整肠生对新型冠状病毒肺炎患者细胞因子水平和临床预后的影响

目的: 探讨整肠生（地衣芽孢杆菌活菌胶囊）改善新型冠状病毒肺炎（coronavirus disease-19, COVID-19）患者高细胞因子水平和临床预后的效果，为临床开展肠道微生态疗法提供实验依据。方法: 回顾性分析2020年2月至3月武汉市同济医院中法新城院区收治的38例成年重症/危重症COVID 19患者，其中，18例患者接受了整肠生治疗（治疗组），20例患者未接受整肠生治疗（对照组）。两组患者除接受常规治疗外，治疗组患者每天还服用整肠生以调节肠道微生态。记录两组患者临床基本特征，治疗前后白细胞、淋巴细胞及血小板计数，TNF-α、IL-1β、IL-6、PCT、CRP、ALT、白蛋白和肌酐水平，以及临床预后指标。结果： 治疗2周后，治疗组和对照组患者外周血中淋巴细胞计数明显高于治疗前（P<0.01），血清C反应蛋白水平显著低于治疗前（P均<0.01），但两组患者间淋巴细胞计数和C反应蛋白差异无统计学意义（P>0.05）。经整肠生治疗2周后，治疗组患者血清中TNF α和IL-1β水平显著低于治疗前，并低于对照组（P<0.05），但是两组患者的临床结局尚无显著差异（P>0.05）。结论： 整肠生可以降低COVID 19患者血清中TNF-α和IL-1β水平，但尚未观察到患者临床结局的显著改善。

Effect of Bacillus licheniformis Capsule on the cytokines level and clinical prognosis of COVID-19 patients

Objective: To investigate the drug of Bacillus licheniformis Capsule (BLC) to improve the high levels of cytokines and clinical prognosis in COVID-19 patients, and to provide the clinical evidence for gut microflora therapy in COVID-19. Methods: A retrospective analysis of 38 cases of adult severe COVID-19 patients admitted from February to March 2020，among whom 18 patients received BLC treatment and 20 did not. All patients received regular treatment, the treatment group taking additional BLC treatment every day to improve gut microflora. The basic clinical characteristics and prognosis were recorded in this experiment, as well as counts of white blood cells, lymphocytes, platelets and level of TNF-α, IL-1β, IL-6, PCT, CRP, ALT, albumin and creatinine before and after treatment. Results: After two weeks of treatment, the BLC treatment group and the control group in peripheral blood lymphocyte count was significantly higher than before treatment (P<0.01), serum-CRP levels were significantly lower than before treatment (P<0.01). There was no significant differences in peripheral blood lymphocyte count and serum-CRP levels between the two groups (P>0.05). After BLC treatment for two weeks, TNF-α and IL-1β levels of serum in the BLC treatment group were significantly lower than before treatment, and lower than the control group (P<0.05). But, there were no significant differences in clinical prognosis in two groups (P>0.05). Conclusion: BLC could reduce the levels of TNF-α and IL-1β in serum of COVID-19 patients, but we do not observe a significantly improve of clinical prognosis in patients.