胆胰散联合双歧杆菌三联活菌散对气滞食积型急性胰腺炎患者肠黏膜屏障功能的影响

Effect of Dan yi-powder and live combined bifidobacterium,lactobacillus and enterococcus powder on intestinal mucosal barrier function in patients with acute pancreatitis due to stagnation of qi and retention of food

目的观察胆胰散联合双歧杆菌三联活菌散对气滞食积型急性胰腺炎患者肠黏膜屏障功能的影响。方法选择气滞食积型AP患者60例,采用随机数字表法将患者随机分为两组。对照组给予常规治疗,治疗组加用胆胰散、双歧杆菌三联活菌散,两组均连续治疗7 d后观察患者疗效情况及胃肠功能情况;同时检测患者血浆二胺氧化酶(DAO)、D-乳酸水平以及肠道菌群变化。结果治疗后7 d,与对照组相比,治疗组疗效优于对照组,差异有统计学意义(P<0.05);胃肠道功能恢复程度优于对照组(t=13.77,P<0.01);DAO水平明显降低,差异有统计学意义(t=2.56,P<0.05)。D-乳酸水平虽有降低,但与治疗前相比,差异无统计学意义(t=0.34,P>0.05);且数值明显高于对照组,差异有统计学意义(t=5.66,P<0.01);治疗组患者肠内乳杆菌、双歧杆菌的数量明显增加(t_(乳杆菌)=6.76,P<0.01;t_(双歧杆菌)=5.73,P<0.01),肠杆菌的数量明显减少(t=8.92,P<0.01),肠内菌群接近正常比例。对照组仍是以肠杆菌为主,乳杆菌、双歧杆菌数量偏少,存在菌群失调。结论胆胰散联合双歧杆菌三联活菌散治疗能有效修复气滞食积型急性胰腺炎患者的肠黏膜损伤及改善其肠道微环境。

Objective To investigate the effects of Dan yi-powder and live combined bifidobac- terium, lactobacillus and enterococcus powder on intestinal mucosal barrier function in patients with acute pancreatitis due to stagnation of qi and retention of food. Methods Sixty patients with acute pancreatitis due to stagnation of qi and retention of food were randomly divided into the control group and the treatment group according to the random numbers table method. Pa- tients in the control group were treated with conventional treatment ; patients in the treatment group were treated with Dan yi-powder and live combined bifidobacterium, lactobacillus and enterococcus powder on the basis of conventional treatment. All selected patients were observed the curative effect and gastrointestinal function and checked the plasma diamine oxidase, d-lactic acid level and intestinal flora after 7days. Results The curative effect （ P 〈 0. 05 ） and the recovery of gastrointestinal function （t = 13.77, P 〈 0. 01 ） of the treatment group were better than the control group. Compared to the control group, the level of DAO of the treatment group was lower （ t = 2. 56, P 〈 0.05 ）. The d-lactic acid level was lower but the difference was not statistically significant compared to before treatment（ t = 0. 34 ,P 〉 0. 05 ）, and higher than the control group, the difference was statistically significant （t = 5.66, P 〈 0. 01 ）. The number of lactobacillus and bacillus bifidus of the treatmet group were obvious higher （ tlactobacillus = 6. 76, P 〈 0.01 ; tbacillus blfidus = 5. ＇73, P 〈 0. 01 ）, and the number of lactobacillus was significantly re- duced （t = 8.92, P 〈0. 01 ）, and the intestinal flora was close to normal. There was a colony disorder in the control group which had still mainly enterobacteriaceae, with less lactobacillus and bifidobacterium. Conclusion The treatment of Dan yi-powder and live combined bifidobacterium, lactobacillus and enterococcus powder could repair the intestinal mucosal inju- ry and improve the intestinal microenvironment of the patients with acute pancreatitis due to stagnation of qi and retention of food.