乳果糖联合枯草杆菌二联活菌治疗慢性便秘的疗效

吴小玲何义波吴瑜梅

四川省峨眉山市中医院肛肠外科(614200)

背景：近年慢性便秘发病率呈上升趋势，严重影响患者的生活质量。目的：探讨乳果糖联合枯草杆菌二联活菌肠溶胶囊治疗慢性便秘的临床疗效。方法：选择2011年1月—2014年1月峨眉山市中医院慢性便秘患者112例，随机分为观察组和对照组。两组患者均接受饮食指导，对照组加服乳果糖，观察组加服乳果糖和枯草杆菌二联活菌肠溶胶囊。治疗4周后，比较两组患者的临床疗效，以便秘患者生活质量量表(PAC-QOL)评估生活质量。结果：观察组的治疗总有效率显著高于对照组(98.2%对72.2%；χ2=12.399，P<0.05)。治疗后，观察组和对照组PAC-QOL各维度评分和总评分均显著低于治疗前(P<0.05)，且观察组躯体不适维度评分和总评分又显著低于对照组(P<0.05)。结论：乳果糖联合枯草杆菌二联活菌可有效改善慢性便秘患者的排便困难、粪便质硬症状，提高生活质量。

关键词便秘；乳果糖；枯草杆菌二联活菌；治疗

Therapeutic Efficacy of Lactulose Combined with

BacillussubtilisandEnterococcusfaeciumPreparation on Chronic ConstipationWUXiaoling,HEYibo,WUYumei.DepartmentofAnorectalSurgery,EmeishanHospitalofTCM,Emeishan,SichuanProvince(614200)

Background: The incidence of chronic constipation is increasing in recent years, which seriously affects the quality of life of patients. Aims: To investigate the therapeutic efficacy of lactulose combined withBacillussubtilisandEnterococcusfaeciumpreparation on chronic constipation. Methods: A total of 112 patients with chronic constipation from Jan. 2011 to Jan. 2014 at Emeishan Hospital of TCM were enrolled, and were randomly divided into observation group and control group. Patients in both groups accepted the guidance of diet. In addition, patients in control group were orally administrated with lactulose while patients in observation group were orally administrated with lactulose combined withBacillussubtilisandEnterococcusfaeciumpreparation. After 4 weeks of treatment, therapeutic efficacy in the two groups was compared, patient assessment of constipation quality of life scale (PAC-QOL) was used to evaluate the quality of life. Results: The overall therapeutic efficacy rate in observation group was significantly higher than that in control group (98.2%vs. 72.2%; χ2=12.399,P<0.05). Score of every factor and the total score of PAC-QOL were significantly lower after treatment than those before treatment in both groups (P<0.05), while physical discomfort score and the total score in observation group were significantly lower than those in control group (P<0.05). Conclusions: Lactulose combined withBacillussubtilisandEnterococcusfaeciumpreparation can effectively improve the symptoms of difficulty in defecation, hard stool, and improve the quality of life in patients with chronic constipation.

Key wordsConstipation;Lactulose;BacillussubtilisandEnterococcusfaeciumPrearation;Therapy

慢性便秘的发病与缺乏运动以及低膳食纤维饮食等因素有关[1]。近年来，慢性便秘的发病率呈上升趋势，严重影响患者的生活质量[2]。生活干预和泻药对慢性便秘有一定疗效，但容易产生药物依赖，反而加重便秘[3]。研究[4]显示，肠道功能紊乱和菌群失调与慢性便秘的发病密切相关。乳果糖可被肠道细菌分解为有机酸，中和肠道碱性环境，刺激肠道蠕动，促进排便[5]。枯草杆菌二联活菌肠溶胶囊含有枯草杆菌和肠球菌，可调节肠道菌群生态，促进肠道生理节律的恢复。本研究通过探讨乳果糖联合枯草杆菌二联活菌治疗慢性便秘的疗效，旨在为临床慢性便秘治疗方案的制定提供参考。

对象与方法

一、研究对象

选择2011年1月—2014年1月四川省峨眉山市中医院门诊慢性便秘患者112例，诊断符合罗马Ⅲ[6]中功能性便秘标准。……