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评估益生菌对克罗恩病患者疾病进展、生活质量和营养状况的疗效:一项多中心、随机、单盲对照试验。

Evaluating the Efficacy of Probiotics on Disease Progression, Quality of Life, and Nutritional Status Among Patients with Crohn's Disease: A Multicenter, Randomized, Single-Blinded Controlled Trial.

作者信息

Hoteit Maha, Hellani Mohamad, Karaja Mohamad, Zayour Nadeen, Sadek Zahra, Hotayt Bilal, Hallal Mahmoud

机构信息

Food Sciences Unit, National Council for Scientific Research of Lebanon (CNRS-L), Beirut P.O. Box 11-8281, Lebanon.

PHENOL Research Program, Faculty of Public Health, Section 1, Lebanese University, Beirut P.O. Box 6573, Lebanon.

出版信息

Nutrients. 2025 Feb 17;17(4):708. doi: 10.3390/nu17040708.

Abstract

BACKGROUND

There is growing interest in the role of gut microbiota in the pathophysiology of inflammatory bowel diseases (IBDs), including Crohn's disease (CD). Probiotics have been proposed as a potential adjunct therapy for these conditions by altering the intestinal environment, although studies on their effectiveness have yielded mixed results.

AIM

This study aims to evaluate the short-term (2 months) effects of a dietary supplement containing , , and on disease progression, remission, quality of life, and nutritional intake in Lebanese patients with CD.

METHOD

A multicenter, randomized, single-blind controlled trial was conducted in 2 medical centers in Beirut from 1 April 2024 to 1 August 2024. Recruitment, prescreening, screening, enrollment, and protocol implementation were carried out at both centers. Data were collected from 21 patients with CD, who were randomly assigned to the control group (n = 10) and the intervention group (n = 11). At baseline and after two months, participants underwent clinical assessments, WHOQOL-BREF evaluation, and 24 h dietary recalls. Follow-up visits included surveys on disease progression, quality of life, adherence, and adverse events, along with repeat body composition and anthropometric measurements.

RESULTS

Probiotic supplementation over two months did not significantly alter symptoms, flares, or hospitalizations outcomes between the control and intervention groups. However, the intervention group experienced notable increases in body weight ( = 0.01), BMI ( = 0.01), body fat mass ( = 0.04), and arm muscle circumference ( = 0.01). Nutrient intake patterns differed, with the intervention group showing increased consumption of calcium, riboflavin, and folate compared to controls ( = 0.01, = 0.04, = 0.013, respectively). Probiotic supplementation led to significant within-group increases in dietary fiber ( = 0.01), total sugar ( = 0.02), and caffeine ( = 0.01) among the intervention participants. Adverse effects in the intervention group were mild, including nausea (18.2%) and abdominal discomfort (9.1%). QOL improved significantly in the intervention group, particularly in physical ( = 0.03), psychological ( = 0.04), and environmental domains ( = 0.003), while the control group exhibited improvements only in psychological health.

CONCLUSIONS

Overall, the findings suggest that probiotics can enhance body composition, nutrient intake, and certain aspects of QOL among CD patients, despite minimal impact on disease symptoms or dietary patterns.

摘要

背景

肠道微生物群在包括克罗恩病(CD)在内的炎症性肠病(IBD)病理生理学中的作用日益受到关注。尽管关于益生菌有效性的研究结果不一,但有人提出通过改变肠道环境,益生菌可作为这些病症的一种潜在辅助治疗方法。

目的

本研究旨在评估一种含有[具体成分未给出]的膳食补充剂对黎巴嫩CD患者疾病进展、缓解、生活质量和营养摄入的短期(2个月)影响。

方法

2024年4月1日至2024年8月1日在贝鲁特的2个医疗中心进行了一项多中心、随机、单盲对照试验。两个中心均进行招募、预筛查、筛查、入组和方案实施。收集了21例CD患者的数据,这些患者被随机分配到对照组(n = 10)和干预组(n = 11)。在基线和两个月后,参与者接受临床评估、世界卫生组织生活质量简表(WHOQOL - BREF)评估以及24小时饮食回顾。随访包括对疾病进展、生活质量、依从性和不良事件的调查,以及重复进行身体成分和人体测量。

结果

两个月的益生菌补充在对照组和干预组之间未显著改变症状、发作或住院结果。然而,干预组的体重(P = 0.01)、体重指数(BMI,P = 0.01)、体脂肪量(P = 0.04)和上臂肌肉围度(P = 0.01)有显著增加。营养摄入模式有所不同,与对照组相比,干预组的钙、核黄素和叶酸摄入量增加(分别为P = 0.01、P = 0.04、P = 0.013)。益生菌补充导致干预组参与者的膳食纤维(P = 0.01)、总糖(P = 0.02)和咖啡因(P = 0.01)在组内显著增加。干预组的不良反应较轻,包括恶心(18.2%)和腹部不适(9.1%)。干预组的生活质量有显著改善,特别是在身体(P = 0.03)、心理(P = 0.04)和环境领域(P = 0.003),而对照组仅在心理健康方面有所改善。

结论

总体而言,研究结果表明,尽管对疾病症状或饮食模式影响最小,但益生菌可改善CD患者的身体成分、营养摄入和生活质量的某些方面。

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