Zhao Yanan, Zhang Rui, Wang Shuling, Yang Chunchun, Wang Yang, Fan Hongyun, Yang Mingyue
Department of Gastroenterology, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Front Med (Lausanne). 2024 Dec 3;11:1492108. doi: 10.3389/fmed.2024.1492108. eCollection 2024.
To evaluate the clinical efficacy of probiotics and early oral feeding in patients with severe acute pancreatitis.
A prospective, randomized, controlled trial was conducted involving 66 patients, who were randomly divided into a control group ( = 32) receiving standard enteral nutrition and an observation group ( = 34) receiving additional Bifidobacterium quadruplex live bacterial tablets. Serum inflammatory markers, including white blood cells (WBC), interleukin-6 (IL-6), tumor necrosis factor- (TNF-α), and C-reactive protein (CRP), were measured on days 1, 3, and 7 post-admission. Abdominal pain scores, the computed tomography severity index (CTSI), and the Bedside Index for Severity in Acute Pancreatitis (BISAP) scores were also assessed. Additionally, defecation time and the total duration of hospitalization were compared between the two groups.
Inflammatory markers declined in all groups by the third day post-admission, with the observation group exhibiting a significantly greater reduction compared to the control group ( < 0.05). Similarly, from the first day to the third day, both groups experienced a decrease in abdominal pain scores, CTSI, and BISAP scores, with the observation group showing a significantly more pronounced decrease in BISAP scores compared to the control group ( < 0.05). By the seventh day of admission, inflammatory markers continued to decline in all groups compared to the third day, except for TNF- levels, and the observation group demonstrated a significantly greater decrease compared to the control group ( < 0.05). Abdominal pain scores, CTSI, and BISAP scores also decreased further in both groups compared to the third day, with the observation group again showing a significantly greater improvement than the control group ( < 0.05). Additionally, the observation group had a significantly shorter time to bowel movement resumption (38.23 ± 2.31 h vs. 43.43 ± 2.75 h, = 0.013) and total hospital stay compared to the control group (10.97 ± 0.35 days vs. 13.40 ± 0.50 days, < 0.001).
Early oral ingestion combined with probiotics can reduce the levels of inflammatory factors, improve abdominal pain symptoms, alleviate pancreatic edema and shorten defecation time and hospital stay in patients with severe acute pancreatitis.
评估益生菌联合早期经口喂养对重症急性胰腺炎患者的临床疗效。
进行一项前瞻性、随机、对照试验，纳入66例患者，随机分为对照组（n = 32），接受标准肠内营养，以及观察组（n = 34），接受额外的双歧杆菌四联活菌片。在入院后第1天、第3天和第7天测量血清炎症标志物，包括白细胞（WBC）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）。还评估了腹痛评分、计算机断层扫描严重程度指数（CTSI）和急性胰腺炎床边严重程度指数（BISAP）评分。此外，比较了两组的排便时间和住院总时长。
入院后第3天，所有组的炎症标志物均下降，观察组的下降幅度显著大于对照组（P < 0.05）。同样，从第1天到第3天，两组的腹痛评分、CTSI和BISAP评分均下降，观察组的BISAP评分下降幅度显著大于对照组（P < 0.05）。入院第7天时，与第3天相比，所有组的炎症标志物持续下降，但TNF-α水平除外，观察组的下降幅度显著大于对照组（P < 0.05）。与第3天相比，两组的腹痛评分、CTSI和BISAP评分进一步下降，观察组的改善幅度再次显著大于对照组（P < 0.05）。此外，观察组恢复排便的时间显著短于对照组（38.23 ± 2.31小时 vs. 43.43 ± 2.75小时，P = 0.013），住院总时长也短于对照组（10.97 ± 0.35天 vs. 13.40 ± 0.50天，P < 0.001）。
早期经口摄入联合益生菌可降低重症急性胰腺炎患者的炎症因子水平，改善腹痛症状，减轻胰腺水肿，缩短排便时间和住院时长。
