大肠癌患者小肠细菌过度生长的检测及枯草杆菌二联活菌对其影响

发布时间：2018-02-23 18:44

本文关键词： 小肠细菌过度生长大肠癌 LBTH 枯草杆菌二联活菌　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究小肠细菌过度生长(small intestinal bacteria overgrowth,SIBO)在大肠癌患者中的发生率及其对消化系统症状的影响,并观察枯草杆菌二联活菌对大肠癌SIBO阳性患者的治疗效果,为大肠癌的综合治疗提供线索,并为提高大肠癌患者的生活质量提供帮助。方法:选取2014年9月至2016年9月期间就诊于郑州大学第一附属医院消化内科、肿瘤内科及胃肠外科初诊的大肠癌患者123例为观察组,所有患者均经病理活检证实为大肠癌。同时选取同期来院体检的健康者30例为对照组。其中,观察组男性73例,女性50例,年龄15-88岁,平均年龄58.7土10.02岁。对照组男性18例,女性12例,年龄35-75岁,平均年龄57.9±9.42岁。通过乳果糖氢呼气试验(lactulose hydrogrn breath test,LHBT)检测观察组及对照组所有人SIBO的发生情况,以了解SIBO在大肠癌患者中的发生率,并与健康人群中SIBO的发生率进行对比。根据LHBT结果,将观察组123例大肠癌患者分为SIBO阳性组和SIBO阴性组。对观察组所有患者进行视觉模拟评分(Visual Analogue Scale/Score,VAS)(见表1),计算出每个个体的总积分,比较SIBO阳性组与SIBO阴性组患者之间消化系统症状积分的差异。SIBO阳性组患者在提高免疫力、保护肠黏膜治疗的基础上给予枯草杆菌二联活菌肠溶胶囊500mg/次、3次/天治疗7天。治疗结束后复查LHBT,比较治疗前后SIBO阳性率的变化。并计算SIBO阳性组患者治疗后消化系统症状积分,比较治疗前后消化系统症状积分的变化情况。以明确枯草杆菌二联活菌对SIBO的治疗效果及其对大肠癌SIBO阳性患者消化系统症状的改善情况。本研究经郑州大学第一附属医院伦理委员会批准,所有入选者均签署知情同意书。结果:1.观察组123例大肠癌患者中SIBO发生率为60.2%(74例),明显高于30例健康体检者组成的对照组SIBO的发生率20%(6例),差异有统计学意义(P0.05)。观察组平均年龄(58.7土10.02)与对照组平均年龄(57.9±9.42)相比,差异无统计学意义(P0.05),两组性别组成亦无统计学差异(P0.05)。SIBO阳性组患者的平均年龄为59.8±10.85高于SIBO阴性组患者的平均年龄(53.5±9.79),差异有统计学意义(P0.05),性别差异无统计学意义。2.SIBO阳性组患者的消化系统症状积分(10.6±2.35)明显高于SIBO阴性组患者的消化系统症状积分(9.2±2.57),差异有统计学意义(P0.05)。3.SIBO阳性组患者在提高免疫力、保护肠黏膜等治疗基础上给予枯草杆菌二联活菌肠溶胶囊500mg/次、3次/天治疗7天后复查LHBT,并重新进行消化系统症状评分。其中40例患者小肠细菌转阴,治疗有效率为54%。治疗后患者消化系统症状积分为(9.0±2.11),与治疗前(10.6±2.35)相比差异有统计学意义(P0.05)。40例小肠细菌转阴患者的消化系统症状评分治疗前后相比(10.7±2.82 vs 9.4±2.35)差异有统计学意义(P0.05)。34例小肠细菌未转阴患者的消化系统症状评分治疗前后相比(10.5±1.66 vs 8.6±1.71)差异亦有统计学意义(P0.05)。结论:1.大肠癌患者SIBO发生率高于健康人。2.SIBO可加重大肠癌患者的消化系统症状。3.枯草杆菌二联活菌对SIBO治疗有效,可使部分SIBO转阴,同时可缓解大肠癌SIBO阳性患者的消化系统症状。
[Abstract]:Objective: To study the intestinal bacterial overgrowth (small intestinal bacteria overgrowth, SIBO) incidence in patients with colorectal cancer and its effect on the symptoms of digestive system, and to observe the therapeutic effect of live combined Bacillus subtilis two strains of colorectal cancer in SIBO positive patients, provide clues for the treatment of colorectal cancer, and to help improve the quality of life of patients with colorectal cancer. Methods: from September 2014 to September 2016 during the period of treatment in the First Affiliated Hospital of Zhengzhou University, colorectal cancer patients with gastrointestinal surgery and diagnosed 123 cases of the observation group, all patients were pathologically confirmed colorectal cancer. At the same time were selected to hospital examination of 30 cases of healthy subjects as control group. Among them, the observation group 73 cases were male, 50 females, age 15-88 years old, the average age of 58.7 years old. 10.02 soil control group male 18 cases, female 12 cases, age 35-75 years, mean age 57.9 + 9.4 At the age of 2. By lactulose hydrogen breath test (lactulose hydrogrn breath test, LHBT) detection of the observation group and control group all occurred in the case of SIBO, in order to understand SIBO in patients with colorectal cancer incidence and incidence of SIBO were compared in healthy population. According to the results of LHBT, the observation group of 123 cases cancer patients were divided into SIBO positive group and SIBO negative group. Of all patients in the observation group by visual analogue scale (Visual Analogue Scale/Score, VAS) (see Table 1), calculate the total score of each individual, comparing the difference between SIBO positive group