| 杨 斌,李 超,朱华军,程 曦,何友军,马立作,胡 欣.低FODMAP饮食治疗腹泻型肠易激综合征的效果分析[J].,2018,(22):4298-4302 |
| 低FODMAP饮食治疗腹泻型肠易激综合征的效果分析 |
| Treatment Effect of Low FODMAP Diet on the Diarrhea-predominant Irritable Bowel Syndrome |
| 投稿时间：2018-03-26 修订日期：2018-04-22 |
| DOI：10.13241/j.cnki.pmb.2018.22.022 |
| 中文关键词: 低FODMAP饮食 腹泻型肠易激综合征 肠道菌群 体质指数 |
| 英文关键词: Low fermentable oligosaccharides, monosaccharides, disaccharides diet Diarrhea-predominant irritable bowel syndrome Intestinal flora Body Mass Index |
| 基金项目:国家自然科学基金面上项目（81670494） |
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| 中文摘要: |
| 摘要 目的：研究低发酵(fermentable)寡糖(oligosaccharides)、单糖(monosaccharides)、双糖(disaccharides)及多元醇(polyols)(FODMAP)饮食治疗腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome，IBS-D)的治疗临床效果及可能机制。方法：选择2015年6月至2017年6月我院收治的107例IBS-D患者作为研究对象，并采用随机数字表法将其分为低FODMAP饮食组54例(LFD)和正常饮食组53例(ND)，分别给予低FODMAP饮食、正常饮食。实验前采集患者的一般情况，于实验的第0天、28天完善IBS症状积分量表(IBS-severity scoring system，IBS-SSS)、生活质量评分量表(IBS-Quality of Life，IBS-QOL)、完善粪便双歧杆菌、乳杆菌及大肠杆菌检查，计算相应积分及菌群计数。结果：两组患者实验前一般情况、IBS-SSS、IBS-QOL比较差异无统计学意义(P＞0.05)，具有可比性。实验28天时，LFD患者IBS-SSS(156.35±95.44vs223.18±66.96)、IBS-QOL(64.81±19.27vs54.62±18.98)较实验前明显改善，且IBS-SSS(156.35±95.44vs201.42±91.28)及IBS-QOL(64.81±19.27vs55.76±20.38)评分明显优于ND组(P＜0.05)；低FODMAP饮食组肠道乳杆菌(6.33±0.95vs6.45±1.12)、双歧杆菌(8.57±0.84vs 8.61±0.79)的活菌数量无显著变化(P＞0.05)，而大肠杆菌数量较前减少(8.01±1.12vs8.65±1.11)(P＜0.05)；LFD患者BMI指数间与0天(23.42±2.38vs22.67±3.75)及ND(23.42±2.38vs 22.93±2.43)相比差异无统计学意义(P＞0.05)。结论：低FODMAP饮食治疗IBS-D患者的效果明显，其机制除了食物的直接作用，还可能与肠道菌群的改变有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical effect and possible mechanism of low FODMAP (fermentable oligosaccharides,monosaccharides, disaccharides, polyols) in the treatment of patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Methods: During June 2015 to June 2017, a total of 107 eligible IBS-D patients were randomly assigned into two groups: low FODMAP(LFD) group(54 cases) and normal diet(ND) group(53 cases). Before experiment, general conditions(age, gender, BMI, smoking history, drinking history) were collected. Quality of Life Scale (IBS-QOL) and IBS Symptom Score Scale (IBS-SSS) of the two groups were recorded on the baseline and day 28. Fecal microbiota(Escherichia coli, Lactobacillus and Bifidobacterium) was examined on the baseline and 28th day of the experiment. Results: No statistical difference was found in the general conditions, IBS-QOL, IBS-SSS between two groups before experiment. On the 28th day of experiment, the IBS-SSS(156.35±95.44vs223.18±66.96) of LFD group was evidently lower (P=0.000) while IBS-QOL(64.81±19.27vs54.62±18.98) was significantly higher(P=0.007) than those before experiment, the IBS-SSS(156.35±95.44vs201.42±91.28) of LFD group was evidently lower (P=0.014) while IBS-QOL(64.81±19.27vs55.76±20.38) was significantly higher(P=0.020) than those of the ND group, the Escherichia coli of LFD (8.01±1.12) was lower(P=0.004) than that before experiment(8.01±1.12vs8.65±1.11) while no statistical difference (P>0.05) of bifidobacterium (8.57±0.84 vs 8.61±0.79) and lactobacillus (6.33±0.95vs6.45±1.12) was observed, the BMI of LFD group at 4th week(23.42±2.38)(P=0.217) had no significant difference than that before experiment(22.67±3.75). Conclusion: Low FODMAP diet showed significant effect on IBS-D, the mechanism may not only related to the direct role of food, but also with the intestinal flora change. |
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