Effek van probiotika op die simptome en immunoglobulienvlakke van prikkelbare dermsindroom

Abstract

Die medisinale gebruik van natuurlike plantmateriaal en voedselaanvullings is vinnig besig om veld te wen. Probiotika word deur die Voedseldirektoraat van die Departement van Gesondheid as voedselaanvulling beskou en van hierdie preparate is reeds geregistreer. In hierdie dubbelblinde studie is die invloed van probiotika (Lactobacillus acidophilus en Bifidobacterium longum en bifidum) op die simptome en sirkulerende immunoglobulienvlakke van pasiënte met prikkelbare dermsindroom (PDS) ondersoek. Vier en twintig pasiënte wat aan die Drossman-kriteria vir die diagnose van PDS voldoen het, is gerandomiseer om óf probiotika óf plasebo vir 28 dae te ontvang. Die serumvlakke van die immunoglobuliene IgG, IgA en IgM, sowel as die gastrointestinale simptome, is voor en na behandeling bepaal. Die simptome is beoordeel volgens 'n klinies erkende skaal vir gastrointestinale versteurings. Die nabehandelingimmunoglobulienvlakke het nie betekenisvol van die voorbehandelingvlakke verskil nie. Al 12 pasiënte op probiotika het die 28 dae-behandeling voltooi en die verbetering in simptome was hoogs betekenisvol (p=0.0001). Van die plasebogroeppasiënte het gedurende die proeftydperk besluit dat die preparaat geen resultate lewer nie en die neem daarvan gestaak. Daar was 'n kleiner maar steeds betekenisvolle verbetering in die simptome van die van die 7 pasiënte wat die 28 dae-behandeling op plasebo voltooi het (p=0.0473). 'n Opvolgstudie word aangedui deur die resultate. The medicinal use of natural plant materials and food supplements is gaining in popularity. The Food Directorate of the Department of Health considers probiotics as a food supplement. In this double blind controlled pilot study the effects of probiotic treatment (Lactobacillus acidophilus and Bifidobacterium longum and bifidum) were evaluated on the symptoms and immunoglobulin levels of patients with Irritable Bowel Syndrome (IBS). Twenty-four patients who fulfilled the Drossman criteria for the diagnosis of IBS were randomised to receive either probiotics or a placebo for 28 days. Immunoglobulins IgG, IgA and IgM were measured and symptoms were rated (according to a clinically recognised questionnaire serving as a rating scale for gastrointestinal symptoms in patients with IBS) before and after treatment. The improvement in symptoms was statistically highly significant in the probiotic group (p = 0.0001, paired t-test). Some patients treated with placebo decided that the treatment was ineffective and stopped taking it. The 7 who completed the trial showed an improvement in symptoms, but this was only marginally significant (p = 0.0473, paired t-test). Serum immunoglobulin levels did not differ significantly. Larger studies to confirm the beneficial effects of probiotic bacteria on the symptoms of patients with IBS are indicated.