枯草杆菌肠球菌二联活菌胶囊对非酒精性脂肪性肝炎肠道菌群失调的干预作用  

Intervention effect of microbiological capsules containing Bacillus subtilis and Enterococcus on intestinal flora in patients with NASH

作　　者：杨林辉[1] 郭华[1] 蔡俊[1] 蔡晓伟[1] 刘贵伦[1] 陈东风[2] 

机构地区：[1]武警重庆市总队医院,重庆市400061 [2]中国人民解放军第三军医大学附属大坪医院消化内科,重庆市400042

出　　处：《世界华人消化杂志》2012年第20期1873-1878,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨枯草杆菌肠球菌二联活菌胶囊对非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)患者肠道菌群失调的干预作用.方法:选择肠道菌群中具有代表性的细菌共8种(肠杆菌、肠球菌、葡萄球菌、双歧杆菌、乳杆菌、拟杆菌、梭菌、酵母样真菌)进行培养和计数,检测所有被研究者的血清内毒素、TNF-α、IL-6和ALT的浓度.选择健康正常成人30例作为正常对照组(A组),NASH共60例,随机分为常规治疗组(B组)和观察组(C组)各30例,B组采用常规保肝治疗,C组常规保肝治疗的同时联用枯草杆菌肠球菌二联活菌胶囊治疗,治疗4wk,比较各组治疗前后肠道细菌数量的变化和内毒素、TNF-α、IL-6、ALT的变化,并比较B组和C组治疗后临床症状的缓解情况.结果:与A组比较,治疗前NASH组肠杆菌显著增多(7.28±1.22 vs 6.54±1.08,t=4.83,P<0.01),而双歧杆菌、乳酸杆菌、拟杆菌显著减少(7.13±1.28 vs 8.83±1.24,t=-6.65,P<0.01;6.67±1.21 vs 7.31±1.12,t=-2.16,P<0.05;6.99±1.31 vs 7.82±1.15,t=-2.41,P<0.05);血清中内毒素、IL-6、TNF-的浓度显著增高(168.37EU/L±24.13EU/L vs 110.53EU/L±18.33EU/L,t=11.69,P<0.01;42.62ng/L±12.65ng/L vs 21.58ng/L±8.47ng/L,t=7.71,P<0.01;15.98ng/L±3.19ng/L vs 8.63ng/L±2.49ng/L,t=11.97,P<0.01);C组治疗后与治疗前比较双歧杆菌、乳杆菌、拟杆菌的数量显著增多(P<0.01),肠杆菌的数量显著减少(P<0.05),血清中内毒素、TNF-α、IL-6、ALT的浓度显著降低(P<0.01),C组治疗后临床症状较B组有显著改善.结论:NASH患者存在肠道菌群失调、革兰氏阴性杆菌过度生长,提示肠道微生态失衡可能参与了NASH的发生发展.枯草杆菌肠球菌二联活菌胶囊可明显改善NASH肠道菌群失调,降低血清中内毒素、TNF-α、IL-6、ALT的水平,改善临床症状.AIM： To investigate the interventional effect of microbiological capsules （Medilac-S） containing Bacillus subtilis and Enterococcus on intestinal flora in patients with nonalcoholic steatohepati- tis （NASH）. METHODS： Thirty healthy adults and sixty pa- tients with NASH were included, and they were divided into three groups： group A （30 healthy adults, control group）, group B （30 patients, treated with basic drugs）, and group C （30 pa- tients, treated with basal drugs and Medilac-S）.Eight types of representative bacteria of the in- testinal flora were cultivated and counted, and the levels of serum endotoxin, TNF-（z, IL-6 and ALT was determined in all groups before treat- ment and 4 wk after treatment.

关 键 词：非酒精性脂肪性肝炎 枯草杆菌 肠球菌 微生态制剂 肠道菌群 内毒素 

分 类 号：R575.5[医药卫生—消化系统]