Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease:: a randomised controlled trial with Lactobacillus GG
Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease:: a randomised controlled trial with Lactobacillus GG
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作者：
Prantera, C;Scribano, ML;Luzi, C
背景和目的：实验研究表明，克罗恩病可能与肠道细菌有关。益生菌是抗生素的可能替代品。这个随机安慰剂对照研究的目的是确定是否乳酸菌GG，给予口服一年，可以防止克罗恩病复发病变后surgery.Methods：病人手术克罗恩病，其中所有的患病肠道已被删除随机分配到接受12亿菌落形成单位的乳酸菌或相同的安慰剂一年。在试验结束或症状发作时进行回结肠镜检查。内镜下复发的定义为2级或更高的Rutgeillary评分system.Results：45例患者中有8例被排除出试验（3例不遵守和5例违反协议）。在三名（16.6%）接受乳酸杆菌治疗的患者和两名（10.5%）接受安慰剂治疗的患者中确定了临床复发。乳酸杆菌治疗临床缓解的15例患者中有9例（60%）内镜下复发，而安慰剂治疗的17例患者中有6例（35.3%）内镜下复发（p=0.297）。有两组之间的病变的严重程度没有显着差异。结论：乳酸菌GG似乎既不能防止内镜下复发在一年内，也不能减少复发病变的严重程度。
Background and aims: Experimental studies have shown that luminal bacteria may be involved in Crohn's disease. Probiotics are a possible alternative to antibiotics. The aim of this randomised placebo controlled study was to determine if Lactobacillus GG, given by mouth for one year, could prevent Crohn's recurrent lesions after surgery or to reduce their severity.Methods: Patients operated on for Crohn's disease in whom all of the diseased gut had been removed were randomly allocated to receive 12 billion colony forming units of Lactobacillus or identical placebo for one year. Ileocolonoscopy was performed at the end of the trial or at the onset of symptoms. Endoscopic recurrence was defined as grade 2 or higher of Rutgeerts scoring system.Results: Eight of 45 patients were excluded from the trial (three for non-compliance and five for protocol violations). Clinical recurrence was ascertained in three (16.6%) patients who received Lactobacillus and in two (10.5%) who received placebo. Nine of 15 patients in clinical remission on Lactobacillus (60%) had endoscopic recurrence compared with six of 17 (35.3%) on placebo (p=0.297). There were no significant differences in the severity of the lesions between the two groups.Conclusions: Lactobacillus GG seems neither to prevent endoscopic recurrence at one year nor reduce the severity of recurrent lesions.