| Objective: This study explores the effect of SIBO on absorption and utilization of UDCA in the small intestine.Also it provides a theoretical basis for changing the bacterial overgrowth in the small intestine in patients with chronic cholecystitis and gallstones,improving the efficacy of UDCA in the clinical treatment of patients with chronic cholecystitis and gallstones and improving the thickness of the gallbladder wall,by studying the difference of clinical therapeutic effect of SIBO negative chronic cholecystitis with gallstones and SIBO positive chronic cholecystitis with gallstones on ursodeoxycholic acid(UDCA)dissolution stones and improving gallbladder wall thickness.Methods: Eighty-six patients with chronic cholecystitis and cholecystolithiasis were confirmed in the Gastroenterology department of hebei North University First Affiliated Hospital from September 2017 to December 2019.All subjects were required not to use antibiotics,microecological agents,lactuloses,antacids or gastrointestinal moements within 4 weeks prior to the hydrogen breath test;no enema was performed within 2 weeks,and no history of acute enteritis was found;avoid hydrogen-producing foods such as dairy products,soy products,wheat and flour products,and high-cellulose vegetables 24 hours before the examination,and avoid overeating;fasting and water prohibition 12 hours before examination;Brush your teeth and gargle on the day of inspection,and do not smoke(including avoiding second-hand smoke).All patients with chronic cholecystitis and cholecystolithiasis were divided by hydrogen breath test into SIBO negative control group(42 cases)and SIBO positive treatment group(44 cases).Six patients dropped out during treatment and follow-up,including 2 patients in the SIBO negative control group and 4patients in the SIBO positive treatment group.A total of 80 patients were followed up after treatment,including 40 patients in the SIBO negative control group and 40 patients in the SIBO positive treatment group.The two groups were given UDCA,10mg/kg,oral treatment once a night.After 6months of oral treatment,the original sonographer performed abdominal ultrasonography,and recorded the changes in the diameter,number and wall thickness of gallbladder in patients with chronic cholecystitis accompanied by gallbladder stones.Results:1.After 6 months of follow-up,the apparently efficiency of SIBO negative control group was 42.5%,and that of the SIBO positive treatment group was 20%.The clinical effect of litholysis therapy in SIBO negative control group was significantly better than that in SIBO positive treatment group,with statistically significant difference(P<0.05).2.After 6 months of follow-up,the effective rate of the SIBO negative control group was 67.5% and that of the SIBO positive treatment group was 45%.2.The clinical effect of litholysis therapy in SIBO negative control group was significantly better than that in SIBO positive treatment group,with statistically significant difference(P<0.05).3.After 6 months of follow-up,the thickness of gallbladder wall of SIBO negative control group was 2.77±0.4mm,significantly improved compared with that of gallbladder wall of 3.74±0.36 mm before treatment.Paired sample T-test was used before and after treatment in SIBO negative control group,T =132.463,P<0.05,and the difference was statistically significant.After 6 months of follow-up,the thickness of gallbladder wall of the SIBO positive treatment group was 3.18±0.55 mm,which was improved compared with that of 3.75±0.41 mm before treatment.Paired sample T-test was used before and after treatment in the SIBO positive treatment group,T=24.978,P<0.05,and the difference was statistically significant.The gallbladder wall thickness of the SIBO negative control group before treatment(3.74±0.36mm)and the SIBO positive treatment group before treatment(3.75±0.41mm)were compared between the two groups using the independent-sample t-test(t=0.029,P>0.05,showing no statistical difference.The gallbladder wall thickness of the SIBO negative control group after treatment(2.77±0.4mm)and the SIBO positive treatment group after treatment(3.18±0.55mm)were compared between the two groups using the independent-sample T-test,t=3.735,P<0.05,and the difference was statistically significant.By comparing SIBO negative control group and SIBO positive treatment group several times,it can be concluded that:3.After 6 months of oral UDCA treatment,the improvement degree of gallbladder wall thickness(2.77±0.4mm)in the SIBO negative control group was significantly better than that in the SIBO positive treatment group(3.18±0.55mm)(T =3.735,P<0.05).Conclusion: SIBO can reduce the absorption and utilization of UDCA in the small intestine and reduce the clinical efficacy of UDCA in patients with chronic cholecystitis and gallstone. |
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