乳果糖口服液治疗慢性肾功能不全的临床观察

目的：观察乳果糖口服液治疗慢性肾功能不全的临床疗效。方法：收集2014年7月—2015年7月慢性肾功能不全患者38例,随机分为治疗组20例,采用乳果糖口服液治疗,对照组18例采用包醛氧淀粉治疗,两组均治疗8周。观察两组治疗后症状评分、血肌酐、尿素、尿酸指标的变化。结果：治疗组总有效率为45.0%（9/20）,对照组为44.4%（8/18）,组间差异无统计学意义（P＞0.05）。两组治疗后症状、体征和肾功能均较治疗前改善（P＜0.05）,但组间差异无统计学意义（P＞0.05）。结论：乳果糖口服液治疗轻、中度慢性肾功能不全有较好疗效。     

Understanding measurements of intestinal permeability in healthy humans with urine lactulose and mannitol excretion

Abstract  Our aim was to understand the information from differential two-sugar excretion (2-SE) in measuring intestinal permeability. In a crossover study in 12 healthy volunteers, we compared urinary excretion ratios of lactulose (L) to mannitol [(M) LMR] after ingestion in liquid formulation (LF) or in delayed-release, methacrylate-coated capsules (CAP). Both formulations were radiolabelled. Urine was collected every 2 h from 0 to 8 h, and from 8 to 24 h. Two hours after LF, gastric residual was 15.9 ± 6.2% (SEM), and the percentage in colon was 49.6 ± 7.8%; in 11/12 participants, liquid had entered colon within 2 h. Average CAP arrival time in colon was 5.16 ± 0.46 h (mode 6 h). After LF, mannitol was extensively absorbed in the first 8 h; lactulose absorption was low thoughout the 24 h. After the LF, the LMR (geometric mean, 95% CI per h) in the 0–2 h urine was [0.08 (0.05, 0.11)], which was lower than in 8–24 h urine [0.32 (0.16, 0.46); P  < 0.05]. Urine LMRs at 8–24 h were similar after LF or CAP. We concluded that, after LF, sugar excretion in 0–2 h urine may reflect both SI and colon permeability. Colonic permeability is reflected by urine sugar excretion between 6 and 24 h. CAP delivery reduces mannitol excreted at 0–6 h, compared with LF. The 0–5 or 6 h 2-SE urine likely reflects both SI and colon permeability; the higher LMR in the 8–24 h urine relative to 0–2 h urine should be interpreted with caution and does not mean that colon is more permeable than SI.     

Critical flicker frequency for diagnosis and assessment of recovery from minimal hepatic encephalopathy in patients with cirrhosis

BACKGROUND:Minimal hepatic encephalopathy (MHE) impairs quality of life and predicts overt hepatic encephalopathy (HE) in cirrhotic patients.Diagnosis of MHE requires cumbersome tests.Lactulose is effective in the treatment of MHE.This study aimed to evaluate the use of critical flicker frequency (CFF) for the diagnosis of MHE in cirrhotic patients after treatment.METHODS:One hundred and ten patients were evaluated by psychometry (number connection tests A,B or figure connection tests A,B),P300 auditory eve...     

多库酯钠治疗慢性功能性便秘的疗效分析

目的观察多库酯钠治疗慢性功能性便秘的疗效和安全性。方法按入组标准将60例功能性便秘患者随机分为2组。治疗组口服多库酯钠（100 mg,每天3次）治疗,对照组口服乳果糖（30 ml,每天1次）治疗,疗程2周。结果在用药1周后、用药2周后及治疗结束后1周,治疗组的大便次数及大便性状评分较对照组有统计学意义（P〈0.05）。两组临床疗效比较无统计学意义,但治疗组在用药1周后、用药2周后显效率显著高于对照组（P〈0.05）。两组不良反应的发生率均较低。结论多库酯钠治疗慢性功能性便秘临床效果明显,安全可靠。     

Abstracts of Articles on Calcium and Magnesium Metabolism in Osteoporosis

Objective: Proteins are degraded in the colon by bacterial fermentation into potentially toxic metabolites such as phenolic compounds. The aim of the present study was to investigate whether long-term administration of lactulose or Saccharomyces boulardii cells would result in a lower protein degradation. In addition, the influence of a long-term dietary intake on different gastrointestinal parameters was investigated.

Methods: The effect of long-term intervention of the substrates was evaluated in a randomized, cross-over study in 43 healthy volunteers. At the start of the study and at the end of each 4-week treatment period, urine was collected during 48 h in different fractions and faeces during 72 h. Breath test samples and blood samples were taken to study gastrointestinal parameters.

Results: No influence of long-term administration of both substrates was found on GE, OCTT and serum lipids. A significant decrease in small intestinal permeability was found after long-term dietary intervention with lactulose. Long-term administration of lactulose significantly decreased urinary p-cresol excretion, but did not lower fecal p-cresol excretion. No significant effects were observed after S. boulardii intake.

Conclusion: The results obtained in present study have indicated that colonic amino acid fermentation can be reduced by the administration of lactulose as a fermentable carbohydrate.     

