替诺福韦联合酪酸梭菌活菌对乙型肝炎患者肠道微生态的影响

Effect of Tenofovir Combined with Clostridium Butyricum on Intestinal Microecology in Patients with Hepatitis B

目的:探讨替诺福韦联合酪酸梭菌活菌片对慢性乙型肝炎(CHB)患者肠道微生态的影响。方法:收集2021年5月-2022年4月于复旦大学附属闵行医院肝炎门诊就诊的CHB患者160例,通过随机数字表法分为观察组和对照组,各80例,观察组予替诺福韦联合酪酸梭菌活菌片口服,对照组予替诺福韦口服。采用全自动生化分析仪检测两组患者治疗前后的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL),γ-谷氨酰转肽酶(GGT),使用实时荧光定量PCR(qRT-PCR)检测粪便标本中菌群。结果:治疗后,观察组的双歧杆菌属、拟杆菌属数量均较对照组显著升高,观察组肠杆菌、肠球菌数量均较对照组明显降低,差异均有统计学意义(P<0.05);治疗后观察组和对照组的ALT、AST、TBIL、GGT水平均较治疗前下降,差异均有统计学意义(P<0.05);治疗后观察组ALT、AST、TBIL、GGT下降水平均优于对照组,差异均有统计学意义(P<0.05)。结论:口服酪酸梭菌活菌片可作为治疗CHB的新策略。

Objective:To investigate the effect of Tenofovir combined with Clostridium Butyricum on intestinal microecology in patients with hepatitis B.Method:A total of 160 patients with chronic hepatitis B in Hepatitis Clinic of Minhang Hospital Affiliated to Fudan University from May 2021 to April 2022 were selected and randomly divided into observation group and control group,with 60 cases in each group.Patients in observation group were given Tenofovir combined with Clostridium Butyricum Tablets orally,and patients in control group were given Tenofovir only.ALT,AST,TBIL and GGT were detected by automatic biochemical analyzer before and after treatment,the microflora in fecal samples was detected by using real-time fluorescence quantitative PCR(qRT-PCR).Result:After treatment,the number of Bifidobacterium and Bacteroides in the observation group were significantly higher than those in the control group,while the number of Enterobacteriaceae and Enterococcus in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05);after treatment,the levels of ALT,AST,TBIL and GGT in the two groups were lower than those before treatment,the differences were statistically significant(P<0.05),the decline levels of ALT,AST,TBIL,GGT in observation group were better than those in control group,the differences were statistically significant(P<0.05).Conclusion:Oral administration of Clostridium Butyricum Tablets may be a new strategy for the treatment of CHB.