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心油心理健康中心
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自閉症與腸道
兒童自閉症（autism）也稱孤獨症，起於嬰幼兒時期的一種嚴重的廣泛性發育障礙，主要表現出三大症狀：社交障礙、交流障礙、刻板行為及興趣。近年來歐美學者傾向於稱之為自閉症譜系障礙（autism spectrum disorder, ASD），除自閉症外，還包括不典型自閉症、Asperger綜合征、Rett綜合征、兒童瓦解性精神障礙和其他未分類的廣泛性發育障礙等。有的患者在6-24月就表現出孤獨症症狀，但也有患者前期發育正常，在2-3歲時出現退行性變化，語言和社交技能喪失。 自閉症曾一直被認為是不治之症，過去的治療也都是對症治療而非對因治療，治療目標是希望患者日後能夠正常獨立生活，比如對於食物過敏的孩子進行禁食，對於不願意交流的孩子進行行為訓練，但只有少數患者能達到這一目標。新世紀以來，腸道微生物的研究給這一領域科帶來了希望。 腸道微生物在自閉症的發生中發揮著重要作用，異常的微生物及其引起的異常代謝和菌-腸-腦軸異常發育和功能可能是自閉症的主要病理機制。而及時恢復健康菌群，才能改善代謝和免疫，調節菌-腸-腦軸功能，糾正大腦和行為異常。 自閉症孩子攜帶的微生物明顯不同於健康兒童。腸道微生物發生了異常變化：不管是腸道細菌，真菌，甚至病毒，都明顯不同於健康孩子。 其他部位微生物異常：口腔微生物變化，有害細菌增加，比如唾液中嗜血桿菌屬和牙菌斑中鏈球菌屬，而有益的普氏菌屬和月形單胞菌屬等細菌減少；尿液微生物變化，如鏈球菌書增加而假單胞菌屬減少；皮膚微生物也可能發生了變化。 自閉症孩子的代謝存在異常。腸道微生物影響個體的代謝組，異常的腸道微生物往往引起代謝問題，最直觀的表現是口臭，大便臭，有體味等。自閉症孩子普遍存在胃腸道問題，大部分孩子會偏食挑食，還可能出現腹瀉、腹痛和便秘等問題。 自閉症孩子菌-腸-腦軸發育異常。自閉症不僅僅是一種神經或心理障礙，除了認知行為障礙和大腦發育異常，患者往往出現全身症狀，比如菌群異常，胃腸道症狀，免疫異常（食物不耐受和慢性炎症）等。 恢復健康菌群，能改善代謝異常和菌-腸-腦軸功能，調節大腦和行為發育，糾正自閉症的絕大部分生理和心理異常。目前已經發現，特定乳酸菌和糞便菌群抑制能明顯改善自閉症症狀。 腸道微生物發育與大腦發育同步，腸道微生物發育情況影響大腦發育和行為發展。發育不同階段擾亂腸道微生物，不僅會引起生理疾病，更可能引發神經和心理疾病。而通過飲食、益生菌和糞便菌群移植等方式及時重建健康菌群，則能改善甚至糾正這些異常。 金鋒實驗室的研究也發現，正確的方法是完全可以讓自閉症逆轉康復的。補充特定乳酸菌，調整飲食，減少食物中可能破壞菌群的因素，比如加工食品點心和飲料，對自閉症孩子的消化免疫和行為情緒均有明顯改善。
文章作者：梁珊博士
香港腸道微生態心理健康中心的個案分享
從2020年起至今，大部份參與計劃的孩子也有非常好的改善。可以說多多的是。我們也觀察到，除了小孩進步明顯，過10歲，甚至20歲以上的參與者也有相當的進步。
4歲男孩來的時候說話遲緩，主要是跟講，句子大多只有2-3個字，亦不肯定他明白別人說話與否；沒有眼神交流，只喜歡獨個兒玩，像生活在只有自己的世界𥚃；情緒很差，很容易就大爆脾氣，也不論身在何方，情緒要爆就爆，有時有情緒時就破壞家裡的東西，在外面吃飯一不喜歡就把飯菜掉到地上，不時大叫；大小便也要用尿片；睡眠很差，每晚醒1-2次，每次要1-2小時才能再入睡；食量很少；去每個地方都要堅持路線，坐那種交通工具，坐那部電梯每次也要一様；老師說他在學校上課時不時離開坐位，也不能專心上課。 孩子一個月後說話已經較能表達自己想要什麼，句子長了，情緒明顯改善受控，大便由原來三天一次變為每日一次；跟家人互動多了，常常要跟爸爸及媽媽玩，亦曉得模仿別人。父母都說：「孩子像是醒了。」；睡眠已沒有夜醒了；媽媽說食量變得正常了；專注有進步亦坐得定一些；現在排隊久了也不生氣。 現在六個月了，各方面進步非常大。媽媽說現在帶孩子上街，根本沒有人能看出他曾是特殊需要孩子。現在說話雖然比之前進步了非常多，但亦有進步空間，因說話是要說得多，聽得多才說得流利。而孩子現在非常有興趣學說話，媽媽希望他在句子運用上能更快追到他的歲數。 媽媽及爸爸說孩子這半年的改變真的很大，看見孩子這樣進步，他們都說這是上天給他們最好的禮物。'
Gut Microbiota and Autism
Autism, commonly referred to as autism, is a neurodevelopmental disorder that begins in early childhood. It is characterized by three main symptoms: speech, social difficulties, cognitive and behavior challenges, and repetitive behaviors or interests. Recently, researchers in Europe and America have begun to refer to it as Autism Spectrum Disorder (ASD), which encompasses not only autism but also atypical autism, Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and other unspecified pervasive developmental disorders. Some children exhibit symptoms as early as 6 to 24 months, while others may develop normally and then experience regression at ages 2 to 3, losing language and social skills.
Autism was once considered untreatable, and past therapies mainly focused on symptom management rather than underlying causes. Treatment goals aimed to help individuals lead independent lives, such as restricting foods for children with allergies or behavioral training for those reluctant to communicate, but only a few achieved this goal. However, research into gut microbiota in the new century has brought hope to this field.
