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  • 兒科醫生:盲目補充益生菌增風險 合理補充促健康
    2019年07月05日 16:56 來源:中新網重慶

      中新網重慶新聞7月5日電(通訊員 劉嘉)現在,益生菌制劑非常火,幾乎所有家長都會為孩子常備益生菌。不管孩子便秘還是拉肚子,胃口不好還是感冒發燒,通通都用益生菌。益生菌真有這么萬能?

      益生菌是對人體“友好、有益”的細菌

      說到菌,很多人第一個想到的是細菌,而且總習慣性地認為細菌有害,其實不然。健康的腸道菌群可以抑制病原菌的入侵,刺激免疫功能發育,合成營養物質等。這些一定數量的、能夠對宿主健康產生有益作用的、活的微生物便是益生菌。

      值得一提的是,我們是否從產道出生、是否母乳喂養、輔食的添加、飲食的結構、環境的改變、抗菌藥物的使用都對我們能否建立健康腸內菌群是有關的。

      益生菌盲目補充增加風險

      講到這里,不少家長應該對益生菌燃起了熊熊的期盼。其實,對于補充益生菌,我們要辨證地看。如果孩子腸道菌群不健康,通過補充益生菌,可能會有助腸道菌群重新實現平衡,從而恢復身體健康。

      但盲目補充益生菌,不僅不會有益處,而且部分學者也擔心引發條件性感染(比如免疫功能低下)、過敏反應、可能導致耐藥基因的傳播等問題,反而可能影響孩子健康。

      健康的孩子 無需額外補充益生菌

      對于健康的人群,不論兒童還是成人,是沒有必要額外補充益生菌的,因為咱們能自然的獲取益生菌:

      1.在正常情況下,順產的寶寶在分娩過程中,會從健康媽媽的產道中獲得有益菌群;

      2.母乳含有活性乳桿菌和雙歧桿菌,可以作為持續為寶寶提供益生菌的來源;

      3.飲食結構:增加含膳食纖維豐富的蔬菜、水果、全谷類、粗糧的攝入,減少高油高脂飲食,有助于建立健康的腸道菌群。

      這些益生菌會在腸道內不斷繁殖,并形成腸道保護膜。因此,對于順產、母乳喂養、飲食結構健康孩子來說,健康狀態下我們不需要額外補充益生菌。

      5類寶寶 可在醫生指導下補充益生菌

      健康的孩子無需補充益生菌,那么,什么時候我們該給孩子補充益生菌呢?中華預防醫學會微生態學分會兒科學組的《益生菌兒科臨床應用循證指南》指出:嬰幼兒或兒童的以下疾病有益,可以在醫生的指導考慮進行補充:

      1.胃腸道疾病:兒童腹瀉病、抗生素相關腹瀉、化療相關腹瀉、炎癥性腸病、腸激惹綜合征、功能性便秘;乳糖不耐受、幽門螺桿菌感染的治療;

      2.肝膽疾病:膽汁淤積性肝病、肝硬化;

      3.新生兒疾病:新生兒壞死性小腸結腸炎、新生兒黃疸、早產兒喂養不耐受;

      4.過敏性疾病:預防與治療;

      5.健康促進:反復呼吸道感染的預防、腹瀉病的預防

      但需要指出的是:

      1.不要違背醫囑隨意更換或增加益生菌:某一菌株的治療作用并不代表本屬或種的益生菌均具有這一作用。不同的菌株發揮作用所需的劑量不同,甚至同一菌株針對不同的疾病所需的劑量也可能不同,并且尚無證據證明多種益生菌聯合使用較單一藥物有更好的臨床療效。

      2.小心抗生素殺死益生菌:益生菌為活的微生物,應避免與抗生素同時服用。若需同時應用抗生素,應加大益生菌劑量或錯開服藥時間,最好間隔2~3 h以上。布拉酵母菌、酪酸梭菌和芽胞桿菌制劑對抗生素不敏感,可以與抗生素同時使用。

      3.排查過敏原:部分益生菌輔劑中含有牛奶成分,對于牛奶過敏的患兒則會發生過敏癥狀;有的益生菌中含有能誘發炎癥的麩質蛋白,可能會加重乳糜瀉患者的病情

      目前,即便在全球范圍內,益生菌的在不同疾病中的應用仍然存在爭議。因此,建議在醫生指導下進行合理補充,隨意購買和使用益生菌事倍功半還增加不必要的風險。

    -
    【編輯:馬佳欣】
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