摘要
目的观察莲子粉、芡实粉与白扁豆粉组合联合合生元对神经重症患者腹泻症状及肠道菌群的影响,从而为临床营养干预提供依据。方法选择2023年6月至2024年12月郴州市第一人民医院收治的60例腹泻患者作为研究对象。按随机数字表法将患者分为试验组和对照组,每组30例。两组患者均给予常规治疗,对照组在常规治疗基础上给予合生元每次2 g,每日2次,口服或管饲注入胃肠道;试验组在对照组基础上给予健脾止泻配方:白莲粉6 g,芡实粉6 g,白扁豆粉6 g,每日3剂,口服或管饲注入胃肠道。两组均连续给药14 d。观察两组患者治疗前后营养指标[血红蛋白(Hb)、白蛋白(Alb)、前白蛋白(PA)]、肠道菌群数量(包括大肠埃希菌、乳酸杆菌、双歧杆菌、肠球菌)、排便情况(排便次数、布里斯托排便类型评分和量)的变化。结果治疗前两组Hb、Alb、PA、每日排便次数、布里斯托排便类型评分及排便量、各菌群数量比较差异均无统计学意义(均P>0.05)。治疗后两组Hb、PA、乳酸杆菌数量、双歧杆菌数量均较治疗前明显升高,每日排便次数、布里斯托排便性状评分及排便量、大肠埃希菌数量、肠球菌数量均较治疗前明显减少(均P<0.05);治疗后试验组Alb水平较治疗前明显升高(g/L:32.87±2.91比32.16±3.13,P<0.05),而对照组Alb水平与治疗前比较差异无统计学意义(P>0.05)。与对照组比较,试验组治疗后Hb、PA、乳酸杆菌数量和双歧杆菌数量均明显升高[Hb(g/L):108.47±8.99比103.40±15.05,PA(mg/L):144.87±34.01比121.77±35.35,乳酸杆菌数量(log_(10)CFU/g):7.83±0.19比7.34±0.21,双歧杆菌数量(log_(10)CFU/g):8.47±0.34比7.47±0.33,均P<0.05],腹泻时间、每日排便次数、布里斯托排便类型评分、大肠埃希菌及肠球菌数量均明显减少[腹泻时间(d):2.73±1.01比3.50±0.94,每日排便次数(次):1.26±0.98比2.13±0.89,布里斯托排便类型评分(分):2.87±1.85比4.07±1.39,大肠埃希菌数量(log_(10)CFU/g):6.75±0.31比8.12比0.26,肠球菌数量(log_(10)CFU/g):7.78±0.66比8.20±0.72,均P<0.05]。结论莲子粉、芡实与白扁豆粉组合联合合生元干预可有效缩短神经重症患者腹泻持续时间,改善营养指标,显著调节肠道菌群结构,有较好的临床推广价值。
Objective To investigate the effects of a combination of lotus seed powder,gordon euryale seed powder,and hyacinth bean powder together with synbiotics on diarrhea symptoms and gut microbiota in neurocritically ill patients,and to provide evidence for clinical nutritional intervention.Methods From June 2023 to December 2024,a total of 60 diarrhoeal patients admitted to Chenzhou First People's Hospital were enrolled as research subjects.The patients were randomly divided into an experimental group and a control group using a random number table method,with 30 patients in each group.All patients received routine treatment.In the control group,a synbiotic preparation was administered at a dose of 2 g per dose,twice daily,in addition to conventional treatment,either orally or via enteral tube.In the experimental group,on the basis of the control group treatment,an additional spleen-strengthening and antidiarrheal formula was administered,consisting of lotus seed powder(6 g),gorgon fruit powder(6 g),and hyacinth bean powder(6 g),three times daily,either orally or via enteral tube.Both groups were treated continuously for 14 days.Changes in nutritional indicators[including hemoglobin(Hb),albumin(Alb),and prealbumin(PA)],intestinal microbiota counts(including Escherichia coli,Lactobacillus,Bifidobacterium,and Enterococcus),and bowel movement characteristics(frequency,stool consistency,and stool volume)were observed before and after treatment.Results Before treatment,there were no statistically significant differences between the two groups in Hb,Alb,PA,stool frequency perday,Bristol Stool Form Scale score,stool volume,or the counts of each intestinal bacterial group(all P>0.05).After treatment,Hb and PA levels,as well as the counts of Lactobacillus and Bifidobacterium,were significantly increased in both groups compared with baseline,while stool frequency perday,Bristol Stool Form Scale score,stool volume,and the counts of Escherichia coli and Enterococcus were significantly decreased(all P<0.05).In the experimental group,Alb levels were significantly higher after treatment than before treatment(g/L:32.87±2.91 vs.32.16±3.13,P<0.05),whereas no significant difference in Alb levels was observed in the control group after treatment compared with baseline(P>0.05).Compared with the control group,the experimental group showed significantly higher Hb,PA levels and higher counts of Lactobacillus and Bifidobacterium after treatment[Hb(g/L):108.47±8.99 vs.103.40±15.05,PA(mg/L):144.87±34.01 vs.121.77±35.35,Lactobacillus count(log_(10)CFU/g):7.83±0.19 vs.7.34±0.21,Bifidobacterium count(log_(10)CFU/g):8.47±0.34 vs.7.47±0.33,all P<0.05].In addition,diarrhea duration,stool frequency perday,Bristol Stool Form Scale score,and the counts of Escherichia coli and Enterococcus were significantly lower in the experimental group than in the control group[diarrhea duration(days):2.73±1.01 vs.3.50±0.94,stool frequency perday(times):1.26±0.98 vs.2.13±0.89,Bristol Stool Form Scale score:2.87±1.85 vs.4.07±1.39,Escherichia coli count(log_(10)CFU/g):6.75±0.31 vs.8.12±0.26,Enterococcus count(log_(10)CFU/g):7.78±0.66 vs.8.20±0.72,all P<0.05].Conclusions The combination of lotus seed powder,Gordon euryale seed powder,and hyacinth bean powder,when used in conjunction with synbiotic intervention,can effectively shorten the duration of diarrhea in critically ill neurological patients,improve nutritional indicators,and significantly modulate the intestinal microbiota composition,demonstrating good clinical applicability and promising value for wider use.
作者
徐大凤
王凯丁
李敏艳
谭莳芳
杨满梅
Xu Dafeng;Wang Kaiding;LI Minyan;Tan Shifang;Yang Manmei(Department of Nutrition,Chenzhou First People's Hospital,Chenzhou,Hunan 423000,China;Department of Emergency and Critical Care Medicine,Chenzhou First People's Hospital,Chenzhou,Hunan 423000,China;Department of Neurosurgery,Chenzhou First People's Hospital,Chenzhou,Hunan 423000,China;Department of Neurocritical Care,Chenzhou First People's Hospital,Chenzhou,Hunan 423000,China)
出处
《中国中西医结合急救杂志》
2025年第5期539-543,共5页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
湖南省中医药管理局科研项目(D2024057)。
关键词
药食同源
合生元
肠内营养并发症
腹泻
Homology of medicine and food
Synbiotics
Enteral nutrition complications
Diarrhea