and SIBO negative group in patients with digestive system symptoms of.SIBO positive patients in improving to protect the intestinal mucosal immunity, based on the treatment of Live Combined Bacillus Subtilis and Enterococcus Faecium Enteric-coated Capsules 500mg/ times, 3 times / day for 7 days. After the end of treatment review of LHBT, compare the change of the positive rate of SIBO before and after treatment. And calculate the SIBO positive group The digestive system symptom score after treatment, the changes of the digestive system symptom score before and after the treatment. In order to clear the live combined Bacillus subtilis two strains of SIBO and its therapeutic effect on colorectal cancer SIBO positive patients with digestive system symptoms to improve the situation. This study was approved by the ethics committee of the First Affiliated Hospital of Zhengzhou University and all participants signed informed consent book 1.. Results: the observation group of 123 cases of SIBO patients with colorectal cancer incidence rate was 60.2% (74 cases), 20% were significantly higher than the control group SIBO and 30 cases of healthy persons were composed of (6 cases), the difference was statistically significant (P0.05). The average age of the observation group (58.7 soil 10.02) and the control group the average age (57.9 + 9.42) compared to the difference was not statistically significant (P0.05), two groups of gender composition there was no statistical difference (P0.05) the average age of.SIBO positive group was 59.8 + 10.85 higher than the average age of SIBO negative patients (53.5 + 9.79), the difference was statistically significant (P0.05), digestive system symptom scores were not statistically significant gender differences in patients with.2.SIBO positive group (10.6 + 2.35) was significantly higher than that of the digestive system symptom score in SIBO negative patients (9.2 + 2.57), the difference was statistically significant (P0.05) in.3.SIBO positive patients in improving immunity to protect the intestinal mucosa, such as treatment on the basis of Live Combined Bacillus Subtilis and Enterococcus Faecium Enteric-coated Capsules 500mg/ times, 3 times / day for 7 days after LHBT, and re digestive system symptom score. In 40 cases of small intestinal bacterial clearance, treatment efficiency was 54%. after treatment in patients with digestive system symptom score is (9 + 2.11), and 10.6 (before treatment + 2.35) compared to the difference was statistically significant (P0.05) before and after the digestive system symptom score in treatment of.40 cases of intestinal bacterial negative patients compared to (10.7 + 2.82 vs 9.4 + 2.35) and there was statistically significant difference (P0.05).34 cases The digestive system symptom score before and after treatment of intestinal bacteria of non negative patients compared to (10.5 + 1.66 vs 8.6 + 1.71) there was also significant difference (P0.05). Conclusion: 1. colorectal cancer patients with SIBO higher incidence of gastrointestinal symptoms in healthy people.2.SIBO.3. subtilis bacteria with major colon cancer patients two live bacteria effective for SIBO the treatment, can make the SIBO negative, and can relieve the symptoms of digestive system in patients with positive SIBO colorectal cancer.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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