Second Department of Internal Medicine, Wakayama Medical University, Kimiidera 811-1 Wakayama, Japan.
Department of Anatomy and Cell Biology, Wakayama Medical University, Kimiidera 811-1 Wakayama, Japan.
Medicine (Baltimore). 2022 Feb 25;101(8):e28858. doi: 10.1097/MD.0000000000028858.
We examined whether synbiotics enhance improvement by probiotics.
Probiotics, which are beneficial microbacteria, are a nutritional intervention for treatment of functional constipation or its tendency. Prebiotics, meanwhile, can promote the proliferation of probiotics in the gastrointestinal tract and enhance their beneficial effects. Synbiotics, a combination of probiotics and prebiotics, may be superior to probiotics in the treatment of defecation-related symptoms, but this requires elucidation.
This randomized, double-blind, placebo-controlled study enrolled 69 healthy adults with constipation tendency. Participants were allocated to either control, probiotics, or synbiotics groups and they recorded details of their defecations and their condition. The first 2 weeks were the observation period and the latter 2 weeks were the intervention period, in which participants took test foods. Probiotic foods included Bifidobacterium longum NT strain (1010 CFU/day), synbiotic foods included the NT strain (1010 CFU/day) and galactooligosaccharide (1 g/day). Placebo foods contained the vehicle only. Participants answered questionnaires (Patient Assessment on Constipation Symptoms [PAC-SYM], and one on dietary history) on the last day of each period.
Nine participants withdrew consent, and 2 of the remaining 60 had missing data. Age, body mass index, and sex were not significantly different between the 3 groups. Frequency of bowel movements in the fourth week, the primary endpoint, was not increased in the probiotics or synbiotics groups compared with the control group, and the frequency of bowel movements and days with defecation were not changed by probiotics or synbiotics during the intervention period. Probiotics and synbiotics did not improve stool conditions, although incomplete defecation was improved by probiotics but not by synbiotics compared with placebo. PAC-SYM indicated that stool condition and total scores were improved by probiotics but not by synbiotics during the intervention compared with placebo.
The probiotic strain Bifidobacterium longum NT can improve constipation symptoms, especially stool condition, but it does not increase bowel movement frequency in healthy adults with constipation tendency. Synbiotics treatment seemed to diminish this improvement of constipation induced by probiotics. This study indicates the possibility of attenuation of beneficial effects from probiotics by the use of synbiotics, contrary to synbiotics theory.
我们研究了合生剂是否能增强益生菌的改善效果。
益生菌是有益的微生物，是治疗功能性便秘或其倾向的营养干预措施。同时，益生元可以促进胃肠道内益生菌的增殖，增强其有益作用。合生剂是益生菌和益生元的结合，在治疗与排便相关的症状方面可能优于益生菌，但这需要进一步阐明。
这项随机、双盲、安慰剂对照研究纳入了 69 名有便秘倾向的健康成年人。参与者被分配到对照组、益生菌组或合生剂组，并记录他们的排便情况和病情。前 2 周为观察期，后 2 周为干预期，期间参与者服用试验食品。益生菌食品包括长双歧杆菌 NT 株（1010 CFU/天），合生剂食品包括 NT 株（1010 CFU/天）和半乳糖寡糖（1 g/天）。安慰剂食品仅含载体。参与者在每个时期的最后一天回答问卷（便秘症状患者评估量表[PAC-SYM]和一份饮食史问卷）。
9 名参与者撤回了同意，其余 60 名参与者中有 2 名数据缺失。3 组间的年龄、体重指数和性别无显著差异。主要终点为第 4 周的排便频率，益生菌或合生剂组与对照组相比无增加，益生菌或合生剂干预期间排便频率和排便天数无变化。益生菌和合生剂均未改善粪便状况，尽管与安慰剂相比，益生菌改善了不完全排便，但合生剂未改善。PAC-SYM 表明，与安慰剂相比，干预期间益生菌改善了粪便状况和总评分，但合生剂未改善。
长双歧杆菌 NT 益生菌株可改善便秘症状，特别是粪便状况，但不能增加有便秘倾向的健康成年人的排便频率。合生剂治疗似乎减弱了益生菌引起的便秘改善。这项研究表明，与合生剂理论相反，使用合生剂可能会减弱益生菌的有益作用。
