枯草杆菌二联活菌肠溶胶囊对肝硬化患者肠道屏障功能及肝功能的影响

目的探讨枯草杆菌二联活菌肠溶胶囊对肝硬化失代偿期患者肠道屏障功能及肝功能状态的影响,为肝硬化患者肠道屏障功能的维护提供实验依据。方法将40例肝硬化患者随机分为对照组和观察组各20例,对照组给予常规保肝、利尿、降门静脉压力治疗和一般对症支持处理;观察组在对照组治疗基础上加用枯草杆菌二联活菌肠溶胶囊治疗。在治疗前后分别测定血清内毒素及尿液乳果糖/甘露醇排出比(L/M),同时测定血清白蛋白(ALB)、天门冬氨酸转移酶(AST)、总胆红素(TBIL)水平,并以Child-pugh分级进行评分。结果治疗前,观察组和对照组的血清内毒素水平、尿液L/M比值及血清ALB、AST和TBIL水平、Child-pugh评分差异均无统计学意义(P>0.05)。治疗后,观察组和对照组的血清内毒素水平、尿液L/M比值、血清AST和TBIL水平均较治疗前降低,差异均有统计学意义(P<0.05);治疗后血清ALB水平与治疗前比较差异无统计学意义(P>0.05)。治疗后,观察组的血清内毒素水平、尿液L/M比值、血清AST水平及Child-pugh评分均低于对照组,差异均有统计学意义(P<0.05);但2组的血清ALB和TBIL水平差异无统计学意义(P>0.05)。结论枯草杆菌二联活菌肠溶胶囊联合常规治疗可有效保护肝硬化患者的肠道屏障功能,降低肠道通透性,对肝硬化患者肝功能的恢复有一定辅助作用。

Effect of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on gut barrier and liver function of cirrhotic patients

Objective To explore the effect of the lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on gut battier and liver function of decompensated cirrhotic patients,and to obtain an experimental evidence for protecting the gut barrier function in patients with liver cirrhosis.Methods Forty patients with liver cirrhosis were randomly divided into observation group and control group,20 patients in each group.The control group was given conventional hepatoprotective,diuretic,reducing portal vein pressure treatment and general symptomatic and supportive treatment;based on these,the observation group was given the lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsule.The serum levels of endotoxin,the ratios of lactulose/mannitol(L/M) in urine,and the serum levels of the albumin(ALB),aspartate aminotransferase(AST) and total bilirubin(TBIL) were measured before and after treatment.At the same time,the Child-pugh scores were detected.Results Before treatment,there were no statistical differences in serum endotoxin levels,L/M ratios,serum ALB,AST,TBIL levels and Child-pugh scores between the observation group and the control group(P>0.05).The serum endotoxin levels,urinary L/M ratios,serum levels of AST and TBIL were reduced after treatment both in the observation group and the control group,the differences were statistically significant(P<0.05).However the difference of serum ALB levels before and after treatment were not statistically significant(P>0.05).After treatment,the serum endotoxin levels,urinary L/M ratios,serum levels of AST and Child-pugh scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,there were no significant differences in the levels of serum ALB and TBIL between two groups(P>0.05).Conclusion The combined therapy of the lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules and general treatment can effectively protect the gut barrier of cirrhotic patients by reducing gut permeability,and asist the restoration of the liver function.