Fennessy Anne, Doyle Micheal, Boland Anna, Bourke Rachel, O'Connor Anthony
Department of Gastroenterology, Tallaght University Hospital, Dublin D24NR0A, Ireland.
World J Gastrointest Pharmacol Ther. 2025 Jun 5;16(2):101268. doi: 10.4292/wjgpt.v16.i2.101268.
BACKGROUND: Irritable bowel syndrome (IBS) symptoms are common in patients with inflammatory bowel disease (IBD), with systematic review reporting an overall pooled prevalence of 35-39% in patients with clinical remission. This subset of patients reports a reduced quality of life and increased anxiety and depression. A multi-strain probiotic (Symprove™, Symprove Ltd, Farnham, United Kingdom) has been shown to improve overall symptom severity in patients with IBS and is associated with decreased intestinal inflammation in patients with ulcerative colitis (UC), but not in Crohn's disease (CD). AIM: To ascertain whether this multi-strain probiotic would be effective in an IBS/IBD overlap population. METHODS: The treatment of symptoms in the absence of inflammation in inflammatory bowel diseases trial was a randomized, double-blind, placebo-controlled trial of a four-strain probiotic Symprove, containing Lactobacillus rhamnosus NCIMB 30174, Lactobacillus plantarum NCIMB 30173, Lactobacillus acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176. The duration of the study was 3 months, at the end of which IBS-Symptom Severity Score (IBS-SSS) was repeated. Primary Endpoint was a 100-point reduction in IBS-SSS. RESULTS: 61 participants were randomized into the intention-to-treat analysis. 45% of patients receiving the active agent achieved the endpoint compared to 33% of those receiving placebo ( = 0.42). In UC, 50% of patients receiving placebo achieved the endpoint compared to 44% of those receiving the active agent ( = 1.00). In CD 45% of those receiving the active agent achieved the endpoint compared to 29% of those receiving placebo ( = 0.34). The mean change in IBS-SSS for patients receiving placebo was a reduction of 61 points, compared to a reduction in 90 points for patients receiving active agent ( = 0.31). There was no difference between the groups with regard to IBD outcomes. CONCLUSION: Probiotics may represent a safe and effective means of addressing the unmet clinical need for symptom relief in patients with overlapping IBS and IBD, especially in those with CD.
背景：肠易激综合征（IBS）症状在炎症性肠病（IBD）患者中很常见，系统评价报告临床缓解患者的总体合并患病率为35%-39%。这部分患者报告生活质量下降，焦虑和抑郁增加。一种多菌株益生菌（Symprove™，Symprove有限公司，英国法纳姆）已被证明可改善IBS患者的总体症状严重程度，并与溃疡性结肠炎（UC）患者肠道炎症减轻有关，但与克罗恩病（CD）患者无关。 目的：确定这种多菌株益生菌在IBS/IBD重叠人群中是否有效。 方法：炎症性肠病无炎症时症状治疗试验是一项随机、双盲、安慰剂对照试验，使用含有鼠李糖乳杆菌NCIMB 30174、植物乳杆菌NCIMB 30173、嗜酸乳杆菌NCIMB 30175和粪肠球菌NCIMB 30176的四菌株益生菌Symprove。研究持续时间为3个月，结束时重复进行IBS症状严重程度评分（IBS-SSS）。主要终点是IBS-SSS降低100分。 结果：61名参与者被随机纳入意向性分析。接受活性药物治疗的患者中有45%达到终点，而接受安慰剂治疗的患者中这一比例为33%（P=0.42）。在UC中，接受安慰剂治疗的患者中有50%达到终点，而接受活性药物治疗的患者中这一比例为44%（P=1.00）。在CD中，接受活性药物治疗的患者中有45%达到终点，而接受安慰剂治疗的患者中这一比例为29%（P=0.34）。接受安慰剂治疗的患者IBS-SSS的平均变化为降低61分，而接受活性药物治疗的患者为降低90分（P=0.31）。两组在IBD结局方面没有差异。 结论：益生菌可能是满足IBS和IBD重叠患者未得到满足的症状缓解临床需求的一种安全有效的方法，尤其是对CD患者。
World J Gastrointest Pharmacol Ther. 2025-6-5
Cochrane Database Syst Rev. 2021-11-29
Cochrane Database Syst Rev. 2017-3-23
Cochrane Database Syst Rev. 2023-10-2
Cochrane Database Syst Rev. 2007-10-17
Cochrane Database Syst Rev. 2022-6-29
Cochrane Database Syst Rev. 2023-2-17
Cochrane Database Syst Rev. 2011-11-9
Curr Opin Gastroenterol. 2023-3-1
Clin Gastroenterol Hepatol. 2022-5
Cochrane Database Syst Rev. 2020-7-17
Cochrane Database Syst Rev. 2020-3-4
Therap Adv Gastroenterol. 2018-12-6
Inflamm Bowel Dis. 2018-11-29
Zotero 插件
