the gut microbiota, decontaminate SIBO, and alleviate the gastrointestinal symptoms of FBDs. This trial is registered with ChiCTR1900026472.
肠道微生物群的变化与功能性肠病（FBDs）的发病机制相关，补充益生菌可能是一种有效的治疗选择。因此，我们旨在通过改变肠道微生物群来研究联合使用活性益生菌对FBDs胃肠道症状的影响。
招募2019年7月至11月在门诊就诊的有FBDs胃肠道症状的患者。在用聚乙二醇电解质粉进行肠道准备和结肠镜检查后，结肠镜检查结果正常的患者被随机分为益生菌组和对照组。益生菌组患者服用联合活性[具体益生菌名称未给出]肠溶胶囊4周。通过乳果糖氢呼气试验检测小肠细菌过度生长（SIBO），并从粪便样本中提取微生物DNA，通过16S rDNA基因扩增子测序对细菌进行分类。
每组招募了25名患者，益生菌组和对照组在基线胃肠道症状评分量表（GSRS）、SIBO阳性率和门水平肠道微生物群的相对丰度方面无显著差异。治疗4周后，益生菌组和对照组的值如下：GSRS分别为1.4±1.4和3.6±1.6，SIBO阳性率分别为28.0%和56.0%。在门水平上，肠道微生物群的中位相对丰度分别为放线菌门1.01%和5.03%、拟杆菌门43.80%和35.17%；在属水平上分别为[具体菌属名称未给出]0.76%和3.29%、[具体菌属名称未给出]0.13%和0.89%、[具体菌属名称未给出]0.03%和0.01%、[具体菌属名称未给出]0.18%和0.36%、[具体菌属名称未给出]0.10%和0.16%、[具体菌属名称未给出]1.31%和2.44%、[具体菌属名称未给出]0.83%和2.02%（P<0.05）。
肠道准备后补充联合活性益生菌可改变肠道微生物群，清除SIBO，并缓解FBDs的胃肠道症状。本试验已在中国临床试验注册中心注册，注册号为ChiCTR1900026472。