Gut microbiota plays a crucial role in the onset of autism. Abnormal microbiota and related metabolic issues, along with dysfunction in the gut-brain axis, may be primary mechanisms behind autism. Timely restoration of healthy gut flora is essential to improve metabolism and immune function, regulating the gut-brain axis and correcting brain and behavioral abnormalities. The microbiota present in autistic children is significantly different from that of healthy children, with notable changes in gut bacteria, fungi, and even viruses.
Additional microbiota abnormalities occur in other areas: oral microbiota changes show an increase in harmful bacteria, such as Haemophilus in saliva and Streptococcus in plaque, while beneficial bacteria like Propionibacterium and Bifidobacterium decrease; urine microbiota shows increased Streptococcus and decreased Pseudomonas; skin microbiota may also change.
Children with autism often exhibit metabolic abnormalities. Gut microbiota influences individual metabolic profiles, and abnormal gut flora can lead to metabolic issues, often presented through symptoms like bad breath and foul stools. Gastrointestinal problems are common in autistic children, many of whom are picky eaters and may experience diarrhea, abdominal pain, or constipation.
The development of the gut-brain axis is often abnormal in autistic children. Autism is not merely a neural or psychological disorder; in addition to cognitive and developmental challenges, patients frequently exhibit systemic symptoms, including imbalances in microbiota, gastrointestinal issues, and immune irregularities (food intolerances and chronic inflammation).
Restoring healthy gut flora can improve metabolic issues and gut-brain axis function, regulating brain and behavioral development and correcting most physiological and psychological abnormalities associated with autism. Research has shown that specific lactobacilli and fecal microbiota transplants can significantly improve autism symptoms.
Gut microbiota development synchronizes with brain development; thus, its condition affects brain growth and behavioral development. Disruption at various developmental stages can lead not only to physical ailments but potentially to neurological and psychological disorders. Promptly rebuilding healthy flora through diet, probiotics, and fecal microbiota transplantation can improve or even correct these abnormalities.
Studies from Prof. Jin Feng's team from The Chinese Academy of Sciences have also found that, with the right approach, autism can be effectively reversed. Supplementing with specific lactobacilli, adjusting the diet, and reducing factors that may disrupt gut flora, such as processed foods and sugary beverages, can lead to significant improvements in digestion, immunity, behavior, and emotional health in children with autism.
