基于网络的低fodmap饮食与益生菌治疗肠易激综合征的长期效应，包括对卡塔尔世界杯8强波胆分析菌群的鸟枪分析:随机双交叉临床试验%A Ankersen,Dorit Vedel, Weimers,Petra, Bennedsen,Mette,Anne Birgitte, Fjordside,Eva Lund,Moritz Emanuel, Lieven,Christian,A Saboori,Sanaz, sad,Nicolai,A Rannem,Terje,A Marker,Dorte,A Paridaens,Kristine,A Frahm,Suzanne,A Jensen,Lisbeth,A Rosager Hansen,Malte,A Burisch,Johan,A Munkholm,Pia +北西兰大学医院消化内科，frederiksundsvej 30, Frederikssund, 3600，丹麦，45 48292078, pia.munkholm@regionh.dk %K肠易激综合征%K基于web的低fodmap饮食%K益生菌%K随机试验%K基于web的%K IBS %K症状管理%K治疗结果%K结果%K治疗%K微生物群%K微生物组%K消化病学%K移动应用%K mHealth %K eHealth %D 2021 %7 14.12.2021 %9原始论文%J J医学互联网Res %G英文%X背景:肠易激综合征(IBS)的长期管理提出了许多挑战。在短期研究中，电子健康干预措施已被证明是安全实用的，可用于在家监测益生菌治疗和低发酵寡糖、双糖、单糖和多元醇(FODMAPs)饮食的效果。肠易激综合征与微生物群的改变有关。目的:本研究的目的是确定基于网络的低fodmap饮食(LFD)干预和益生菌治疗是否同样能很好地减轻IBS症状，以及对治疗的反应是否可以用患者的微生物群解释。方法:成年IBS患者被纳入一项开放标签、随机交叉试验(针对无应答者)，并使用IBS Constant Care (IBS CC) web应用程序进行了1年的随访。患者从丹麦北西兰大学医院消化内科的门诊招募。患者要么接受VSL#3 4周(每天2 × 4500亿菌落形成单位)，要么接受LFD 4周。对LFD有反应的患者被重新引入高FODMAPs的食物，每当他们出现症状时，益生菌反应者就接受治疗。 Treatment response and symptom flare-ups were defined as a reduction or increase, respectively, of at least 50 points on the IBS Severity Scoring System (IBS-SSS). Web-based ward rounds were performed daily by the study investigator. Fecal microbiota were analyzed by shotgun metagenomic sequencing (at least 10 million 2 × 100 bp paired-end sequencing reads per sample). Results: A total of 34 IBS patients without comorbidities and 6 healthy controls were enrolled in the study. Taken from participating subjects, 180 fecal samples were analyzed for their microbiota composition. Out of 21 IBS patients, 12 (57%) responded to the LFD and 8 (38%) completed the reintroduction of FODMAPs. Out of 21 patients, 13 (62%) responded to their first treatment of VSL#3 and 7 (33%) responded to multiple VSL#3 treatments. A median of 3 (IQR 2.25-3.75) probiotic treatments were needed for sustained symptom control. LFD responders were reintroduced to a median of 14.50 (IQR 7.25-21.75) high-FODMAP items. No significant difference in the median reduction of IBS-SSS for LFD versus probiotic responders was observed, where for LFD it was –126.50 (IQR –196.75 to –76.75) and for VSL#3 it was –130.00 (IQR –211.00 to –70.50; P>.99). Responses to either of the two treatments were not able to be predicted using patients’ microbiota. Conclusions: The web-based LFD intervention and probiotic treatment were equally efficacious in managing IBS symptoms. The response to treatments could not be explained by the composition of the microbiota. The IBS CC web application was shown to be practical, safe, and useful for clinical decision making in the long-term management of IBS. Although this study was underpowered, findings from this study warrant further research in a larger sample of patients with IBS to confirm these long-term outcomes. Trial Registration: ClinicalTrials.gov NCT03586622; https://clinicaltrials.gov/ct2/show/NCT03586622 %M 34904950 %R 10.2196/30291 %U //www.mybigtv.com/2021/12/e30291 %U https://doi.org/10.2196/30291 %U http://www.ncbi.nlm.nih.gov/pubmed/34904950