摘 要
便秘可能会诱发心血管疾病的产生，从而危害人体健康。口服益生菌片剂来改善肠道菌群及脂肪酸代谢对改善维持性血透患者的便秘情况的研究有重大的意义。大量的乳杆菌和双歧杆菌在肠道中通常是健康肠道的象征，因此，乳杆菌和双歧杆菌在保护肠道健康方面成为研究的焦点。本研究使用的益生菌片剂选用副干酪乳杆菌 L9、嗜酸乳杆菌 A5、动物双岐杆菌 A6、鼠李糖乳杆菌 LGG。
采用对排便调查问卷的收集，粪便分类、粪便 pH、粪便水分含量数据分析的方法，对 20 名实验对象的便秘情况进行研究。研究结果表明在干预 V2 期和 V6 期的排便费力由 11 例到 5 例，干预到 V6 期时减少到 3 例，排便不尽感由 18 例显着减少到 3 例，便秘人数只为 2 例，这三个指标都有显着减少，干预 V2 期的乙酸、丙酸含量显着上升,乙酸含量由 1.77±1.30 增加到 V2 期的 3.72±3.31，丙酸含量由 1.47±1.49 到 V2 期的 2.63±2.28，干预 V6 期含量减少但和基线 V0 期相比还是有所上升。说明益生菌对患者的感觉有改善作用，使之感到轻松，心情较干预之前比有所好转，但对粪便 pH 和水分含量的变化没有显着性差异。
采用粪便短链脂肪酸的测定和 16s 高通量菌群测序方法，对 20 名实验对象的便秘情况进行研究。研究结果表明干预 V2 期的双歧杆菌属下降到 3.82%，链球菌属，罗斯氏菌属增加。到干预 V6 期双歧杆菌属增长到 6.98%，肠球菌属上升至6.59%，链球菌属持续上升至 2.43%，巨单胞菌属增加至 1.02%。长期口服益生菌片剂六个月对其便秘效果和短链脂肪酸还有肠道菌群的影响是持续影响。
关键词： 血液透析；便秘；益生菌；肠道菌群。
Abstract
Constipation may induce the cardiovascular disease, which will be harmful tohuman health. The oral probiotics tablets will improve the intestinal flora and fatty acidsmetabolism, which will give great study significance for improving the constipation ofmaintained-hemodialysis patients. The large amount of Lactobacillus andBifidobacterium existed in the intestinal tract symbolize the healthy intestinal tract.
Therefore, the study on the protection of intestinal tract by Lactobacillus andBifidobacterium becomes the focal points. The Lactobacillus Paracasei L9,Lactobacillus Acidophilus A5, Bfidobacterium A6 and Lactobacillus Rhamnosus LGGare selected as the probiotics tablets used in this study.
Twenty experiment objects are studies on the constipation. The data is collected byquestionnaire about defecation. It uses the methods of data analysis on fecesclassification, feces pH and feces water content. The research result indicates that theexertion in defecation is reduced from 11 cases to 5 cases in the intervention period ofV2 and V6, and reduced to 3 cases in the intervention period of V6. The unfinishedfeeling of defecation is significantly reduced from 18 cases to 3 cases. The number ofpeople with constipation is just 2 cases. These three indexes are significantly reduced.
The content of acetic acid and propionic acid in the intervention period of V2 issignificantly increased. The content of acetic acid is increased from 1.77±1.30 to the3.72±3.31 in the period of V2. The content of propionic acid is increased from1.47±1.49to the 2.63±2.28 in the period of V2. The content is reduced in the intervention period ofV6, but it is still increased by comparing with the baseline period of V0. It indicates thatthe probiotics can improve the feeling of the patients and make them feel relax. Thefeeling of patients will be better than before the intervention. However, it has nosignificant differences on the change of the feces PH and feces water content.
Twenty experiment objects are studies on the constipation with the method of themeasurement of feces short chain fatty acids and 16s high-throughput sequencing. Theresearch result indicates that the Bifidobacterium is reduced to 3.82% in the interventionperiod of V2, but the streptococcus and roseburia stanton and savage are increased. Inthe intervention period of V6, the Bifidobacterium is increased to 6.98%, theenterococcus is increased to 6.59%, the streptococcus is continuous to be increased to2.43% and the megamonas shah and collins is increased to 1.02%. The oral probioticstablets for 6 months will have continuous effect on the constipation, short chain fattyacids and intestinal flora.
Dobacterium in V6 was increased to 6.98%, Enterococcus was up to 6.59%,Sstreptococcus was up to 2.43%, and the Genus Monocytosis increased to 1.02%.Theeffects of long-term oral probiotic tablets on constipation effect and short chain fattyacids and intestinal flora in six months were continuously affected.
Keywords： Hemodialysis; Constipation; Probiotics; Intestinal flora。
目 录
摘 要
Abstract
第一章 绪论
1.1 血液透析病人便秘
1.1.1 便秘症状介绍
1.1.2 血液透析病人便秘的特征和原因
1.1.3 血液透析便秘患者的主要干预措施
1.2 益生菌的含义、制剂功能及对血透患者便秘的研究进展
1.2.1 益生菌含义
1.2.2 益生菌及其制剂的功能及研究进展
1.2.3 益生菌防治便秘及血液透析患者便秘症状的研究进展
1.3 本课题的研究目的、意义及技术路线
1.3.1 研究目的
1.3.2 研究意义
1.3.3 技术路线
第二章 口服益生菌对血液透析病人的便秘症状的改善作用
2.1 前言
2.2 材料与方法
2.2.1 益生菌片
2.2.2 主要设备
2.2.3 实验对象招募与人群实验.
2.3 结果与分析
2.3.1 实验对象基本情况
2.3.2 便秘及排便问题的结果分析
2.3.3 粪便类型评分结果分析
2.3.4 粪便 pH 测定结果分析
2.4 本章小结
第三章 口服益生菌对血液透析病人的肠道菌群及短链脂肪酸的调节作用
3.1 前言
3.2 材料与方法.
3.2.1 主要试剂
3.2.2 主要设备
3.2.3 研究样品
3.2.4 粪便短链脂肪酸提取与测定实验步骤
3.3 结果与分析
3.3.1 粪便短链脂肪酸分析
3.3.2 益生菌和短链脂肪酸相关性分析
3.3.4 益生菌和肠道菌群相关性分析
3.3.5 肠道菌群和短链脂肪酸相关性分析
3.4 本章小结
第四章 结论与展望
4.1 结论
参考文献
