补充布拉氏酵母菌和粪肠球菌益生菌可改善患有慢性非萎缩性胃炎的航空公司飞行员的胃痛和腹胀:一项开放标签研究。
Probiotic Supplementation With Saccharomyces boulardii and Enterococcus faecium Improves Gastric Pain and Bloating in Airline Pilots With Chronic Non-atrophic Gastritis: An Open-Label Study.
作者信息
Minoretti Piercarlo, Liaño Riera Miryam, Santiago Sáez Andrés, Gómez Serrano Manuel, García Martín Ángel
机构信息
General Direction, Studio Minoretti, Oggiono, ITA.
Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, ESP.
出版信息
Cureus. 2024 Jan 18;16(1):e52502. doi: 10.7759/cureus.52502. eCollection 2024 Jan.
Background Commercial airline pilots (APs) are prone to upper gastrointestinal symptoms, such as epigastric pain and bloating. These issues are often linked to occupational risk factors like irregular diet, sleep disruption, and circadian rhythm disturbance. The use of probiotics to enhance intestinal health is well established, but their efficacy in treating upper gastrointestinal diseases is still debated. This is primarily due to the stomach's small resident microbiota and its low pH, which is inhospitable to most microbes. However, emerging research suggests that specific probiotic strains, such as , can withstand acidic environments. Moreover, certain yeast species, including , can survive at a low pH. Consequently, we conducted a preliminary, three-arm, randomized, open-label, dose-finding, four-week study to compare the effects of watchful waiting (WW) with the administration of an oral probiotic supplement containing and in APs diagnosed with -negative chronic non-atrophic gastritis (CNG). Methods The study included 39 APs with CNG who were randomized into three groups with a 1:1:1 ratio. The low-dose group (n = 13) received one capsule of the probiotic supplement twice daily, before meals, for four weeks. The high-dose group (n = 13) was administered two capsules of the supplement on the same schedule. The third group (n = 13) underwent WW and served as the control arm. Blinding was maintained for the examining physicians and laboratory staff, but not for the patients. All participants self-rated their experiences of gastric pain and bloating at the beginning and conclusion of the four-week treatment period. Additionally, serum levels of pepsinogen I (PGI) and pepsinogen II (PGII) were measured at these time points. Results Supplementation with probiotics significantly outperformed WW in reducing subjective gastric pain and bloating. This effect was consistent across both tested dosages, with no significant differences observed. However, only high-dose probiotics led to a statistically significant decrease in PGII levels and an increase in the PGI/PGII ratio after the four-week study period, a result not observed with low-dose probiotics. Conclusions Oral administration of and demonstrated potential efficacy in reducing gastric pain and bloating symptoms in APs with CNG, as evidenced by statistically significant symptom improvement compared to the control group that did not receive the probiotic supplementation. Notably, high-dose probiotics resulted in a significant increase in the PGI/PGII ratio, indicating potential long-term cytoprotective effects on the gastric mucosa.
背景 商业航空公司飞行员(AP)容易出现上消化道症状,如胃痛和腹胀。这些问题通常与职业风险因素有关,如饮食不规律、睡眠中断和昼夜节律紊乱。使用益生菌来促进肠道健康已得到充分证实,但其在治疗上消化道疾病方面的疗效仍存在争议。这主要是由于胃内常驻微生物群数量少且pH值低,这对大多数微生物来说是不适宜生存的环境。然而,新出现的研究表明,特定的益生菌菌株,如 ,能够耐受酸性环境。此外,某些酵母菌种,包括 ,可以在低pH值下存活。因此,我们进行了一项初步的、三臂、随机、开放标签、剂量探索性的四周研究,以比较观察等待(WW)与给被诊断为 阴性慢性非萎缩性胃炎(CNG)的AP服用含有 和 的口服益生菌补充剂的效果。
方法 该研究纳入了39名患有CNG的AP,他们被随机分为三组,比例为1:1:1。低剂量组(n = 13)每天在饭前服用一粒益生菌补充剂,共四周。高剂量组(n = 13)按相同时间表服用两粒补充剂。第三组(n = 13)进行观察等待并作为对照组。检查医生和实验室工作人员保持盲态,但患者不盲。所有参与者在四周治疗期开始和结束时自行评估胃痛和腹胀的感受。此外,在这些时间点测量血清胃蛋白酶原I(PGI)和胃蛋白酶原II(PGII)水平。
结果 在减轻主观胃痛和腹胀方面,补充益生菌的效果明显优于观察等待。两种测试剂量的效果均一致,未观察到显著差异。然而,仅高剂量益生菌在四周研究期后导致PGII水平有统计学意义的下降和PGI/PGII比值升高,低剂量益生菌未观察到这一结果。
结论 口服 和 对减轻患有CNG的AP的胃痛和腹胀症状显示出潜在疗效,与未接受益生菌补充剂的对照组相比,症状改善具有统计学意义。值得注意的是,高剂量益生菌导致PGI/PGII比值显著升高,表明对胃黏膜可能有长期的细胞保护作用。
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