Gastroenterology: 益生菌和低短链碳水化合物饮食对肠功能失调患者的治疗,何者更优?

2018-10-15 MedSci MedSci原创

尽管有报道称某些不可吸收的可发酵膳食产品(益生元)为结肠细菌提供营养基础,可以减轻肠功能失调患者的症状。但可发酵的低聚糖,二糖,单糖和多元醇(低FODMAP饮食)饮食也可以减轻功能性胃肠道疾病患者的症状,而目前对于这两者的治疗效果学界还没有一个统一的认识。

背景及目的
尽管有报道称某些不可吸收的可发酵膳食产品(益生元)为结肠细菌提供营养基础,可以减轻肠功能失调患者的症状。但可发酵的低聚糖,二糖,单糖和多元醇(低FODMAP饮食)饮食也可以减轻功能性肠道疾病患者的症状,而目前对于这两者的治疗效果学界还没有一个统一的认识。

方法
研究人员对患有肠功能紊乱的患者进行了随机,平行,双盲研究,比较了益生元补充剂(含有1.37克β-半乳糖寡糖/天)加安慰剂(地中海型饮食(益生元组))的治疗方案与安慰剂补充剂(2.8克木糖)加低短链碳水化合物饮食(低FODMAP组)治疗方案的优劣。所有方案都维持4周;随后随访2周。主要观察结果通过16S测序分析对粪便微生物群的组成的变化进行分析。次要结果是肠道气体产生的情况和患者的主观感觉。

结果
实验进行4周后,研究人员观察到每组中粪便微生物群出现明显变化,特别是与丰度相关双歧杆菌序列(益生元组增加和低 FODMAP 组减少; P = .042)和Bilophila wadsworthia(益生元组减少和低FODMAP组增加; P  = .050)。4周后,两组在所有症状评分中均有统计学显着性降低,但在益生组中肠胃胀气和腹胀的减少并不显着。尽管在患者停止益生元补充后效果可以维持2周,但在患者停用低FODMAP饮食后症状立即再次出现。因此,间断性使用益生元可以成为患有功能性肠道症状的患者的饮食限制的替代方案。

原始出处:

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    2019-01-07 许安
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    2018-10-17 yuanming9
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