Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Neurology, The First Hospital of Tsinghua University, Beijing, China.
Parkinsonism Relat Disord. 2022 Oct;103:92-97. doi: 10.1016/j.parkreldis.2022.08.022. Epub 2022 Sep 5.
Constipation is one of the common non-motor symptoms in Parkinson's disease that significantly impacts patient quality of life. Probiotics supplementation may improve constipation symptoms, but its effect on the gut microbiota population is unclear.
In this randomized controlled study, 46 PD patients with constipation according to Rome Ⅲ criteria were recruited. The number of complete bowel movements per week, degree of defecation effort, Bristol stool Scale (BSS), Patient Assessment of Constipation symptom (PAC-SYM) and Patient assessment of constipation quality of life questionnaire (PAC-QOL) were collected pre- and post-intervention to evaluate the constipation symptoms. In addition, fresh feces of subjects before and after intervention and healthy controls were collected for 16s rRNA gene V3-V4 region sequencing to compare bacterial flora differences.
Compared with the control group, the treatment group increased the average number of complete bowel movements per week (1.09 ± 1.24 vs. 0.04 ± 0.64, P < 0.001). Probiotics supplementation reduced the BSS score (0.65 ± 0.93 vs. -0.17 ± 0.94, P = 0.004), PAC-SYM score (4.09 ± 6.31 vs. -1.83 ± 4.14, P < 0.001), PAC-QOL score (10.65 ± 16.53 vs. 0.57 ± 12.82, P = 0.042), and degree of defecation effort score (1.00 ± 0.80 vs. 0.00 ± 0.30, P < 0.001). The improvement rate of constipation in the probiotics group was significantly higher than that in the control group (52.2% vs. 8.7%, P = 0.001). PD patients showed intestinal flora disorders compared to healthy controls. After 12 weeks of probiotics treatment, g_Christensenella_sp._Marseille-P2437 significantly increased, while g_Eubacterium_oxidoreducens_group, g_Eubacterium_hallii_group and s_Odoribacter_sp._N54.MGS-14 decreased (p < 0 0.05).
Probiotics treatment can effectively improve the constipation symptoms of PD patients and positively affected the gut microbiota.
便秘是帕金森病常见的非运动症状之一，严重影响患者的生活质量。益生菌补充剂可能改善便秘症状，但对肠道微生物群的影响尚不清楚。
本随机对照研究纳入了 46 例符合罗马 III 标准的帕金森病便秘患者。采用每周完全排便次数、排便费力程度、布里斯托大便形状量表（Bristol stool Scale，BSS）、便秘患者症状评估（Patient Assessment of Constipation symptom，PAC-SYM）和便秘患者生活质量问卷（Patient assessment of constipation quality of life questionnaire，PAC-QOL）评估便秘症状。此外，在干预前后采集受试者新鲜粪便和健康对照者的粪便进行 16s rRNA 基因 V3-V4 区测序，比较细菌菌群差异。
与对照组相比，治疗组每周完全排便次数增加（1.09±1.24 比 0.04±0.64，P＜0.001）。益生菌补充剂降低了 BSS 评分（0.65±0.93 比-0.17±0.94，P=0.004）、PAC-SYM 评分（4.09±6.31 比-1.83±4.14，P＜0.001）、PAC-QOL 评分（10.65±16.53 比 0.57±12.82，P=0.042）和排便费力程度评分（1.00±0.80 比 0.00±0.30，P＜0.001）。益生菌组便秘改善率明显高于对照组（52.2%比 8.7%，P=0.001）。与健康对照组相比，PD 患者表现出肠道菌群失调。经过 12 周的益生菌治疗后，g_Christensenella_sp._Marseille-P2437 显著增加，而 g_Eubacterium_oxidoreducens_group、g_Eubacterium_hallii_group 和 s_Odoribacter_sp._N54.MGS-14 减少（p＜0.05）。
益生菌治疗可有效改善 PD 患者的便秘症状，并对肠道微生物群产生积极影响。
