乳果糖和益生菌治疗轻微型肝性脑病的对照研究  

A randomized-controlled trial to compare the effect of lactulose and probiotics on treatment of minimal hepatic encephalopathy

作　　者：赵新华[1] 冯琦[1] 章静[1] 蒋玉凤[2] 

机构地区：[1]四川省绵阳市中心医院消化内科,四川绵阳621000 [2]泸州医学院附属医院肝病科,四川泸州646000

出　　处：《实用医院临床杂志》2013年第4期61-63,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生厅科研基金资助项目(编号:080197)

摘　　要：目的探讨乳果糖和益生菌治疗轻微型肝性脑病(minimal hepatic encephalopathy,MHE)的疗效。方法患有MHE的肝硬化患者120例,按随机数字表法分为未治疗组(A组,仅接受肝硬化标准治疗)、乳果糖组(B组,每天2次30～60ml乳果糖)和益生菌组(C组,每天2次益生菌110亿菌落单位),共治疗1月,比较三组治疗效果、不良反应及血氨水平。结果 MHE改善情况:A组4例(10%)、B组13例(35%)、C组12例(30%),与A组比较,B、C组患者MHE显著改善(χ2=6.639,P=0.036),而B、C组间疗效差异无统计学意义(χ2=0.058,P=0.809)。A、B和C组分别有7、1、2例患者因显性肝性脑病住院,B、C组显性肝性脑病发生率显著低于A组(χ2=6.707,P=0.035)。A组的动脉血氨水平与B、C组比较差异有统计学意义(F=18.47,P=0.000),而B、C组间血氨差异无统计学意义(q=-1.627,P=0.111)。结论乳果糖、益生菌均能够显著改善肝硬化患者MHE的病情,并能预防显性肝性脑病的发生。Objective To compare the effect of lactulose and probioties on treatment of minimal hepatic encephalopathy （MHE）. Methods One hundred twenty patients with MHE were randomized divided into control group treated with standard therapy for hepatic cirrhosis, lactulose group treated with 30-60 ml/twice per clay ,and probiotics group treated with 110 billion colony forming units twice in a day for 1 months. The levels of arterial ammonia and psychometric tests were used to compare the clinical effect after one month of treatment. Results After one month of treatment,the rate of recovery was 10% in the control group,35% in the lactu- lose group and 30% in probioties group. The improvement in the ]actulose and probiotics groups was significantly better than that in the control group （P = 0. 036）. There was no significant change in arterial ammonia levels after therapy in the control group before and af- ter treatment. The arterial ammonia levels in the lactulose and probiotics groups were significantly lower than that in the control group after therapy （P = 0. 000）. However, no significant difference in arterial ammonia levels was found between the laetulose and probiot- ies groups after therapy. Hepatic encephalopathy was developed in 10 （8.26%） of 120 patients in which 7 （17. 50% ） in the control group,1 （2. 5% ） in the laetulose group and ：2 in the probiotic group. There was a significant difference between and the treatment groups and control group （P = 0. 035 ）. Conclusion Lactulose and probiotics significantly improve MHE and eventually reduce the incidence of hepatic encephalopathy.

关 键 词：乳果糖 益生菌 轻微型肝性脑病 

分 类 号：R575.2[医药卫生—消化系统] R975.5[医药卫生—内科学]