Author: Dr. Shan Liang
Below is One of the Cases: A 4-Year-Old Boy
When the 4-year-old boy first arrived, his speech was delayed. He primarily communicated in short phrases of 2 to 3 words and it was uncertain whether he understood what others were saying. He had no eye contact and preferred to play alone, as if living in his own world. His emotions were volatile, leading to frequent outbursts, regardless of where he was. If he felt upset, he would sometimes destroy things at home, and at restaurants, he would throw food on the floor and yell if he didn’t like something. He still needed to use diapers for bowel movements, had poor sleep, waking up 1 to 2 times a night and taking 1 to 2 hours to fall back asleep. His appetite was minimal; he insisted on specific routes to get anywhere and preferred the same form of transportation and elevator each time. Teachers reported that he often left his seat during class and struggled to concentrate.
One month later, his speech improved significantly, allowing him to express his wants more clearly, with longer sentences. His emotional control was markedly better, and bowel movements changed from once every three days to daily. He interacted more with family, frequently wanting to play with his parents, and he began to imitate others. His parents remarked, “It’s like our child has woken up.” His sleep issues were resolved, and his appetite normalized. He showed improved focus and was able to sit still for longer periods. He no longer gets upset when waiting in line.
Now, six months later, his progress has been remarkable. His mother mentioned that when they go out, no one can tell he was once a child with special needs. Although his speech has improved significantly, there is still room for growth, as fluency develops with more speaking and listening practice. He is highly interested in learning to speak, and his mother hopes he can quickly catch up with his peers in sentence usage.
His parents expressed that their child’s transformation over the past six months has been substantial, and seeing his progress feels like the best gift from God.
Sharing from the Hong Kong Gut Microbiota Mental Health Centre
Since 2020, most of the children participating in the program have shown significant improvement. This is certainly noteworthy. We have also observed substantial progress not only in younger children but also in participants over 10 and even over 20 years old. Below are some case studies:
從2020年起至今，大部份參與計劃的孩子也有非常好的改善。可以說多多的是。我們也觀察到，除了小孩進步明顯，過10歲，甚至20歲以上的參與者也有相當的進行。下面是個案分享：
個案: 在香港的4歲男孩
從2020年起至今，大部份參與計劃的孩子也有非常好的改善。可以說多多的是。我們也觀察到，除了小孩進步明顯，過10歲，甚至20歲以上的參與者也有相當的進行。下面是個案分享：
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Since 2020, most of the children participating in the program have shown significant improvement. This is certainly noteworthy. We have also observed substantial progress not only in younger children but also in participants over 10 and even over 20 years old. Below are a case study:
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Below is One of the Cases: A 4-Year-Old Boy
When the 4-year-old boy first arrived, his speech was delayed. He primarily communicated in short phrases of 2 to 3 words and it was uncertain whether he understood what others were saying. He had no eye contact and preferred to play alone, as if living in his own world. His emotions were volatile, leading to frequent outbursts, regardless of where he was. If he felt upset, he would sometimes destroy things at home, and at restaurants, he would throw food on the floor and yell if he didn’t like something. He still needed to use diapers for bowel movements, had poor sleep, waking up 1 to 2 times a night and taking 1 to 2 hours to fall back asleep. His appetite was minimal; he insisted on specific routes to get anywhere and preferred the same form of transportation and elevator each time. Teachers reported that he often left his seat during class and struggled to concentrate.
One month later, his speech improved significantly, allowing him to express his wants more clearly, with longer sentences. His emotional control was markedly better, and bowel movements changed from once every three days to daily. He interacted more with family, frequently wanting to play with his parents, and he began to imitate others. His parents remarked, “It’s like our child has woken up.” His sleep issues were resolved, and his appetite normalized. He showed improved focus and was able to sit still for longer periods. He no longer gets upset when waiting in line.
Now, six months later, his progress has been remarkable. His mother mentioned that when they go out, no one can tell he was once a child with special needs. Although his speech has improved significantly, there is still room for growth, as fluency develops with more speaking and listening practice. He is highly interested in learning to speak, and his mother hopes he can quickly catch up with his peers in sentence usage. His parents expressed that their child’s transformation over the past six months has been substantial, and seeing his progress feels like the best gift from God.