| Purpose:To explore the benefits of the therapy of broad-spectrum antibiotics in combination with probiotics(Microbiological capsules containing Bacillus subtilis and Enterococcus) on intestinal dysbacteriosis and immunity function in elderly patients.Method:66 elderly patients with moderate and severe pneumonia who diagnosed by PSI scoring system and in conformity with the inclusion criteria and exclusion criteria were randomly divided into Group A and Group B. Among them there were 36 male patients and 30 female patients with the ratio of male to female as about 1.2:1. The youngest was 67 years old while the eldest was 91 years old with the average age as 77.17. The 33 patients in Group A were treated by broad-spectrum antibiotics and symptomatic treatment. While the 33 patients in Group B were based on treatment of group A with micro-biological capsules containing Bacillus subtilis and Enterococcus to treat disease. Analysis on clinical symptoms and signs, feces smear situation, fecal PH value, serum interleukin-2, complete blood count, liver function, renal function, electrolyte, chest X-ray, sputum culture and incidence of diarrhea and other adverse reaction to all patients before and after treatment, and the SPSS statistical software were taken to analyze the changing of the aforementioned indexes observed.Results:As to the incidence of intestinal dysbacteriosis and fungal infection rate: the fecal smear showed that the bacillu/coccus ratio was greater than or equal to 3:1、the bacterial count was 501~5000 per oil lens field of view, and there were no fungal infection between the two groups of patients before the treatment, which indicated that there was no intestinal flora imbalance in all the patients;there are 10 patients(33.33%) with intestinal flora imbalance in group A and 2 patients(6.67%) with intestinal flora imbalance in group B, there was no statistically significant difference by comparison(P>0.05); patients of the group A after treatment, the use of broad-spectrum antibiotics for 14 days in the incidence of intestinal dysbacteriosis were significantly higher than the patients who use 7 days, also higher than the group B of who use 14 days, with the comparative differences of statistical meaning,(P<0.05); while compared the patients who use broad-spectrum antibiotics for 14 days to the patients who use 7 days among group B in the incidence of intestinal dys-bacteriosis, there was no statistically significant difference(P>0.05); as to the number of cases of fungal infection between the two groups of patients after the treatment, Only A group of 3 patients with fecal smears to fungi, there were no significant differences(P>0.05). As to the incidence of diarrhea:after the treatment group A have 6 cases with diarrhea, its incidence is 20.0%, while group B with 1 case appeared diarrhea, its incidence is 3.3%, there was no statistically significant difference by comparison(P>0.05). As to the Fecal PH value, there was no significant differences among the patients in Group A and Group B before the treatment(P>0.05), which suggested that they had comparable; and the Fecal PH of Group A were increased significantly compared to those before the treatment(P<0.05), in addition, the fecal PH level of A group was significantly higher than that in group B after treatment(P<0.05), with the comparative differences of statistical meaning. while no significant changes occurred to the Fecal PH of Group B compared to those before the treatment(P>0.05). As to serum interleukin-2, there was no significant differences among the patients in Group A and Group B(P>0.05) before treatment, indicating that these two were of comparability, and the serum interleukin-2 of group A and group B were reduced compared to those before the treatment, but the decrease level of serum interleukin 2 in A group was significantly higher than that in B group(P<0.05), with the comparative differences of statistical meaning. As to curative effect, after treatment, the total effective rate of group A was 66.67%, while the group B is 90.00%, with the comparative differences of statistical meaning(P<0.05). As to the liver function, the renal function and the electrolyte, there were no significant differences among the patients in Group A and Group B on the abnormal rate before the treatment(P>0.05), which suggested that they had comparable; and the liver function abnormal rate of group A and group B were reduced compared to those before the treatment, also the decrease level of liver function abnormal rate in B group was significantly higher than that in A group(P<0.05), with the comparative differences of statistical meaning; while the renal function and electrolyte abnormal rate of group A after treatment are 3.33% and 0.00%, there were no significant differences compared to the abnormal rate before treatment(P>0.05); the renal function and electrolyte abnormal rate of group B after treatment are 3.33% and 3.33%, there were no significant differences compared with before treatment(P>0.05); in addition, there were no significant differences between group A and group B after treatment(P>0.05).As to adverse reaction: all patients who use the broad-spectrum antibiotics treatment combined with probiotics(Microbiological capsules containing Bacillus subtilis and Enterococcus) had no adverse reaction, there was no statistically significant difference by comparison(P>0.05). There are 3 patients(9.09%) in group A who had change other antibiotic due to the p- oor effect; and there are 2 patients(6.06%) in group B who had change other antibiotic due to the poor effect and 1 patient(3.03%) in group B who had change other antibiotic because of the use of antibiotics hadn’t covered by the etiologic agent.Conclusion:1. Senile patients with the use of broad-spectrum antibiotics can lead to the flora imbalance, along with the prolonged use of broadspectrum antibiotics, the incidence of the dysbacteriosis also increases. It can also make intestinal PH value rising and reduce the body’s immune function.2. Elderly patients in broad-spectrum antibiotics treatment combined with probiotics to be compared with pure antibiotics group, can effectively reduce the incidence of the antibiotic-associated dysbacteriosis, can adjust the changes of the intestinal PH value, improve the body’s immune function and the liver function. Also the effect is more obvious, and no obvious adverse reaction were found. |
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