聂刚　张茜玲

【摘要】 目的：觀察益生菌对结直肠腺瘤患者内镜下切除术后肠道菌群的影响。方法：选取40例结直肠腺瘤患者，以10例健康体检者作对照为正常组，采集粪便标本，测定肠道菌群，观察不同组间患者肠道菌群构成变化。将40例结直肠腺瘤患者随机分成3组：手术对照组10例，内镜下切除术后不予益生菌治疗；美常安组患者15例，在结肠镜下切除腺瘤后给予美常安（枯草杆菌二联活菌肠溶胶囊）口服（2粒，3次/d）；培菲康组患者15例，在结肠镜下切除腺瘤后给予培菲康（双歧杆菌三联活菌胶囊）口服（2粒，2次/d）。总疗程均为4周，分别采集术前和术后的粪便标本进行检测，对比两种益生菌对肠道菌群的影响。结果：结直肠腺瘤患者存在肠道菌群紊乱，与正常组相比，结直肠腺瘤患者粪便中的粪肠球菌、双歧杆菌及乳杆菌数量明显下降，而大肠杆菌数目明显上调，差异均有统计学意义（P<0.05），拟杆菌数量比较差异无统计学意义（P>0.05）。与术前比较，服用两种益生菌后患者粪便中的双歧杆菌、乳杆菌数量均上调，而大肠杆菌数量降低，差异均有统计学意义（P<0.05）；粪肠球菌的数量较术前有所上升，但差异无统计学意义（P>0.05）；拟杆菌数量在治疗前后比较差异均无统计学意义（P>0.05）。结论：结直肠腺瘤患者存在肠道菌群改变，益生菌制剂可使结直肠腺瘤患者的有助于恢复肠道菌群，在结直肠腺瘤的治疗中有重要的临床意义。

【关键词】 大肠癌； 结直肠腺瘤； 肠道菌群； 益生菌

Effect of Probiotic on Intestinal Flora in Patients after Resection of Colorectal Adenomas/NIE Gang，ZHANG Xi-ling.//Medical Innovation of China，2017，14（16）：009-012

【Abstract】 Objective：To observe the effect of probiotic on intestinal flora in patients after resection of colorectal adenomas.Method：Forty patients with colorectal adenomas were selected to test the changes of intestinal flora，the results were compared with 10 cases of healthy physical examination.Patients with colorectal adenomas were divided into three groups，the operational control group with 10 cases of colonoscopy surgery without other special treatments，the observation group of 15 cases were given Medilac-s （two tablets，three times a day） or Bifico （two tablets，twice a day）.After colonoscopy surgery， for a period of treatment 4 weeks，the changes of intestinal flora and the recurrence of colorectal adenomas of all groups were observed.Result：The intestinal flora disturbance was confirmed in patients with colorectal adenomas.Compared with the normal group，the numbers of dung enterococcus， bifidobacterium and lactobacillus were decreased in patients with colorectal adenomas，otherwise，the numbers of escherichia coli were increased，the differences were statistically significant（P<0.05），but there was no difference in Bacteroides（P>0.05）.After using two kinds of probiotics，the numbers of Bifidobacterium and Lactobacillus were increased in patients with colorectal adenomas，otherwise，the numbers of Escherichia Coli were decreased，the differences were statistically significant（P<0.05）.The numbers of dung Enterococcus were insignificant increased（P>0.05）.There was no difference in Bacteroides（P>0.05）.Conclusion：Patients with colorectal adenomas existed intestinal flora changes.Intestinal flora could be recovered by probiotics among patients with colorectal adenomas.It has an important clinical significance in the treatment of colorectal adenomas.

【Key words】 Colorectal cancer； Colorectal adenomas； Intestinal flora； Probiotics

First-authors address：The University Affiliated Hospital，Chongqing Medical University，Chongqing 401331，China

doi：10.3969/j.issn.1674-4985.2017.16.003

大肠癌是欧美国家常见的消化系肿瘤，在我国其发病率也已升至恶性肿瘤发生率的第4～6位，其中约3/4患者系由大肠腺瘤发展而来[1]。国……