乳果糖联合乳酸菌素治疗轻微型肝性脑病临床观察

Clinical observation of lactulose combined with lactein on mild hepatic encephalopathy

目的观察乳果糖联合乳酸菌素治疗轻微型肝性脑病(MHE)的疗效及对神经功能的影响。方法选取我院肝硬化合并MHE患者86例,按照随机数字表法分为观察组和对照组各43例。2组均给予西医常规治疗,对照组加用乳果糖治疗;观察组在对照组基础上加用乳酸菌素,2组均连续治疗8周。观察2组临床疗效、不良反应发生率,采用数码符号测验(DST)和数字连接测验-A(NCT-A)评定神经功能变化,测定肝功能、血氨水平。结果治疗8周后,2组神经功能评估(DST和NCT-A)和血氨水平均有改善,与对照组比较,观察组改善更显著(P<0.05);2组肝功能指标ALT、AST和TBIL均下降显著,且观察组AST、TBIL显著低于对照组(P<0.05);观察组总有效率(88.37%)明显优于对照组(69.77%,P<0.05)。结论乳果糖联合乳酸菌素可有效治疗MHE。

Objective To observe the effect of lactulose combined with lactein on mild hepatic encephalopathy（MHE）and its effect on neurological function.Methods Eighty-six cases with liver cirrhosis complicated with MHE were randomly divided into observation group（43 cases）and control group（43 cases）.The control group was treated with lactulose on the conventional treatment;the observation group was added with lactein on basis of control group.The patients in two groups were treated for 8 weeks continuously.The clinical efficacy,adverse reaction rate,digit symbol test（DST）and Number Connection Test-A（NCT-A）were used to evaluate the changes of neurological function,and the levels of liver function and blood ammonia were measured.Results The levels of DST,NCT and blood ammonia in the two groups were improved after treatment of 8 weeks.Compared with control group,the observation group had a significant improvement（P〈0.05）.The liver function was significantly decreased after 8 weeks treatment（P〈0.05）,and AST and TBIL were significantly lower in the observation group than those in the control group（P〈0.05）.The total effective rate of the observation group（88.37%）was significantly better than that of the control group（69.77%）.Conclusion Lactulose combined with lactein can effectively treat MHE.