双歧三联活菌胶囊联合还原型谷胱甘肽注射剂用于原发性肝癌患者化疗栓塞术后的临床研究

Clinic trial of bifid-triple viable capsule combined with reduced glutathione injection in the treatment of primary liver cancer patients after transcatheter hepatic arterial chemoembolization

目的观察双歧三联活菌胶囊联合还原型谷胱甘肽注射剂对原发性肝癌患者化疗栓塞术后肝功能、内毒素和肠道菌群的影响。方法将88例原发性肝癌患者分为对照组42例和试验组46例。2组患者均给予化疗栓塞的基础治疗。术后,对照组予以静脉滴注还原型谷胱甘肽1.8 g qd;试验组在对照组治疗的基础上,予以口服双歧三联活菌胶囊每次0.42 g tid。2组患者均治疗2周。比较2组患者手术前后的肝功能、内毒素和肠道菌群水平,以及药物不良反应的发生情况。结果术后,试验组和对照组的谷丙转氨酶分别为(96.12±7.56),(147.42±8.23)U·L^(-1);谷草转氨酶分别为(90.45±8.43),(163.90±9.58)U·L^(-1);总胆红素分别为(23.96±4.12),(27.46±5.17)μmol·L^(-1);内毒素分别为(97.15±8.44),(164.53±10.74)ng·L^(-1),差异均有统计学意义(P<0.05)。术后,试验组和对照组的粪便中大肠埃希菌含量分别为(7.85±1.06),(8.43±1.40)Lg·g^(-1);双歧杆菌含量分别为(7.28±0.36),(6.41±0.43)Lg·g^(-1);乳杆菌含量分别为(7.02±0.34),(6.18±0.32)Lg·g^(-1),差异均有统计学意义(P<0.05)。2组患者发生的药物不良反应主要有胃肠道反应和皮疹,且试验组和对照组的药物不良反应发生率分别为4.35%和7.14%,差异无统计学意义(P>0.05)。结论双歧三联活菌胶囊联合还原型谷胱甘肽注射剂可以明显改善原发性肝癌患者化疗栓塞术后的肝功能,避免内毒素水平异常升高,并可有效地调节肠道菌群。

Objective To observe the influence of bifid- triple viable capsule combined with reduced glutathione injection in the treatment of primary liver cancer patients after transcatheter hepatic arterial chemoem- bolization （TACE） on liver function, endotoxin and intestinal flora. Methods Eighty patients with primary liver cancer were divided into control group （ n = 42 cases） and treatment group （ n = 46 cases）. All patients were given TACE. After operation, control group was treated with intravenous infusion of reduced glutathione 1.8 g qd. Treatment group was given oral bifid - triple viable capsule 0. 42 g tid, on the basis of ：control group. Two groups were treated for two weeks. The liver function, endotoxin and intestinal flora were compared between two groups. Results After operation, the main indexes were compared in treatment and control groups： alanine aminotransferase were （96. 12±7.56）, （ 147.42±8.23 ） U·L^-1; aspartate aminotransferase were （90. 45 ±8.43 ）, （163.90 ± 9.58） U·L^-1; total bilirubin were （ 23.96 ± 4. 12 ） （ 27.46 ± 5.17 ） μLmol·L^-1; endotoxin were （97. 15 ± 8.44）, （ 164. 53±10.74） ng·L^-1, with statistically significant differences （ P 〈 0. 05 ）. After operation, the bacterial content in feces were compared between treatment and control groups： Escherichia coli were （7.85 ± 1.06） （8.43±1.40）Lg·g^-1; Bacillus bifidus were （7.28±0.36）, （6.41±0.43）Lg·g^-1; Lactobacillus were （7.02 ± 0. 34 ） , （6. 18 ± 0.32） Lg·g^-1, with significant differences （ P 〈 0.05 ）. Adverse drug reactions were based on gastrointestinal reactions and rashes in two groups, and the incidence of treatment and control groups were 4. 35% and 7. 14% without significant difference （P 〉 0. 05 ）. Conclusion For patients with primary liver cancer after TACE, bifid -triple viable capsule combined with reduced glutathione injection can significantly improve liver function, avoid abnormal increase of endotoxin and regulate intestinal flora.