Analysis Of The Efficacy Of Probiotics In The Treatment Of Inflammatory Bowel Disease

Objective: To investigate the therapeutic effect of combined probiotic therapy on Inflammatory Bowel Disease(IBD),the difference in efficacy between combining single probiotics and alternating multiple probiotics,and the difference in efficacy between combining different probiotics,in order to provide a new therapeutic avenue for the prevention and treatment of IBD.Methods: Clinical data of patients with inflammatory bowel disease hospitalized in Wuhan Central Hospital between October 2020 and April 2022 were collected.211 patients with inflammatory bowel disease were selected according to the inclusion and exclusion criteria,and were classified into Ulcerative Colitis(UC)and Crohn’s Disease(CD)according to the subtype of the disease,UC The 5-aminosalicylic acid(5-ASA)preparation was combined with probiotics for UC(5-ASA)according to the conventional medication in 41 cases of the probiotic group and 34 cases of the control group without probiotics for UC(5-ASA).19 cases in the probiotic group where the biologic combined with the probiotic treatment was UC(biologic)and 20 cases in the control group where the uncombined probiotic was UC(biologic).The probiotic group was divided into one probiotic alone and multiple probiotics alternately according to whether the probiotics were alternated during treatment.The UC(5-ASA)probiotic group with combined probiotics was further divided into 23 cases in the UC(5-ASA)alone group and 18 cases in the UC(5-ASA)alternate group,and the UC(biologic)probiotic group with combined probiotics was divided into UC(biologic)alone10 cases in the UC(biologic)group and 9 cases in the UC(biologic)alternate group.In response to the different probiotics used,the UC(5-ASA)single-use group was further divided into 7 cases in group A: using Bifidobacterium bifidum triplex capsules;5 cases in group B: using Bacillus subtilis dibacterium enteric capsules;4 cases in group C: using Bacillus licheniformis live capsules;and 7 cases in group D: using compound Lactobacillus acidophilus tablets.CD was treated with 5-ASA combined with probiotics according to the conventional dosing as CD(5-The probiotic group with 5-ASA combined with probiotics as CD(5-ASA)was 20 cases,the control group without combined probiotics as CD(5-ASA)was 20 cases,the probiotic group with biologics combined with probiotics as CD(biologic)was 13 cases,and the control group without combined probiotics as CD(biologic)was 26 cases.General data,serological test results,disease activity scores and duration of remission were collected before and after 4 weeks of treatment and statistically analysed.Results: Comparison of baseline information between the probiotic and control groups for UC and CD,and between the single and alternate groups was not statistically significant between the groups(P>0.05);changes in endotoxin,D-lactate,diamine oxidase and erythrocyte sedimentation rate,C-reactive protein and disease activity score reflecting intestinal barrier function were more significant in the probiotic group in UC(5-ASA)than in the control group after treatment(P<0.05).Changes in endotoxin,D-lactate,diamine oxidase and erythrocyte sedimentation rate reflecting inflammatory factor levels were more significant in the probiotic group of UC(biologic)than in the control group(P<0.05).changes in endotoxin,D-lactate,diamine oxidase reflecting intestinal barrier function and erythrocyte sedimentation rate reflecting inflammatory factor levels were more significant in the alternate group of UC(5-ASA)than in the control group(P<0.05).The changes in platelet distribution width,which reflects platelet parameters,and erythrocyte sedimentation rate and C-reactive protein,which reflect the level of inflammatory factors,were more significant in the UC(5-ASA)alternate group than in the single-use group(P<0.05).The duration of remission was not statistically significant in the probiotic group compared to the control group for UC(P>0.05).serological test results,disease activity scores and duration of remission were not statistically significant in the probiotic and control groups for CD(P>0.05).Conclusion: The combination of 5-ASA with probiotics had better efficacy than 5-ASA in the treatment of ulcerative colitis,mainly in terms of positive effect on repair of intestinal barrier function,more significant effect on reduction of serum inflammatory factor levels and more significant reduction in disease activity scores,but no effect on prevention of recurrence of ulcerative colitis.The positive effect on repair of intestinal barrier function and the decrease in serum inflammatory factor levels were more pronounced with the alternating use of multiple probiotics than with the combination of single probiotics.No significant differences in efficacy were found between the different probiotics.Biologics combined with probiotics had a positive effect on repair of intestinal barrier function and a more pronounced decrease in serum inflammatory factor levels than biologics for ulcerative colitis,but had no effect on disease activity scores and no effect on prevention of recurrence of ulcerative colitis.The positive effect on repair of intestinal barrier function was more pronounced with alternating probiotics than with combining single probiotics,but had no effect on changes in serum inflammatory factor levels.there was no significant difference in the efficacy of5-ASA or biologics in the treatment of Crohn’s disease with or without combining probiotics.