双歧三联活菌联合乳果糖治疗肝硬化肠源性内毒素血症的疗效观察  

Effect of bifidobacterium triple viable combined with lactulose in treating enterogenous endotoxemia inpatients with hepatic cirrhosis

作　　者：郑三菊[1] 王小华[1] 

机构地区：[1]湖北医药学院附属人民医院肝病科,湖北十堰442000

出　　处：《临床消化病杂志》2015年第3期138-141,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]观察双歧三联活菌联合乳果糖治疗肝硬化肠源性内毒素血症的疗效。[方法]86例肝硬化患者随机分对照组(40例)和治疗组(32例)。2组均给予常规综合治疗,观察组在常规综合治疗基础上给予双歧三联活菌胶囊联合乳果糖口服治疗;2组疗程均为3周。比较2组治疗后肝功能、凝血功能、血清内毒素(ET)、血氨、肿瘤坏死因子-!(TNF-!)、白细胞介素-6(IL-6)水平变化。[结果]治疗后观察组白蛋白(ALB)、凝血酶原活动度(PTA)较对照组升高(P<0.05),血清总胆红素(TBil)、ET、血氨、TNF-!、IL-6较对照组明显降低(P<0.01);观察组总有效率为87.0%,优于对照组的67.5%(P<0.05)。[结论]双歧三联活菌联合乳果糖能够降低肝硬化患者ET和血氨,通过下调促炎因子TNF-!和IL-6水平,以达到缓解肝脏炎症、改善肝功能和凝血功能的作用。[Objective]To observe the clinical efficacy of bifidobacterium triple viable combined with lactulose in treating enterogenous endotoxemia in patients with hepatic cirrhosis. [Methods] Eighty-six patients with hepatic cirrhosis were randomly divided into control group（n=40）and observation group（n=46）. The two groups received comprehensive liver-protecting treatment, observation group were given hifidobaeterium triple viable capsule and lactulose oral solution on the basis of regular treatment, the course of therapy was three weeks. After treatment, the liver function and coagulable function,levels of total bilirubin （ TBil）, endotoxin（ ET）, blood ammonia, tumor necrosis factor-alph （TNF-α） and Interleukin-6 （ IL-6 ） of the two groups were compared respectively. [Results] Albumin （ALB）, prothrombin active （PTA） were higher（P〈0.05）, serum TBil, ET, ammonia,TNF-α and IL-6 were all lower（P〈0.01）in the observation group than those in the control group. The effective rate of observation group was 87.0% ,which was significantly better than 67.5% of control group（P〈0.05）. [Conclusion]Bifidobacterium triple viable combined with lactulose can reduce enterogenous endotoxemia and blood ammonia, relieve liver inflammation, improve liver function and coagulable function in patients with hepatic cirrhosis by down-regulating the levels of TNF-α and IL-6.

关 键 词：肝硬化 双歧三联活菌 乳果糖 内毒素血症 

分 类 号：R575.2[医药卫生—消化系统]