双歧杆菌三联活菌散联合常规保肝治疗对乙肝肝硬化患者的疗效观察

Bifidobacterium triple viable powder combined with routine liver protection therapy in the treatment of hepatitis B cirrhosis

目的研究双歧杆菌三联活菌散联合常规保肝治疗对乙肝肝硬化患者的临床效果。方法抽取2020年6月至2021年6月商丘市第四人民医院收治的乙肝肝硬化患者40例,随机分为单一组和联合组,每组20例。单一组采用常规保肝治疗,联合组在单一组基础上联合双歧杆菌三联活菌散治疗。比较两组肠道菌群情况(双歧杆菌、肠球菌、乳酸杆菌、拟杆菌)、血清因子[白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、内毒素(FT)]水平、肝纤维化指标[透明质酸(HA)、层粘蛋白(LN)、Ⅳ型胶原(Ⅳ-C)]、肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)]及不良反应发生率。结果治疗后,联合组双歧杆菌、肠球菌、乳酸杆菌、拟杆菌菌落数量多于单一组(P<0.05);治疗后,联合组IL-1β、TNF-α、PCT、ET水平低于单一组(P<0.05);治疗后,联合组HA、LN、Ⅳ-C水平低于单一组(P<0.05);治疗后,联合组ALT、AST、TB水平低于单一组(P<0.05);联合组不良反应发生率(10.00%,2/20)与单一组(20.00%,4/20)比较差异未见统计学意义(P>0.05)。结论双歧杆菌三联活菌散联合保肝治疗乙肝肝硬化能改善患者肠道微生态环境,纠正肠道菌群失调,并能有效抑制机体炎症,抑制肝纤维化,促进患者肝功能改善。

Objective To study the effect of bifidobacterium triple viable powder combined with routine liver protection therapy in the treatment of hepatitis B cirrhosis.Methods Forty patients with hepatitis B cirrhosis treated in the Fourth People’s Hospital of Shangqiu from June 2020 to June 2021 were selected.And they were divided into single group and combination group by random number table method,with 20 cases in each group.The single group was treated by routine liver protection therapy,and the combination group was treated by bifidobacterium triple viable treatment based on the treatment of the single group.The intestinal flora(Bifidobacterium,Enterococcus,Lactobacillus,Bacteroides)and levels of cytokines including interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)and endotoxin(FT),liver fibrosis indicators including hyaluronic acid(HA),laminin(LN)and type IV collagen(Ⅳ-C),liver function assessed by alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TB),and the incidence of adverse reactions were compared between the two groups.Results After treatment,the number of colonies of Bifidobacterium,Enterococcus,Lactobacillus and Bacteroides in the combination group were higher than those in the single group(P<0.05).After treatment,the levels of IL-1β,TNF-α,PCT and ET in the combination group were lower than those in the single group(P<0.05).After treatment,the levels of HA,LN,IV-C in the combination group were lower than those in the single group(P<0.05).After treatment,the levels of ALT,AST,and TB in the combination group were lower than those in the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combination group(10.00%,2/20)and the single group(20.00%,4/20),P>0.05.Conclusions The Bifidobacterium triple viable powder combined with liver protection therapy in the treatment of hepatitis B cirrhosis of the liver can improve the intestinal micro ecology environment,correct intestinal flora disturbance,effectively restrain hepatic fibrosis,and promote the recovery of liver function.