本文關(guān)鍵詞： 小腸細(xì)菌過度生長 大腸癌 LBTH 枯草桿菌二聯(lián)活菌　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究小腸細(xì)菌過度生長(small intestinal bacteria overgrowth,SIBO)在大腸癌患者中的發(fā)生率及其對(duì)消化系統(tǒng)癥狀的影響,并觀察枯草桿菌二聯(lián)活菌對(duì)大腸癌SIBO陽性患者的治療效果,為大腸癌的綜合治療提供線索,并為提高大腸癌患者的生活質(zhì)量提供幫助。方法:選取2014年9月至2016年9月期間就診于鄭州大學(xué)第一附屬醫(yī)院消化內(nèi)科、腫瘤內(nèi)科及胃腸外科初診的大腸癌患者123例為觀察組,所有患者均經(jīng)病理活檢證實(shí)為大腸癌。同時(shí)選取同期來院體檢的健康者30例為對(duì)照組。其中,觀察組男性73例,女性50例,年齡15-88歲,平均年齡58.7土10.02歲。對(duì)照組男性18例,女性12例,年齡35-75歲,平均年齡57.9±9.42歲。通過乳果糖氫呼氣試驗(yàn)(lactulose hydrogrn breath test,LHBT)檢測觀察組及對(duì)照組所有人SIBO的發(fā)生情況,以了解SIBO在大腸癌患者中的發(fā)生率,并與健康人群中SIBO的發(fā)生率進(jìn)行對(duì)比。根據(jù)LHBT結(jié)果,將觀察組123例大腸癌患者分為SIBO陽性組和SIBO陰性組。對(duì)觀察組所有患者進(jìn)行視覺模擬評(píng)分(Visual Analogue Scale/Score,VAS)(見表1),計(jì)算出每個(gè)個(gè)體的總積分,比較SIBO陽性組與SIBO陰性組患者之間消化系統(tǒng)癥狀積分的差異。SIBO陽性組患者在提高免疫力、保護(hù)腸黏膜治療的基礎(chǔ)上給予枯草桿菌二聯(lián)活菌腸溶膠囊500mg/次、3次/天治療7天。治療結(jié)束后復(fù)查LHBT,比較治療前后SIBO陽性率的變化。并計(jì)算SIBO陽性組患者治療后消化系統(tǒng)癥狀積分,比較治療前后消化系統(tǒng)癥狀積分的變化情況。以明確枯草桿菌二聯(lián)活菌對(duì)SIBO的治療效果及其對(duì)大腸癌SIBO陽性患者消化系統(tǒng)癥狀的改善情況。本研究經(jīng)鄭州大學(xué)第一附屬醫(yī)院倫理委員會(huì)批準(zhǔn),所有入選者均簽署知情同意書。結(jié)果:1.觀察組123例大腸癌患者中SIBO發(fā)生率為60.2%(74例),明顯高于30例健康體檢者組成的對(duì)照組SIBO的發(fā)生率20%(6例),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組平均年齡(58.7土10.02)與對(duì)照組平均年齡(57.9±9.42)相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組性別組成亦無統(tǒng)計(jì)學(xué)差異(P0.05)。SIBO陽性組患者的平均年齡為59.8±10.85高于SIBO陰性組患者的平均年齡(53.5±9.79),差異有統(tǒng)計(jì)學(xué)意義(P0.05),性別差異無統(tǒng)計(jì)學(xué)意義。2.SIBO陽性組患者的消化系統(tǒng)癥狀積分(10.6±2.35)明顯高于SIBO陰性組患者的消化系統(tǒng)癥狀積分(9.2±2.57),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3.SIBO陽性組患者在提高免疫力、保護(hù)腸黏膜等治療基礎(chǔ)上給予枯草桿菌二聯(lián)活菌腸溶膠囊500mg/次、3次/天治療7天后復(fù)查LHBT,并重新進(jìn)行消化系統(tǒng)癥狀評(píng)分。其中40例患者小腸細(xì)菌轉(zhuǎn)陰,治療有效率為54%。治療后患者消化系統(tǒng)癥狀積分為(9.0±2.11),與治療前(10.6±2.35)相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。40例小腸細(xì)菌轉(zhuǎn)陰患者的消化系統(tǒng)癥狀評(píng)分治療前后相比(10.7±2.82 vs 9.4±2.35)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。34例小腸細(xì)菌未轉(zhuǎn)陰患者的消化系統(tǒng)癥狀評(píng)分治療前后相比(10.5±1.66 vs 8.6±1.71)差異亦有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.大腸癌患者SIBO發(fā)生率高于健康人。2.SIBO可加重大腸癌患者的消化系統(tǒng)癥狀。3.枯草桿菌二聯(lián)活菌對(duì)SIBO治療有效,可使部分SIBO轉(zhuǎn)陰,同時(shí)可緩解大腸癌SIBO陽性患者的消化系統(tǒng)癥狀。
[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.

【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.34

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 梁素妨;許琳;張東生;黃維清;;腸道菌群失調(diào)與原發(fā)性肝癌的關(guān)系研究[J];中國肝臟病雜志(電子版);2015年04期

2 Agata Mulak;Bruno Bonaz;;Brain-gut-microbiota axis in Parkinson's disease[J];World Journal of Gastroenterology;2015年37期

3 高曉;馬英杰;魏新朋;;小腸細(xì)菌過度生長與肝病關(guān)系的研究進(jìn)展[J];臨床醫(yī)學(xué);2015年09期

4 劉揚(yáng);李媛;張東生;張愛軍;許琳;;小腸細(xì)菌過度生長與小腸腫瘤的關(guān)系及其臨床意義[J];世界華人消化雜志;2013年31期

5 王為;周國華;冷明芳;馮海魄;周紅宇;陳葉青;;酒精性肝病患者小腸細(xì)菌過度生長情況研究[J];中華臨床醫(yī)師雜志(電子版);2009年11期

6 Sergio Peralta;Claudia Cottone;Tiziana Doveri;Piero Luigi Almasio;Antonio Craxi;;Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms:Experience with Rifaximin[J];World Journal of Gastroenterology;2009年21期

7 Alberto Rubio-Tapia;Jorge Hernández-Calleros;Luis Uscanga;Sagrario Trinidad-Hernández;;Clinical characteristics of a group of adults with nodular lymphoid hyperplasia:A single center experience[J];World Journal of Gastroenterology;2006年12期

8 劉偉,蔣義斌,鐘良,戎蘭,孫大裕;慢性肝病小腸細(xì)菌過度生長與內(nèi)毒素血癥[J];中華消化雜志;2005年07期

9 陶琳,柯美云,王智鳳;小腸細(xì)菌過度生長與功能性胃腸疾病的關(guān)系[J];中國中西醫(yī)結(jié)合消化雜志;2005年02期

10 王錦輝 ,陳e，

本文編號(hào)：1527219