Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial
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DOI：
10.1053/gast.2000.9370
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发表时间：
2000-08-01
期刊：
影响因子：
29.4
通讯作者：
Campieri, M
中科院分区：
文献类型：
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作者：
Gionchetti, P;Rizzello, F;Campieri, M
背景与目的：储袋炎是溃疡性结肠炎回肠储袋-肛门吻合术后主要的长期并发症。大多数患者患有复发性疾病，并且尚未进行维持治疗研究。我们评估了益生菌制剂 (VSL#3) 的功效，该制剂每克含有 5 x 10(11) 活冻干细菌，包括 4 株乳杆菌、3 株双歧杆菌和 1 株唾液链球菌亚种。嗜热菌与安慰剂在维持慢性贮袋炎缓解方面的比较。方法：40 名临床和内镜缓解的患者被随机分配接受 VSL#3（6 g/天）或相同的安慰剂，为期 9 个月。每个月对患者进行一次临床评估，每两个月或在复发的情况下对患者进行内窥镜和组织学评估。在抗生素治疗前后以及维持治疗期间每月收集粪便样本进行粪便培养。结果：VSL#3 组中有 3 名患者（15%）在 9 个月的随访期内复发，而安慰剂组有 20 名患者（100%）复发（P < 0.001）。仅在 VSL#3 治疗组中，乳酸杆菌、双歧杆菌和嗜热链球菌的粪便浓度较基线水平显着增加（P < 0.01）。结论：这些结果表明口服这种新型益生菌制剂可有效预防慢性储袋炎的发作。
Background & Aims: Pouchitis is the major long-term complication after ileal pouch-anal anastomosis for ulcerative colitis. Most patients have relapsing disease, and no maintenance treatment study has been performed. We evaluated the efficacy of a probiotic preparation (VSL#3) containing 5 x 10(11) per gram of viable lyophilized bacteria of 4 strains of lactobacilli, 3 strains of bifidobacteria, and 1 strain of Streptococcus salivarius subsp. thermophilus compared with placebo in maintenance of remission of chronic pouchitis. Methods: Forty patients in clinical and endoscopic remission were randomized to receive either VSL#3, 6 g/day, or an identical placebo for 9 months. Patients were assessed clinically every month and endoscopically and histologically every 2 months or in the case of a relapse. Fecal samples were collected for stool culture before and after antibiotic treatment and each month during maintenance treatment. Results: Three patients (15%) in the VSL#3 group had relapses within the 9-month follow-up period, compared with 20 (100%) in the placebo group (P < 0.001). Fecal concentration of lactobacilli, bifidobacteria, and S. thermophilus increased significantly from baseline levels only in the VSL#3-treated group (P < 0.01). Conclusions: These results suggest that oral administration of this new probiotic preparation is effective in preventing flare-ups of chronic pouchitis.