枯草杆菌二联活菌联合莫沙必利与恩替卡韦治疗乙型肝炎后肝硬化合并肠道菌群失调患者临床效果观察  

Clinical efficacy of Bacillus subtilis combined with mosapride and entecavir in the treatment of patients with post hepatitis B cirrhosis complicated by intestinal dysbiosis

作　　者：张攀 廖海珍 杨建宇 ZHANG Pan;LIAO Haizhen;YANG Jianyu(Department of Gastroenterology,Xinyu People's Hospital,Xinyu Jiangxi 338000,China)

机构地区：[1]新余市人民医院消化内科,江西新余338000

出　　处：《天津药学》2025年第2期166-169,共4页Tianjin Pharmacy

摘　　要：目的 探讨枯草杆菌二联活菌联合莫沙必利与恩替卡韦治疗乙型肝炎后肝硬化合并肠道菌群失调患者临床效果。方法 选取2022年5月至2024年5月新余市人民医院收治的80例乙型肝炎后肝硬化合并肠道菌群失调患者,按随机数字表法分为两组,各40例。两组均采取恩替卡韦治疗,此外,对照组口服莫沙必利,观察组在对照组基础上加用枯草杆菌二联活菌。对比两组肠道菌群改善疗效、肠道屏障功能、肝功能指标、炎症水平及不良反应发生情况。结果 观察组肠道菌群改善疗效为95.00%,高于对照组的80.00%。观察组血浆D-乳酸为(5.47±0.65)mg/L,二胺氧化酶为(4.05±0.47)U/L,低于对照组的(6.53±0.87)mg/L、(4.97±0.55)U/L;天冬氨酸氨基转移酶(AST)为(23.46±3.12)U/L,丙氨酸转氨酶(ALT)为(33.56±3.58)U/L,总胆红素(TBIL)为(21.19±2.94)μmol/L,谷氨酰转移酶(GGT)为(43.28±5.11)U/L,白介素-6(IL-6)为(22.24±3.07)ng/L,超敏C反应蛋白(hs-CRP)为(2.52±0.32)mg/L,肿瘤坏死因子-α(TNF-α)为(5.03±0.85)ng/L,均低于对照组的(28.49±3.24)U/L、(41.32±4.22)U/L、(26.53±3.16)μmol/L、(51.36±6.08)U/L、(27.55±3.13)ng/L、(3.21±0.58)mg/L、(6.20±1.14)ng/L(P<0.05)。两组不良反应比较无统计学差异(P>0.05)。结论 枯草杆菌二联活菌联合莫沙必利与恩替卡韦治疗乙型肝炎后肝硬合并肠道菌群失调疗效显著,可改善患者肠道屏障功能,减轻肝功能炎症与肝功能损伤,安全有效。Objective To investigate the clinical efficacy of Bacillus subtilis combined with mosapride and entecavir in the treatment of patients with post hepatitis B cirrhosis complicated by intestinal dysbiosis.Methods A total of 80 patients with hepatitis B cirrhosis complicated with intestinal dysbiosis admitted to Xinyu People's Hospital from May 2022 to May 2024 were selected and randomly divided into two groups,with 40 patients in each group,using a random number table method.Both groups were treated with entecavir.In addition,the control group was orally administered mosapride,while the observation group was treated with Bacillus subtilis on the base of the control group.The efficacy of improving gut microbiota,intestinal barrier function,liver function indicators,inflammation levels,and incidence of adverse reactions between two groups were compared.Results The observation group showed a 95.00%improvement in gut microbiota,which was higher than the 80.00%improvement in the control group;Plasma D-lactate of observation group was(5.47±0.65)mg/L,and diamine oxidase was(4.05±0.47)U/L,which were lower than those in the control group[(6.53±0.87)mg/L and(4.97±0.55)U/L];Aspartate aminotransferase(AST)of observation group was(23.46±3.12)U/L,alanine aminotransferase(ALT)was(33.56±3.58)U/L,total bilirubin(TBIL)was(21.19±2.94)μmol/L,glutamyl transferase(GGT)was(43.28±5.11)U/L,interleukin-6(IL-6)was(22.24±3.07)ng/L,high-sensitivity C-reactive protein(hs-CRP)was(2.52±0.32)mg/L,tumor necrosis factor alpha(TNF-α)was(5.03±0.85)ng/L,which were lower than those of the control group[(28.49±3.24)U/L,(41.32±4.22)U/L,(26.53±3.16)μmol/L,(51.36±6.08)U/L,(27.55±3.13)ng/L,(3.21±0.58)mg/L,(6.20±1.14)ng/L](P<0.05);Comparison of adverse reactions between two groups had no significant difference(P>0.05).Conclusion The combination of Bacillus subtilis and mosapride with entecavir has a significant therapeutic effect on liver cirrhosis and intestinal dysbiosis after hepatitis B.It can improve the intestinal barrier function o

关 键 词：乙型肝炎 肝硬化 肠道菌群失调 枯草杆菌二联活菌 莫沙必利 恩替卡韦 临床疗效 肠道屏障功能 

分 类 号：R978.7[医药卫生—药品] R512.62[医药卫生—药学]