微生态制剂联合复方甘草酸苷治疗肝炎肝硬化的效果及对肠道菌群和血清炎性因子水平的影响

Effect of probiotics combined with compound Glycyrrhizin glycoside for hepatitis B cirrhosis and its influences on gut microbiota and serum inflammatory factors

目的探讨微生态制剂联合复方甘草酸苷治疗肝炎肝硬化的效果及对肠道菌群和血清炎性因子水平的影响,为该类患者的治疗提供参考。方法选择2020年6月至2022年12月我院收治的108例乙型肝炎(HB)肝硬化患者,按随机数表法分成对照组(54例)和试验组(54例)。所有患者均使用恩替卡韦进行治疗,在此基础上对照组加用复方甘草酸苷,试验组在对照组基础上联合双歧杆菌四联活菌片(BTVT)治疗。判定两组疗效,并比较治疗前、治疗6个月后患者肠道菌群、血清炎性因子[白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α]水平及肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]。结果试验组患者总有效率高于对照组(94.44%vs 79.63%,P<0.05)。治疗6个月后,试验组患者肠道双歧杆菌、乳杆菌数量高于治疗前及同期对照组,大肠埃希菌数量低于治疗前及同期对照组(均P<0.05)。治疗6个月后,试验组患者血清IL-6、TNF-α以及ALT、AST、TBIL水平均低于治疗前及同期对照组(均P<0.05)。结论对HB肝硬化患者实施BTVB联合复方甘草酸苷治疗的效果较佳,可有效调节患者节肠道菌群,减轻炎性反应,显著改善肝功能。

Objective To observe the effect of probiotics combined with compound Glycyrrhizin glycoside(CGG)for hepatitis B cirrhosis,and its influences on gut microbiota and serum inflammatory factors,providing a reference for the treatment.Methods A total of 108 patients with hepatitis B(HB)cirrhosis admitted to our hospital from June 2020 to December 2022 were randomly grouped into a control group(54 cases)and an experimental group(54 cases).All the patients were treated with entecavir;on this basis,the control group was given CGG,while the observation group was treated with CGG and Bifidobacterium Tetragenous Viable Bacteria(BTVT).The efficacies in the two groups were determined,and the gut microbiota,serum inflammatory factor[interleukin(IL)-6,tumor necrosis factor-α(TNF-α)]levels and liver function indicators[alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(TBIL)]were compared between groups before treatment and after 6 months of treatment.Results The total efficiency rate in the experimental group was higher than in the control group(94.44%vs 79.63%,P<0.05).After 6 months of treatment,the counts of Bifidobacterium and Lactobacillus in the experimental group were higher than before treatment and the control group at same time(all P<0.05),while that of Escherichia coli was lower than those before treatment respectively and those in the control group at same time(all P<0.05),respectively.After 6 months of treatment,the serum levels of IL-6,TNF-α,ALT,AST and TBIL in the experimental group were lower than those before treatment and those in the control group at same time,respectively(all P<0.05).Conclusion The effect of BTVB combined with CGG for patients with HB cirrhosis is better,which can effectively regulate gut microbiota,reduce inflammatory reactions,and obviously improve liver function.