功能性便秘患儿的肠道菌群分析及治疗干预

刘四香; 黄永坤; 王明英; 胡红卫; 马敏; 凌昱

doi:10.12259/j.issn.2095-610X.S20220309

功能性便秘患儿的肠道菌群分析及治疗干预

doi: 10.12259/j.issn.2095-610X.S20220309

1.
昆明医科大学附属儿童医院儿保科，云南昆明　650034
2.
昆明医科大学第一附属医院儿科，云南昆明　650032
3.
昆明医科大学附属儿童医院消化内科，云南昆明　650034

基金项目: 昆明市科技计划项目（2019-1-S-25318000001121）

详细信息

作者简介:
刘四香（1987～），女，云南南涧人，医学硕士，主治医师，主要从事儿童保健与消化系统疾病诊治的临床工作

通讯作者:
凌昱， E-mail：lingyu@etyy.cn

中图分类号: R72
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出版历程
- 收稿日期: 2022-01-19
- 网络出版日期: 2022-02-18
- 刊出日期: 2022-03-22

Analysis of Intestinal Flora and Therapeutic Intervention in Children with Functional Constipation

1.
Dept. of Children Healthcare，The Affiliated Children Hospital of Kunming Medical University，Kunming Yunnan 650034
2.
Dept. of Pediatrics，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
3.
Dept. of Gastroenterology，The Affiliated Children Hospital of Kunming Medical University，Kunming Yunnan 650034，China

摘要

摘要: 目的分析功能性便秘（FC）患儿肠道菌群含量的变化及非药物基础治疗的临床疗效。方法选取2019年9月至2021年10月在昆明医科大学附属儿童医院消化内科门诊诊断为FC的患儿30例作为研究对象，选取同期来该院儿童保健科体检的30例健康儿童作为正常对照组。收集FC患儿经饮食结构调整、定时排便训练、适量运动等基础治疗前、治疗后和正常对照组的粪便标本。利用昆明合和医学检验所的MiNi8 plus荧光定量PCR仪测定各组儿童粪便中的肠道菌群含量。同时观察FC患儿经基础治疗后便秘症状的缓解情况。结果 FC患儿双歧杆菌属、乳酸杆菌属含量显著低于正常对照组，差异有统计学意义（P < 0.01）。FC患儿经基础治疗后乳酸杆菌属含量较治疗前组明显增多，差异有统计学意义（P < 0.01）。FC患儿经基础治疗后便秘症状评分均较治疗前组降低，差异有统计学意义（P < 0.01）。结论 FC患儿会出现肠道菌群紊乱，经饮食结构调整、生活方式改善等基础治疗后肠道菌群紊乱和便秘症状得以改善。
- 功能性便秘 /
- 肠道菌群 /
- 基础治疗 /
- 儿童
Abstract: Objective To analyze the changes of intestinal flora in children with functional constipation （FC） and the clinical significance of non-pharmacological basic treatment. Methods A total of 30 children with FC were selected from the outpatient department of the Children's Hospital affiliated to Kunming Medical University between September 2019-October 2021, and 30 health children were selected as control group. The children with FC were given basic treatment that including dietary structure adjustment, regular defecation training and appropriate exercise.The fecal samples were collected respectively in the pre-treatment group and post-treatment group from the children with FC and from the healthy children. The contents of intestinal flora in the stools of children in each group were measured by the MiNi8 plus fluorescence quantitative PCR instrument from the Kunming Hehe Medical Laboratory. In addition, the relief of constipation symptoms after basic treatment in children with FC was observed. Results The content of lactobacillus and bifidobacterium in children with FC was significantly lower than that in control group , and the difference was statistically significant （P < 0.01）. The content of lactobacillus in the post-treatment group was significantly higher than that in the pre-treatment group, and the difference was statistically significant （P < 0.01）. The scores of constipation symptoms in children with FC after basic treatment were lower than those in pre-treatment group, and the difference was statistically significant （P < 0.01）. Conclusions The children with FC will have intestinal flora disorder. After basic treatment such as dietary structure adjustment and lifestyle improvement, the intestinal flora disorder and constipation symptoms can be improved.
- Functional constipation /
- Intestinal flora /
- Basic treatment /
- Children

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表 1 便秘组（治疗前组）与正常对照组肠道菌群含量的比较（$\bar x \pm s $）

Table 1. Comparison of intestinal flora between FC and control group （$\bar x \pm s $）

组别	双歧杆菌属	乳酸杆菌属	拟杆菌属	柔嫩梭菌属	埃希氏菌属
便秘组	10.51 ± 0.58	9.00 ± 0.17	11.94 ± 0.82	11.72 ± 0.88	10.62 ± 1.31
对照组	11.39 ± 0.40	10.73 ± 0.75	12.05 ± 0.36	11.48 ± 1.16	10.78 ± 0.61
t	6.874	12.238	0.649	0.911	0.643
P	< 0.001^*	< 0.001^*	0.520	0.366	0.524
^*P < 0.05。

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表 2 治疗前组与治疗后组肠道菌群含量的比较（$\bar x \pm s $）

Table 2. Comparison of intestinal flora between pre-treatment group and post-treatment group （$\bar x \pm s $）

组别	双歧杆菌属	乳酸杆菌属
治疗前组	10.51 ± 0.58	9.00 ± 0.17
治疗后组	10.58 ± 0.55	10.40 ± 0.46
t	1.279	17.312
P	0.211	< 0.001^*
^*P < 0.05。

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表 3 治疗前组与治疗后组的便秘症状评分比较[n/（$\bar x \pm s $）]

Table 3. Comparison of constipation symptom scores between pre-treatment group and post-treatment group [n/（$\bar x \pm s $）]

项目	时间	1分	2分	3分	4分	5分	6分	总分（分）	平均值（分）	t	P
排便次数	治疗前	0	0	0	9	16	5	146	4.87 ± 0.68
	治疗后	6	9	7	5	2	1	81	2.70 ± 1.34	14.231	< 0.001^*
排便困难	治疗前	0	4	23	3	—	—	89	2.97 ± 0.49
	治疗后	17	6	5	2	—	—	52	1.73 ± 0.98	8.729	< 0.001^*
粪便性状	治疗前	1	29	—	—	—	—	59	1.97 ± 0.18
	治疗后	23	7	—	—	—	—	37	1.23 ± 0.43	8.930	< 0.001^*
^*P < 0.05。

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