CAJ | 학술논문

目的：探讨布拉酵母菌对腹泻型肠易激综合征( IBS-D)患者的临床症状的改善及炎性反应的影响。方法选取2013年1月—2014年12月在海军总医院消化内科就诊的IBS-D患者112例，随机分为观察组和对照组各56例。对照组予以饮食、生活方式指导及常规对症治疗，观察组在对照组治疗的基础上给予布拉酵母菌治疗，疗程8周。观察两组治疗前后IBS-D相关症状和血清炎性因子白介素-6( IL-6)、肿瘤坏死因子-α( TNF-α)及核因子-κB ( NF-κB)的变化。结果观察组和对照组治疗后症状改善方面均取得明显效果，观察组总体有效率明显高于对照组(P<0．01)；两组治疗后症状评分均较前降低(P<0．05)，观察组下降更加明显(P<0．05)；观察组治疗后血清IL-6、TNF-α及NF-κB明显下降(P<0．05)，对照组上述指标亦有下降，但与治疗前比较差异无统计学意义(P>0．05)，两组治疗后IL-6、TNF-α及NF-κB差异有统计学意义( P<0．05)。结论布拉酵母菌可以通过抑制NF-κB活性进而调节IBS-D患者肠道的异常炎性反应改善临床症状，是一种治疗IBS-D的有效药物。
목적：탐토포랍효모균대복사형장역격종합정( IBS-D)환자적림상증상적개선급염성반응적영향。방법선취2013년1월—2014년12월재해군총의원소화내과취진적IBS-D환자112례，수궤분위관찰조화대조조각56례。대조조여이음식、생활방식지도급상규대증치료，관찰조재대조조치료적기출상급여포랍효모균치료，료정8주。관찰량조치료전후IBS-D상관증상화혈청염성인자백개소-6( IL-6)、종류배사인자-α( TNF-α)급핵인자-κB ( NF-κB)적변화。결과관찰조화대조조치료후증상개선방면균취득명현효과，관찰조총체유효솔명현고우대조조(P<0．01)；량조치료후증상평분균교전강저(P<0．05)，관찰조하강경가명현(P<0．05)；관찰조치료후혈청IL-6、TNF-α급NF-κB명현하강(P<0．05)，대조조상술지표역유하강，단여치료전비교차이무통계학의의(P>0．05)，량조치료후IL-6、TNF-α급NF-κB차이유통계학의의( P<0．05)。결론포랍효모균가이통과억제NF-κB활성진이조절IBS-D환자장도적이상염성반응개선림상증상，시일충치료IBS-D적유효약물。
Objective To investigate the effect of Saccharomyces Boulardii on clinical symptoms improvement and inflammatory response of diarrhea-predominant irritable bowel syndrome ( IBS-D) . Methods A total of 112 patients with IBS-D admitted during January 2013 and December 2014 were randomly divided into observation group (n=56) and control group (n=56). The control group was treated with routine treatment combined with guidance for diet and lifes-tyle, while the observation group was added with Saccharomyces Boulardii on the basis of control group treatment. A course of treatment was 8 weeks. The differences of IBS-D related symptoms, and levels of serum interleukin-6 (IL-6), tumor necrosis factor-α( TNF-α) and nuclear factor-κB ( NF-κB) before and after the treatment were observed in the two groups. Results The symptoms were obviously improved in the two groups after the treatment, and the total efficiency in the observation group was significantly higher than that in control group (P<0. 01);IBS-D related symptom scores after the treatment in the two groups were significantly lower than those before the treatment ( P<0. 05 ) , and the decreased score in the observation group was more significant than that in the control group (P<0. 05). The serum IL-6, TNF-αand NF-κB levels after treatment in the observation group were significantly lower (P<0. 05);the indexes in the control group were lower than those before the treatment, but the differences were not statistically significant (P>0. 05). The differences of serum IL-6, TNF-α and NF-κB levels after the treatment in the two groups were statistically significant (P<0. 05). Conclusion Saccharomyces boulardii can adjust abnormal inflammatory reaction of IBS-D patients by in-hibiting the NF-κB activity and therefore improve the clinical symptoms.