地衣芽孢杆菌治疗肝硬化患者的临床药效评价  

Clinical Evaluation of Bacillus Licheniformis in the Treatment of Liver Cirrhosis

作　　者：高璐[1] 于锋[2] 王坚[1] 

机构地区：[1]东南大学附属第二医院临床药学室,南京210003 [2]中国药科大学临床药学教研室,南京210009

出　　处：《药学与临床研究》2015年第2期127-130,共4页Pharmaceutical and Clinical Research

基　　金：江苏省药学会奥赛康临床药学科研项目(No.201010)

摘　　要：目的:评价肝硬化患者肠黏膜屏障功能、血氨和血内毒素的变化特点及地衣芽孢杆菌胶囊对肝硬化患者的影响。方法:选择60例肝硬化患者进行随机开放性对照试验,使用随机数字表法分为治疗组和对照组,给予保肝、利尿、支持治疗,治疗组在此基础上加用地衣芽孢杆菌胶囊(整肠生)治疗两周。比较两组治疗前后血二胺氧化酶(DAO)、D-乳酸(D-L)、内毒素(ETX)、氨及肝功能变化情况。结果:肝硬化患者血DAO、D-L、ETX、氨四项指标与标准参考值相比增高,并且都随肝硬化Child-Pugh评分升高而升高(0.4<r<0.7,t<0.01)。酒精与嗜肝病毒导致的肝硬化相比,前者DAO、D-L水平显著升高(P<0.01)。14天的治疗观察后复查两组肝功能无明显差异,然而治疗组DAO、D-L、EXT、氨较治疗前都显著下降(P<0.01)。治疗组停用整肠生后第14天复查总胆红素、DAO、D-L水平较停药前均无显著性差异(P>0.05)。在14天的观察期内,治疗组与对照组并发症发生率差异无统计学意义(13.3%vs 3.3%,P>0.0.5)。结论:地衣芽孢杆菌短期内治疗具有潜在保护肝硬化患者肠黏膜屏障的作用,从而降低循环血中的内毒素和氨水平。Objective: To investigate the function of intestinal mucosal barrier in patients with liver cirrhosis(LC) and explore the clinical efficacy and safety of Bacillus licheniformis in the treatment of LC patients. Methods: In a randomized open study, 60 participants with LC, in accordance with the random number table, were divided into experimental group and control group. Patients in the control group received hepatoprotective, diuretic and supporting treatment, and patients in the experimental group were given probiotic capsules containing Bacillus licheniformis(Zhengchangsheng capsules) besides the same general therapy for a period of 14 days. The changes of DAO, D-L, EXT and ammonia levels and liver function before or after treatment between the 2 groups were compared. Results: The levels of DAO, D-L, EXT and ammonia were higher in patients with LC than the reference values. The levels were also positively correlated with the Child-Pugh scores. The levels of DAO and D-L were significantly higher with alcoholic cirrhosis than with liver cirrhosis of hepatitis(P<0.01). Our study did not show a significant beneficial effect of probiotic supplementation to improve liver function in patients with LC. Nevertheless, the administration of probiotics appeared to significantly reduce the DAO, D-L, ETX and ammonia levels starting after14 days of treatment(P<0.01). Up to 14-day after probiotics withdrawal, total bilirubin, DAO and D-L did not rebound. There was no statistical difference in the incidence of complications between the 2 groups(13.3% vs 3.3%, P>0.05). Conclusions: Bacillus licheniformis could improve the function of intestinal mucosal barrier, reduce the absorption of enterological EXT and ammonia.

关 键 词：地衣芽孢杆菌 益生菌 肝硬化 肠黏膜通透性 内毒素 氨 

分 类 号：R969.4[医药卫生—药理学] R657.31[医药卫生—药学]