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詹雅萍,王国芬,李娴,朱香顺,童筱君.酪酸梭菌活菌片联合非布司他对非急性期痛风的临床疗效观察[J].浙江中西医结合杂志,2020,30(5):
酪酸梭菌活菌片联合非布司他对非急性期痛风的临床疗效观察
Clinical Efficacy of Clostridium Butyricum Tablets combined with Febuxostat in the Treatment of Non-acute GoutZHAN Yaping, WANG Guofen, LI Xian, ZHU Xiangshun, TONG Xiaojun,
投稿时间:2019-11-16  修订日期:2020-01-10
DOI:
中文关键词:  酪酸梭菌活菌片  痛风  肠道菌群  非布司他
英文关键词:Clostridium Butyricum Tablets  Gout  Intestinal flora  Febuxostat
基金项目:台州学院科研启动费(编号 QD2018133)
作者单位E-mail
詹雅萍 浙江省台州市中心医院 zhanyaping10@163.com 
王国芬 浙江省台州市中心医院风湿免疫科浙江 台州 318000  
李娴 浙江省台州市中心医院风湿免疫科浙江 台州 318000  
朱香顺 浙江省台州市中心医院风湿免疫科浙江 台州 318000  
童筱君 浙江省台州市中心医院风湿免疫科浙江 台州 318000  
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中文摘要:
      目的 研究痛风患者肠道菌群变化,观察酪酸梭菌活菌联合非布司他对痛风的降尿酸疗效、关节炎发作率及肠道菌群影响。 方法 将100例非急性期痛风患者随机分为实验组A组和标准组B组各50例,另选择同期健康体检者50例作为对照组C组,三组患者基线资料无明显差异。 A、B组患者均予非布司他治疗,B组加服酪酸梭菌活菌片,疗程为4周。测定各组治疗前后的血清学指标及粪便尿酸含量和菌群结构变化,并观察降尿酸过程中急性关节炎再发率。结果 治疗前,痛风组血清及粪便本身含有的尿酸、黄嘌呤氧化酶、白细胞介素-6、C反应蛋白、血沉较对照组明显升高,三组患者粪便中细菌分解的尿酸量无殊,粪便尿酸中双歧杆菌、乳酸杆菌含量明显低于正常对照组,而大肠杆菌含量明显增多。治疗后痛风组血清学指标均下降,其中A组明显低于B组,A组患者粪便内细菌分解尿酸量较治疗前明显升高,且与B组具有统计学差异,A组粪便中双歧杆菌、乳酸杆菌、拟杆菌较治疗前明显增多,肠杆菌较治疗前下降,且双歧杆菌、乳酸杆菌、肠杆菌含量变化与B组存在明显统计学差异,B组治疗前后无明显变化。 结论 酪酸梭菌活菌片可能通过改善肠道菌群失调、减少细菌代谢产物和内毒素生成,降低XOD活性及炎性因子产生,从而减少尿酸生成和关节病变。
英文摘要:
      Objective This research is aimed at investigating the characteristics ofintestinal flora in gout patients, and exploring theStherapeutic effects and microflora changes of probiotics intervention on gout. Methods 100 non-acute gout patients were enrolled and randomly divided into experimental group (group A) and standard group (group B) while 50 healthy volunteers were selected as the control group (group C), among which baseline characteristics were similar. Group B were given Febuxostat tablets as routine therapeutic strategies for 4 weeks while Group A received Clostridium butyricum tablets plus Febuxostat tablets. The indexes were followed and recorded including the levels of serum uric acid (UA), xanthine oxidase (XOD), interleukin-6 (IL-6), C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR), fecal uric acid and intestinal flora composition respectively as well as frequency of gout flares. Results Concentrations of serum and fecal UA, XOD, IL-6, CRP and ESR in both gout groups before medication were all remarkably higher than those in control group. The premedication contents of bifidobacterium, lactobacillus in feces of in both group A and B were significantly lower than those in group C, while the enterobacter were in higher level. Concentrations of serum indexes in both group A and B were substantially reduced after treatment and a greater decline was observed in group A than group B (p<0.05). The amount of bacterial uric acid decomposition along with contents of bifidobacterium, lactobacillus in the feces of patients in group A were statistically higher than those before treatment and in group B (p<0.05), so was the decrement of enterobacter. Conclusions Clostridium butyricum tablets may help to reduce the production of uric acid and joint damage by improving the intestinal flora disorder, reducing the production of bacterial metabolites and endotoxin and XOD activity as well as the production of inflammatory factors.
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