混吃多种益生菌，会对孕期便秘有效吗？
多种益生菌混合物对孕期便秘有效吗?
Is a multispecies probiotic mixtureeffective in constipation during pregnancy? ‘A pilot study’
Milliano et al. Nutrition Journal(2012)
DOI 10.1186/1475-2891-11-80
孕期便秘是一个常见的问题。目前，预防或治疗孕期便秘的有效干预措施很少，并且由于副作用，这些干预措施的使用很有限。
Bekkali等描述了Ecologic®Relief（双叉型双歧杆菌W23、乳双歧杆菌W52、长双歧杆菌W108、干酪乳杆菌W79、植物乳杆菌W62和鼠李糖乳杆菌W71的混合物）对儿童便秘的缓解作用【参考文献：Bekkali N, Bongers ME, Van den Berg MM, Liem O, Benninga MA: Therole of a probiotics mixture in the treatment of childhood constipation: apilot study. Nutr J 2007, 6:17.】。
根据益生菌对便秘儿童的阳性结果和妊娠期便秘的现有治疗方案的不良影响，我们假设这种益生菌混合物对便秘孕妇的相同的阳性效果，而对常规治疗没有反应。
因此，本文进行了一项初步研究，以确定Ecologic®Relief这种混合益生元是否对妊娠期便秘有效。
Abstract
Background: Constipation during pregnancy is a common problem. Nowadays onlyfew effective interventions are published preventing or treating constipationduring pregnancy. However, their use is limited due to side-effects. Thisuncontrolled intervention study was performed to determine if a mixture ofprobiotics in the treatment of constipation during pregnancy is effective.
Methods: Women aged ≥ 18 years with functional constipation were includedat the Obstetrical outpatient clinic and midwife practices. Patients receivedduring four weeks a daily dose of EcologicâRelief (Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Bifidobacterium longum W108, Lactobacillus casei W79, Lactobacillus plantarum W62 and Lactobacillus rhamnosus W71 (total 4*109CFU)). For all analyses, the non-parametric paired Wilcoxon test was used.Primary outcome measure was change in defecation frequency. Secondary outcomemeasures were stool consistency, sensation of incomplete evacuation, sensationof anorectal obstruction, manual manoeuvres to facilitate defecation, abdominalpain, adverse effects, presence of reflux episodes and intake of Bisacodyl.
Results: 20 women were included. Defecation frequency significantlyincreased from 3.1 at baseline to 6.7 in week four (p < 0.01). Compared tobaseline, a significant decrease in 1) sensation of anorectal obstruction from90.0% to 45.0% (p < 0.01), 2) sensation of incomplete evacuation from 90.0%to 40.0% (p < 0.01), 3) straining during defecation from 100% to 65% (p =0.01), 4) episodes of abdominal pain from 60% to 20% (p = 0.01) and 5) thepresence of reflux episodes from 60% to 20% in week four (p = 0.01) was found.Other secondary outcomes did not decrease significantly. No side effects werereported.
Conclusions: EcologicâRelief is effective in the treatment of constipation duringpregnancy. A randomised placebo controlled trial is required to confirm thesedata.
研究对象：阿姆斯特丹的20名孕妇。
入组条件：
孕12-34周、年龄大于18岁的孕妇；
符合Rome III 标准的功能性便秘患者，并且症状出现至少两周；
排除在试验开始前一周内已接受便秘治疗的孕妇；
排除以下疾病患者：精神发育迟滞或代谢疾病(甲状腺功能减退)、Hirschsprung病、脊柱异常、肛肠病理、炎症性肠病、既往胃肠手术；
排除研究前两周使用含益生菌发酵乳制品的孕妇。
研究方法：
该试验研究是一项不受控制的干预研究，旨在评估便秘孕妇使用益生菌的可行性、不良反应及影响大小。在益生菌治疗开始前，所有受试者每日1次直肠灌肠(Microlax)，连续3天，以达到rectal disimpaction，建立同质研究组。所有受试者连续四周每天服用4克的Ecologic®Relief（4*109CFU，含双叉型双歧杆菌W23、乳双歧杆菌W52、长双歧杆菌W108、干酪乳杆菌W79、植物乳杆菌W62和鼠李糖乳杆菌W71的混合物），并填写问卷记录进食前一周的排便频率、大便情况，同时对胃肠症状如腹痛和反流发作进行评估。此外，还列出了一般病史和用药情况。在开始使用益生菌后的第2周、第4周和第6周进行临床评估、不良反应频率和依从性评估。
研究结果：
平均每周排便次数从基线的3.0次显著增加到第2周的7.0次和第4周的6.0次。除硬便和手动操作外，所有二级疗效指标均在2周后显著改善，且持续至治疗结束；
该试验研究结果与在非孕妇中发表的研究结果一致，这一事实表明，至少有一些病理生理机制与妊娠无关，与非妊娠类似，比如低纤维和低液体摄入量；
由于缺乏对照组，益生菌的安慰剂效应不能排除。然而，由于这项研究中益生菌疗效显著，因此值得进行一项大型随机试验，以阐明这种混合益生菌菌株对便秘孕妇的疗效。
Figure 1 Primary outcome: change indefecation frequency (n=20), p < 0.01.
图1 试验主要结果：排便频率变化（n=20），P<0.01。
知几未来研究院正在搭建一个“疾病-肠道菌群”知识库。
你可以在公众号对话框回复“IBD”或“肠易激综合征”，查看与疾病相关的菌群；
也可以回复“双歧杆菌”或“Hp”，查看与细菌相关的疾病。
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