双歧杆菌四联活菌片联合谷氨酰胺治疗酒精性肝硬化的临床研究

Clinical Observation of Bifidobacterium Tetravaccine Tablets Combined with Glutamine for Treatment of Alcoholic Liver Cirrhosis

目的探讨双歧杆菌四联活菌片联合谷氨酰胺治疗酒精性肝硬化的临床疗效及安全性。方法选择2015年1月到2017年12月我院收治的103例酒精性肝硬化患者,随机分为对照组和治疗组,对照组给予双歧杆菌四联活菌片治疗,1.5g/次,3次/d,治疗组在对照组治疗的基础上给予谷氨酰胺治疗,1.0g/次,3次/d,两组均治疗8周。治疗后进行临床疗效评价并检测、比较两组治疗前后血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、III型前胶原氨基端肽(PCIII)、IV胶原(CIV)、透明质酸(HA)、层粘连蛋白(LN)、降钙素原、二胺氧化酶及尿乳果糖/甘露醇比值。记录并比较两组患者治疗过程中不良反应的发生情况。结果治疗组的总有效率为94.23%(49/52),对照组为72.55%(37/51),治疗组高于对照组(χ2=8.783,P=0.003)。治疗后,两组血清ALT、AST、TBIL、PCIII、CIV、HA、LN、降钙素原、二胺氧化酶水平及尿乳果糖/甘露醇比值均小于治疗前,且治疗组血清ALT、AST、TBIL、PCIII、CIV、HA、LN、降钙素原、二胺氧化酶水平及尿乳果糖/甘露醇比值均小于对照组(P均<0.05)。两组治疗过程中均无严重的不良反应发生。结论双歧杆菌四联活菌片联合谷氨酰胺治疗酒精性肝硬化的临床疗效显著,能够改善肝功能和肠黏膜屏障功能,减轻肝纤维化,且安全性较好,值得在临床上推广应用。

Objective To explore the clinical efficacy and safety of bifidobacterium tetravaccine tablets combined with glutamine for treatment of alcoholic liver cirrhosis. Methods According to the random indicator method,103 cases of patients with alcoholic liver cirrhosis in our hospital from January 2015 to December 2017 were divided into control group(n=51)and treatment group(n=52). Patients of control group were treated with bifidobacterium tetravaccine tablets,1.5g/time,3 times/d,while patients in the treatment group were treated with glutamine(1.5g/time,3 times/d) on the basis of the control group.The two groups were treated for 8 weeks. Clinical curative effect was evaluated after treatment.The serum ALT,AST,TBIL,PCIII,CIV,HA,LN,original calcitonin,diamine oxidase and urinary lactulose/mannitol ratios of the two groups before and after treatment were compared.The adverse reactions of the two groups during the treatment were compared. Results Total effective rate of treatment group was 94.23%(49/52),which was higher than the control group[72.55%(37/51)],and the difference was statistically significant(χ2=8.783,P=0.003). After treatment,the levels of serum ALT,AST,TBIL,PCIII,CIV,HA,LN,procalcitonin, diamine oxidase and urinary lactulose/mannitol ratio in the two groups were lower than those before treatment, and the levels of serum ALT,AST,TBIL, PCIII,CIV,HA,LN,procalcitonin,diamine oxidase and lactulose/mannitol ratio in the treatment group were lower than those in the control group(all P<0.05). There were no serious adverse reactions in both groups. Conclusions Bifidobacterium tetravaccine tablets combined with glutamine for treatment of alcoholic liver cirrhosis has a good efficacy and low adverse reactions,can improve the liver function and intestinal mucosal barrier function,reduce the liver fibrosis. It is worth popularizing and applying in clinic because of its good safety.