枯草桿菌二聯活菌對結腸癌患者小腸細菌過度生長的影響

孫柯科　胡萍萍　許豐　李小平　陸德文

[摘要] 目的 探討結腸癌患者小腸細菌過度生長（SIBO）的檢測及枯草桿菌二聯活菌對其的影響。 方法 選取2015年1月～2016年5月于我院接受結腸癌手術治療的患者86例為觀察組，同時選取同期來院體檢的健康者62例為對照組。所有研究對象均進行葡萄糖氫呼氣試驗，檢測SIBO情況。將表現為SIBO陽性的結腸癌患者隨機分為A、B兩組。A組患者僅進行利福昔明治療，B組在A組基礎上服用枯草桿菌二聯活菌顆粒。觀察兩組研究對象SIBO陽性率、治療前后A、B兩組胃腸道癥狀積分及治療后A、B兩組SIBO轉陰率情況。 結果 觀察組SIBO陽性率為60.47%（52例），明顯高于健康體檢者組成的對照組的SIBO陽性率9.68%（6例）（P<0.05）。治療前，A、B兩組的胃腸道癥狀積分得分相比，差異無統計學意義（P>0.05）。A、B兩組治療后的胃腸道癥狀積分均低于治療前（P<0.05）。治療后，A組的胃腸道癥狀積分為（9.11±0.83）分，明顯高于B組的（8.75±0.57）分（P<0.05）。治療后，A組的SIBO轉陰率為34.62%，明顯低于B組的88.46%（P<0.05）。 結論 結腸癌術后患者相對于健康人發生SIBO可能性更高。枯草桿菌二聯活菌聯合利福昔明治療結腸癌術后SIBO效果較好，能夠明顯改善患者的胃腸道狀況，提高SIBO的轉陰率。

[關鍵詞] 結腸癌；小腸細菌過度生長；枯草桿菌二聯活菌

[中圖分類號] R735.3 [文獻標識碼] A [文章編號] 1673-9701（2017）36-0026-04

[Abstract] Objective To investigate the detection of small intestinal bacterial overgrowth（SIBO） in colon cancer patients and the effect of viable combined bacillus subtilis on it. Methods From January 2015 to May 2016， 86 patients who were given the surgery of colon cancer were selected as the observation group. At the same time， 62 healthy subjects who were given physical examination in our hospital were selected as the control group. All subjects were given glucose hydrogen breath test to detect SIBO condition. Patients with colon cancer and with positive SIBO were randomly divided into group A and group B. Patients in group A were treated with rifaximin only， and patients in group B were given viable combined bacillus subtilis on the basis of group A. The positive rates of SIBO in both groups， the scores of gastrointestinal symptoms in groups A and B before and after treatment and the SIBO negative turning rates in groups A and B after treatment were observed. Results The positive rate of SIBO in the observation group was 60.47% （52 cases）， which was significantly higher than that of 9.68% （6 cases） in the healthy subjects in the control group（P<0.05）. Before treatment， the gastrointestinal symptom scores were compared between group A and group B， and the difference was not significant（P>0.05）. Gastrointestinal symptom scores in group A and group B after the treatment were lower than those before treatment（P<0.05）. After treatment， the score of gastrointestinal symptoms in group A was（9.11±0.83） points， significantly higher than that in group B（8.75±0.57）（P<0.05）. After treatment， the SIBO negative turning rate in group A was 34.62%， which was significantly lower than that of 88.46% in group B（P<0.05）. Conclusion Patients with postoperative colon cancer has a higher possibility of SIBO compared with healthy people. Viable combined bacillus subtilis combined with rifaximin in the treatment of SIBO after the surgery of colon cancer has a better effect， which can significantly improve the patient's gastrointestinal conditions， and improve the SIBO negative turning rate.

[Key words] Colon cancer； Small intestinal bacterial overgrowth （SIBO）； Viable combined bacillus subtilis

結腸癌屬于常見的消化道惡性腫瘤之一[1]。結腸癌影響著眾多患者的健康，甚至可能威脅到其生命。臨床多采用手術方式進行治療，取得了一定療效。但是許多患者術后常常產生腹部脹痛等不適癥狀，給患者生活造成了不良影響[2]。近期以來，如何減少結腸癌患者術后不良反應發生，減輕患者痛苦，越來越引起人們的關注。有學者指出[3-4]小腸細菌過度生長（small intestinal bacterial overgrowth，SIBO）是影響結腸癌患者腹瀉等不適因素之一。因此本研究對結腸癌患者小腸細菌過度生長進行了檢測，并且使用枯草桿菌二聯活菌進行治療，旨在探討枯草桿菌二聯活菌對其的影響。……