还原型谷胱甘肽联合双歧杆菌四联活菌片对酒精性肝病患者肠道菌群的影响

Effect of reduced glutathione combined with bifidobacterium quadruple viable tablets on the intestinal flora of alcoholic liver disease

目的:探讨还原型谷胱甘肽联合双歧杆菌四联活菌片对酒精性肝病患者肠道菌群的影响。方法:选择2018年12月—2020年12月就诊的79例酒精性肝病患者为研究对象,采用随机数字表法分为对照组(39例)及观察组(40例)。2组均进行常规干预,对照组给予还原型谷胱甘肽联合枯草杆菌二联活菌肠溶胶囊进行治疗,观察组在对照组基础上增加双歧杆菌四联活菌片进行治疗,比较2组肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)],T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)),肠道菌群(肠球菌、乳酸菌、双歧杆菌、大肠杆菌)及不良反应发生率。结果:治疗1个月后,2组AST、ALT、GGT均较治疗前降低,且观察组AST、ALT、GGT指标均低于对照组,差异有统计学意义(P<0.05);治疗1个月后,2组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均较治疗前升高,CD_(8)^(+)较治疗前降低,且观察组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)高于对照组,CD_(8)^(+)低于对照组,差异有统计学意义(P<0.05);治疗1个月后,2组肠球菌、大肠杆菌均较治疗前降低,乳酸菌、双歧杆菌均较治疗前升高,且观察组肠球菌、大肠杆菌指标低于对照组,乳酸菌、双歧杆菌指标高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率略低于对照组,但差异无统计学意义(P>0.05)。结论:在酒精性肝病患者中实施还原型谷胱甘肽联合双歧杆菌四联活菌片治疗方案,可有效改善患者的肝功能及肠道菌群,增强患者的免疫功能,且不会增加用药不良反应的发生率。

Objective:To explore the effect of reduced glutathione combined with bifidobacteria quadruple viable tablets on the intestinal flora of alcoholic liver disease(ALD).Methods:We selected 79 patients with alcoholic liver disease who were treated from December 2018 to December 2020 and divided them into a control group(39 cases)and an observation group(40 cases)using a random number table method.Both groups received routine intervention.The control group was treated with reduced glutathione combined with bacillus subtilis double live bacteria enteric-coated capsules,and the observation group was treated with bifidobacterium quadruple viable tablets on the basis of the control group.The liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyl transpeptidase(GGT)],T lymphocytes(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)),intestinal flora(enterococcus,lactobacillus,bifidobacterium,escherichia coli)and the incidence of adverse reactions.Results:After 1 month of treatment,the two groups of AST,ALT,GGT were lower than before treatment,and the AST,ALT,GGT indicators of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).After 1 month of treatment,the two groups’CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)were higher than before treatment,and CD_(8)^(+)was lower than before treatment.The observation group’s CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)were higher than the control group,and the CD_(8)^(+)was lower than the control group;There is statistical significance(P<0.05).After 1 month of treatment,the enterococcus and escherichia coli in the two groups were lower than before the treatment,and the lactic acid bacteria and bifidobacterium were higher than before the treatment.The indicators of enterococcus and escherichia coli in the observation group were lower than those of the control group,and Lactobacillus and bifidobacterium were lower than those in the control group.The index was higher than the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:The treatment of reduced glutathione combined with bifidobacteria quadruple viable tablets in ALD patients can effectively improve the patient’s liver function and intestinal flora,enhance the patient’s immune function,and will not increase the incidence of adverse drug reactions.