布拉氏酵母菌联合熊去氧胆酸胶囊治疗乙肝肝硬化内毒素血症效果及对肠黏膜屏障功能的影响  

Efficacy of Saccharomyces boulardii combined with ursodeoxycholic acid capsules in the treatment of hepatitis B cirrhosis with endotoxemia and its effect on the intestinal mucosal barrier function of patients

作　　者：赵宝生 高美丽 贺新竹 赵严亮 张龙 ZHAO Bao-sheng;GAO Mei-li;HE Xin-zhu;ZHAO Yan-liang;ZHANG long(Department of Iniection,Hebei Petrochina Central Hospital,Langfang 065000,China)

机构地区：[1]河北中石油中心医院感染科,廊坊065000

出　　处：《传染病信息》2022年第3期241-244,共4页Infectious Disease Information

基　　金：2019年度河北省医学科学研究课题计划(20191734)。

摘　　要：目的探讨布拉氏酵母菌联合熊去氧胆酸胶囊治疗乙肝肝硬化内毒素血症的效果及对患者肠黏膜屏障功能的影响。方法选取2018年2月—2020年1月在河北中石油中心医院就诊的60例乙肝肝硬化内毒素血症患者作为研究对象,采用随机数字表法分为2组(对照组和观察组),每组30例。对照组采用布拉氏酵母菌治疗,观察组在对照组基础上联合熊去氧胆酸胶囊治疗,比较2组治疗前、治疗8周后血清内毒素和炎性因子水平、肠黏膜屏障功能、原发性腹膜炎发生率及不良反应发生情况。结果治疗8周后,2组血清内毒素、TNF-α、IL-6、二胺氧化酶(diamine oxidase,DAO)、血浆D-乳酸水平均低于治疗前(P均<0.05)。观察组治疗8周后血清内毒素、TNF-α、IL-6、DAO、血浆D-乳酸水平下降幅度平均高于对照组(P均<0.05)。观察组治疗期间原发性腹膜炎发生率为3.33%(1/30),明显低于对照组的20.00%(6/30)(P<0.05)。2组治疗期间顽固性便秘、荨麻疹、过敏反应、上腹部疼痛等不良反应发生率比较,差异均无统计意义(P均>0.05)。结论布拉氏酵母菌联合熊去氧胆酸胶囊治疗乙肝肝硬化内毒素血症患者,有助于降低炎性因子水平,改善患者肠黏膜屏障功能,降低原发性腹膜炎发生率,且不会增加不良反应,值得推广应用。Objective To investigate the effect of Saccharomyces boulardii combined with ursodeoxycholic acid capsule in the treatment of hepatitis B cirrhosis with endotoxemia and its effect on intestinal mucosal barrier function of patients.Methods Sixty patients with endotoxemia due to cirrhosis of hepatitis B who were treated in the Central Hospital of CNPC in Hebei from February 2018 to January 2020 were selected as the research objects.They were randomly divided into 2 groups(control group and observation group)with 30 patients in each one.The control group was treated with Saccharomyces boulardii and the observation group was treated with ursodeoxycholic acid capsule on the basis of the control group.The levels of serum endotoxin and inflammatory factors,intestinal mucosal barrier function,incidence of primary peritonitis and adverse reactions were compared between the 2 groups before and 8 weeks after treatment.Results After 8 weeks of treatment,the levels of serum endotoxin and TNF-α,IL-6,diamine oxidase(DAO)and plasma D-lactic acid were lower than those before treatment in the 2 groups(P<0.05).The decline of the levels of serum endotoxin,TNF-α,IL-6,DAO and plasma D-lactate after 8 weeks of treatment in the observation group were significantly higher than those in the control group(P<0.05).The incidence of primary peritonitis in the observation group was 3.33%(1/30),which was significantly lower than 20.00%(6/30)in the control group(P<0.05).There was no significant difference in the incidence of intractable constipation,urticaria,allergic reaction and epigastric pain between the 2 groups(P>0.05).Conclusions The use of Saccharomyces boulardii combined with ursodeoxycholic acid capsule in patients with endotoxemia due to cirrhosis of hepatitis B can help to reduce the level of inflammatory factor,improve the intestinal mucosal barrier function,reduce the incidence of primary peritonitis,and will not increase adverse reactions.It is worth popularizing.

关 键 词：布拉氏酵母菌 熊去氧胆酸胶囊 乙肝肝硬化内毒素血症 肠黏膜屏障功能 炎性因子 原发性腹膜炎 不良反应 治疗效果 

分 类 号：R453[医药卫生—治疗学] R575.2[医药卫生—临床医学]