有肠道失调表现的急慢性湿疹患者的治疗及预后优化

L. V. Fominа, A. Dashchuk, E. Dobrzhanska
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引用次数: 1

摘要

目的:本工作的目的是在研究免疫防御系统的基础上,通过开发有效的综合矫正疗法,提高急慢性湿疹患者的治疗效果。材料和方法。选取治疗前后的急慢性湿疹患者47例作为研究对象。为了评估这些患者的治疗效果,我们评估了生化研究数据、细胞和体液免疫指标以及结肠微生物群指标的变化程度。结果和讨论。急性期伴有肠道失调表现的急慢性湿疹患者的细胞免疫和体液免疫最具信息量的指标是:CD3+淋巴细胞、IFN-γ、IL-4、IL-6和IgA。这些指标的监测对于控制这类患者的防治效果是必要和充分的。根据所有患者粪便的细菌学检查结果,确定存在I-IV度的结肠生态失调。湿疹患者结肠内双歧杆菌和乳酸菌的含量(分别为2.09倍和2.58倍)、类杆菌的含量(分别为1.96倍)和大肠杆菌的总数(分别为2.56倍)也显著降低,而具有酶促性质的大肠杆菌、机会性肠杆菌、肠球菌和念珠菌属真菌的数量较多(分别为1.87倍、14.4倍、4.20倍和3.22倍)。主组患者在添加益生素和益生元治疗后,结肠生态失调的表现消失,而对照组患者的生态失调表现持续存在:结肠内双歧杆菌和乳酸菌含量较低(分别为1.82和2.32倍),类杆菌含量较低(分别为1.2倍),大肠杆菌总数较低(分别为1.48倍),而具有酶促性质的大肠杆菌、机会性肠杆菌、肠球菌和念珠菌属真菌数量较多(分别为1.32、12.3、3.24和2.85倍)。结论。这种治疗旨在使胃肠道恢复正常,提高患者的免疫力,对湿疹患者的治疗复合物具有激活和刺激作用。与仅接受常规病理治疗的个体相比,添加益生元和益生元有助于显著缩短患者的治疗持续时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimization of treatment and prognosis of acute and chronic eczema in patients with manifestations of intestinal dysbiosis
Objective — the purpose of the work is to increase the effectiveness of treatment of patients with acute and chronic eczema by developing effective comprehensive corrective therapy based on the study of the immune defense system. Materials and methods. 47 patients with acute and chronic eczema before and after treatment were selected for the study. To assess the effectiveness of therapy in these patients, we evaluated the data of biochemical studies, indicators of cellular and humoral immunity, as well as the degree of changes in indicators of the microbiota of the colon cavity. Results and discussion. The most informative indicators of cellular and humoral immunity of patients with acute and chronic eczema in the acute stage, accompanied by manifestations of intestinal dysbiosis are determined: CD3+-lympho­cytes, IFN-γ, IL-4, IL-6 and IgA. The monitoring of these indicators is necessary and sufficient for controlling the effectiveness of prevention and treatment of this group of patients.According to the results of bacteriological examination of feces in all patients, the presence of dysbiosis of the colon of I—IV degrees was established. Patients with eczema also had a significantly lower content of bifidobacteria and lactobacilli in the colon cavity (by 2.09 and 2.58 times, respectively), bacteroids (by 1.96 times) and the total number of Escherichia coli (by 2.56 times) against the background of a larger number of Escherichia coli with enzymatic properties, opportunistic enterobacteria, enterococci and fungi of the genus Candida (by 1.87, 14.4, 4.20 and 3.22 times, respectively). After the treatment with the addition of pro- and prebiotics of the patients of the main group, the manifestations of dysbiosis of the colon were eliminated, while in the patients of the control group, the manifestations of dysbiosis persisted: lower content of bifidobacteria and lactobacilli in the colon cavity (by 1.82 and 2.32 times, respectively), bacteroids (by 1.2 times) and the total number of Escherichia coli (by 1.48 times) against the background of a bigger number of Escherichia coli with enzymatic properties, opportunistic enterobacteria, enterococci and fungi of genus Candida (by 1.32, 12.3, 3.24 and 2.85 times, respectively). Conclusions. The treatment aimed at normalizing the gastrointestinal tract and increasing the patient’s immunity, has an activating and stimulating effect on the therapeutic treatment complex of a patient with eczema. The addition of pro and prebiotics contributed to a significant reduction in the duration of treatment in patients compared with the indicator in individuals who received only conventional pathogenetic therapy.
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