关键词: 超重；肥胖症；儿童；复合肠道微生态制剂；膳食, 低碳水化合物；瘦素；脂联素；食欲

Abstract: Background　Childhood obesity has become a worldwide public health problem.Clinical treatment is mainly based on dietary and exercise intervention，while drug or surgical treatment is not recommended.But children showed poor compliance with dietary and exercise intervention caused by severe hunger ect..Intestinal microecological disorder is considered to be a key factor leading to simple obesity and metabolic disorder in children.Objective　To study the effect of the combination treatment of intestinal microecological preparations and modified low-carbonhydrate diet on children appetite，body fat metabolism and gastrointestinal reactions.Methods　74 overweight or simple obese children admitted to Shenzhen Hospital of Southern Medical University from January 2017 to September 2019 were selected as study objects.The samples were divided into intervention group（n=36） and control group（n=38） according to random assignment.Behavioral intervention was used in both groups.The intervention group was treated with combination of compound intestinal microecological preparation and modified low-carbonhydrate diet，supplemented with bifidobacterium triplets + compound glutamine enteric capsule + calcium carbonate + multidimensional element tablets to basic treatment，while the control group was simply treated with calorie restrict balanced diet.Intervention lasted for 6 weeks for both groups.The indicator of blood lipid〔serum triglyceride（TG），total serum cholesterol（TC），high-density lipoprotein（HDL），low density lipoprotein（LDL）〕，leptin（LP），adiponectin（ADPN），body mass index（BMI），body fat mass，muscle mass，degree of hunger，and the incidence of gastrointestinal reactions were compared between the two groups.Results　The results of TC，HDL，LDL at post-intervention between the two groups were not statistically significant（P>0.05）.TG in the intervention group was lower than in control group after intervention（P<0.05）.LP level，BMI，and body fat mass were lower in the intervention group than in control group after intervention，while ADPN was higher than in controls（P<0.05）.There was no statistically significant difference in muscle mass between the two groups after intervention（P>0.05）.LP，BMI，body fat mass at post-intervention in both groups were lower than those at pre-intervention，while ADPN was higher than pre-intervention（P<0.05）.There was statistical evidence for difference in degree of hunger between the two groups at post-intervention（P<0.05）.The incidence of constipation in the intervention group at post-intervention was lower than in controls（P<0.05），while there was no statistically significant difference in the incidence of diarrhea and abdominal pain between the two groups at post-intervention （P>0.05）.The incidence of constipation at the end of intervention was lower than pre-intervention （P<0.05）.Conclusion　Combination of compound intestinal microecological preparation and modified low-carbonhydrate diet could promote the body fat metabolism in children and reduce the incidence of gastrointestinal reactions such as constipation by regulating the LP level and ADPN.It could also increase the sense of satiety and reduce degree of hunger in children by blocking the possible mechanism of gut-cerebral axis-anorexia peptide.Further research on its mechanism shall provide basis and ideas for the intervention treatment of simple childhood obesity with the combination of intestinal microecological preparation and diet regulation.

Key words: Overweight；Obesity；Child；Compound intestinal microecological preparation；Diet, carbohydrate-restricted；Leptin；Adiponectin；Appetite