Table_2_Dietary fiber and probiotics based on gut microbiota targeting for functional constipation in children with cerebral palsy.XLSX

Gastrointestinal (GI) disorders are very common among children with cerebral palsy. Gut microbiota has been confirmed to maintain normal GI physiological function and further contributed to cerebral palsy through the gut-brain axis. Our study was to investigate the effect of dietary fiber combined with probiotics on functional constipated children with cerebral palsy. In total, 35 patient children were enrolled and divided into general diet group (n = 14) and liquid diet group (n = 21). All the participants received Compound Dietary Fiber (CDF) for 1 month and lactic acid-producing and butyric acid-producing probiotics for 6 months. After a 1-month intervention, the frequency of spontaneous and manual defecation, and Bristol score were all significantly improved (P < 0.001). The α-diversity of the gut microbiota was significantly increased after a 1-month intervention (P < 0.05), with a higher abundance of butyric acid-producing bacteria and a lower abundance of opportunistic pathogens (P < 0.05, FDR < 0.05). However, the impersistent effect of the 6-month intervention suggested the insufficient impact of intaking probiotics alone and the short duration of CDF intervention. Moreover, although the intervention had affected the constipation symptoms equally in cerebral palsy children with a general diet and liquid diet, the general diet group showed a greater and more durable change in gut microbiota and clinical phenotypes after intervention than the liquid diet group, which indicated that longer intervention time should be considered for liquid diet children. This study not only illustrated that supplementation of dietary fiber combined with probiotics can improve functional constipation in children with cerebral palsy, but also provides guidance for optimal intervention strategy for future studies, which will further benefit cerebral palsy children.
Clinical trial registration:http://www.chictr.org.cn/showproj.aspx?proj=46902, identifier: ChiCTR1900028257.

胃肠道（Gastrointestinal, GI）疾病在脑瘫儿童中极为常见。肠道菌群（Gut microbiota）已被证实可维持正常胃肠道生理功能，并通过肠-脑轴（gut-brain axis）参与脑瘫的发生发展。本研究旨在探讨膳食纤维联合益生菌对脑瘫功能性便秘患儿的干预效果。本研究共纳入35例患儿，分为普通饮食组（n=14）与流质饮食组（n=21）。所有受试者均接受复合膳食纤维（Compound Dietary Fiber, CDF）干预1个月，同时服用产乳酸及产丁酸益生菌6个月。干预1个月后，患儿的自主排便与辅助排便频率、布里斯托大便评分（Bristol score）均显著改善（P<0.001）。干预1个月后，肠道菌群的α多样性（α-diversity）显著升高（P<0.05），产丁酸菌丰度显著升高，条件致病菌丰度显著降低（P<0.05，错误发现率（False Discovery Rate, FDR）<0.05）。然而，6个月干预的效果并不持久，提示单独摄入益生菌的干预效果不足，且复合膳食纤维干预时长过短。此外，尽管普通饮食组与流质饮食组患儿的便秘症状均得到同等程度的改善，但干预后普通饮食组患儿的肠道菌群与临床表型的改变程度更显著、持续时间更久，提示流质饮食患儿需延长干预时长。本研究不仅证实膳食纤维联合益生菌补充可改善脑瘫患儿的功能性便秘，还为未来研究的最优干预策略提供了参考，将进一步惠及脑瘫儿童。
临床试验注册信息：http://www.chictr.org.cn/showproj.aspx?proj=46902，注册编号：ChiCTR1900028257。