枯草杆菌二联活菌联合乳果糖治疗儿童功能性便秘远期疗效观察

目的 探讨枯草杆菌二联活菌联合乳果糖治疗儿童功能性便秘（functional constipation,FC）的远期疗效。方法 选择180例儿童FC患者,按照治疗的方式不同分为联合组、乳果糖组和妈咪爱组,每组60例。3组均给予足量饮水、合理饮食、排便习惯训练、增加活动量、心理行为治疗,乳果糖组口服乳果糖,妈咪爱组口服枯草杆菌二联活菌多维颗粒剂,联合组口服枯草杆菌二联活菌多维颗粒剂和乳果糖,疗程8周,观察大便次数、性状、排便困难及疼痛情况,比较3组停药后3个月、6个月和12个月的复发率。结果 停药3个月,联合组、乳果糖组和妈咪爱组复发率分别为10.34%、30.00%和25.49%,联合组明显低于其他两组（P<0.05）;停药6个月,联合组、乳果糖组和妈咪爱组复发率分别为18.97%、52.00%和41.18%,联合组明显低于其他两组（P<0.05）;停药12个月,联合组、乳果糖组和妈咪爱组复发率分别为24.14%、58.00%和49.02%,联合组明显低于其他两组（P<0.05）;随访3、6、12个月,联合组患儿大便次数及性状恢复、排便困难及疼痛缓解情况优于乳果糖组和妈咪爱组（P<0.05）。结论 枯草杆菌二联活菌联合乳果糖治疗儿童FC,远期疗效显著,复发率低,具有一定的临床应用价值。     

乳果糖灌肠联合醒脑静治疗肝性脑病的效果观察

[目的]观察乳果糖灌肠联合醒脑静治疗肝性脑病的效果。[方法]将60例肝性脑病病人随机分为对照组和观察组,每组30例,两组均给予常规治疗,观察组在常规治疗基础上应用乳果糖灌肠联合醒脑静治疗。比较两组病人治疗效果。[结果]观察组总有效率为83.4%,对照组为63.4%,观察组总有效率高于对照组（P〈0.05）;两组病人治疗后血氨水平下降,且观察组低于对照组（P〈0.05）。[结论]乳果糖灌肠联合醒脑静治疗肝性脑病的效果优于单纯常规治疗。     

尿乳果糖/甘露醇比值与肠脂肪酸结合蛋白检测对脓毒症患者肠壁损伤的临床意义

目的 评价尿中乳果糖/甘露醇比值(LMR)和肠脂肪酸结合蛋白(IFABP)检测对脓毒症患者肠屏障功能损伤的诊断价值以及对患者病情严重程度和预后的评估作用.方法 选择首都医科大学附属北京友谊医院中心重症监护病房(ICU)2007年6月-2008年2月收治的38例脓毒症患者,确诊72 h内留取尿样,应用高压液相色谱仪-脉冲电化学检测器测定尿LMR值,用酶联免疫吸附法(ELISA)测定尿IFABP浓度,分别按急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分不同分值、是否合并多器官功能障碍综合征(MODS)及28 d转归分组,比较两种检测指标的差异,并对两者及胃肠功能评分进行相关性分析.结果 38例脓毒症患者尿LMR、IFABP均明显增高.APACHEⅡ评分>20分组尿LMR高于≤20分组(P=0.056);合并MODS组及死亡组尿LMR分别高于未合并MODS组与存活组(P均<0.05).APACHEⅡ评分>20分组、合并MODS组、死亡组尿IFABP浓度分别与APACHEⅡ评分≤20分组、未合并MODS组、存活组比较差异无统计学意义.存在应激性溃疡组尿IFABP浓度较无应激性溃疡组明显增高(P<0.05).LMR、IFABP、胃肠功能评分间均无显著相关性.结论 脓毒症患者存在肠上皮细胞损伤和肠黏膜通透性增高;尿LMR增高对判断患者病情及预后有一定指导作用;尿IFABP浓度与患者病情严重程度及预后无明显相关性;肠黏膜上皮损伤重者尿IFABP浓度也高;LMR、IFABP、胃肠功能评分三者无明显相关关系.     

首荟通便胶囊预防肝胆胰恶性肿瘤化疗后便秘的疗效观察

目的:探讨首荟通便胶囊预防肝胆胰恶性肿瘤化疗后便秘的临床疗效。方法:选取2016年8月至2018年8月河北医科大学第二医院肝胆外科收治的老年肝胆胰恶性肿瘤化疗患者80例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组40例。对照组口服乳果糖口服液,观察组在对照组基础上加服首荟通便胶囊。治疗14 d后,比较2组的临床疗效。结果:中医病症临床疗效观察,对照组总有效率达到75%;观察组,总有效率达到90%,2组比较差异有统计学意义(P<0.05)。临床症状评分观察,对照组总有效率达到77.5%;观察组总有效率达到92.5%,2组比较差异有统计学意义(P<0.05)。排便评分(VAS评分)观察,治疗后对照组排便间隔时间和每次排便时间均长于观察组,2组VAS评分比较,差异均有统计学意义(P<0.05)。结论:首荟通便胶囊可以有效预防肝胆胰恶性肿瘤化疗后的便秘,有效缓解患者排便疼痛程度,减少排便时间,效果显著,值得临床推广。     

肝硬化患者肠通透性及乳果糖对其影响的研究

研究肝硬化患者肠通透性特点;肠通透性与内毒素血症的关系以及乳果糖对肠通透性和内毒素血症的作用。实验分两部分,第一部分研究肝硬化患者肠通透性特点。肝硬化组测定血二胺氧化酶(d iam ine oxidaseDAO)、血内毒素。正常对照组检查血二胺氧化酶。第二部分行乳果糖干预治疗的研究。入选的肝硬化患者随机分乳果糖治疗组和非乳果糖治疗组,两周后重复检查血清DAO和血清内毒素。肝硬化患者内毒素血症阳性率为73.8%,血DAO水平均较正常对照增加,血清内毒素水平与血DAO水平呈线性正相关。腹水患者较无腹水者血DAO和血内毒素水平高,组间有显著性差异。乳果糖治疗后血清DAO水平及血内毒素水平较治疗前有显著降低。