双歧杆菌三联活菌胶囊治疗乙型肝炎病毒感染失代偿期肝硬化的效果

Efficacy of Bifidobacterium Triple Live Capsules in the treatment of decompensated cirrhosis of hepatitis B virus infection and its influence on intestinal flora and liver fibrosis indexes

目的 分析双歧杆菌三联活菌胶囊治疗乙型肝炎病毒(hepatitis B virus,HBV)感染失代偿期肝硬化的疗效及对患者肠道菌群、肝纤维化指标的影响。方法 选取80例HBV感染失代偿期肝硬化患者,随机分为联合组及对照组,每组40例。对照组给予常规治疗联合恩替卡韦治疗,联合组在对照组治疗的基础上给予双歧杆菌三联活菌胶囊治疗,2组均治疗3个月。比较2组治疗3个月后的临床疗效,治疗前、治疗3个月后肠道菌群、肝纤维化指标、肝功能和HBV脱氧核糖核苷酸(deoxyribonucleotide,DNA)及治疗期间不良反应的发生率。结果 治疗后,联合组的总有效率更高(90.00%vs. 70.00%,P<0.05);联合组乳酸杆菌、双歧杆菌和肠球菌水平升高,且高于对照组(P<0.05);白色假丝酵母菌水平降低,且低于对照组(P<0.05);2组血清白蛋白(albumin,ALB)水平升高,且联合组更高(P<0.05)。2组血清透明质酸(hyaluronic acid,HA)、层黏连蛋白(laminin,LN)、Ⅲ型前胶原(typeⅢprocollagen,PCⅢ)、Ⅳ型胶原(typeⅣcollagenCⅣ)、谷丙转氨酶(alanine aminotransferase,ALT)、总胆红素(total bilirubin,TBiL)、HBV DNA水平和肝脏硬度值(liver hardness,LSM)均下降,且联合组更低(P<0.05)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 双歧杆菌三联活菌胶囊治疗HBV感染失代偿期肝硬化的临床疗效确切,可降低HBV负荷,调节肠道菌群平衡,降低肝纤维化指标,最终提高肝功能。

Objective To analyze the efficacy of Bifidobacterium Triple Live Capsules in the treatment of decompensated cirrhosis of hepatitis B virus(HBV)infection and the effects on intestinal flora and liver fibrosis indexes.Methods A total of 80 patients with decompensated HBV infection cirrhosis were randomly included and divided into combination group and control group,with 40 cases in each group,by using random number table method.The control group received conventional treatment combined with entecavir treatment,and the combined group received Bifidobacterium Triple Live Capsules treatment on the basis of the control group.The both groups were treated for 3 months.The clinical efficacy after 3 months of treatment,intestinal flora,liver fibrosis index,liver function and HBV deoxyribonucleotide(DNA)were compared between the 2 groups after 3 months of treatment,before and after 3 months of treatment,and the adverse reactions during treatment were also recorded and compared.Results After 3 months of treatment,the total effective rate of combination group was higher than that of control group(90.00%vs.70.00%,P<0.05).After 3 months of treatment,the levels of lactobacillus,bifidobacterium,and enterococcusin in combination group increased,and the combination group were higher than the control group(P<0.05);the levels of candida albicansin in combination group decreased,and the combination group was lower than the control group(P<0.05).After 3 months of treatment,the serum albumin(ALB)in the 2 groups increased,and the combination group was higher than the control group(P<0.05).After 3 months of treatment,the serum levels of hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ),typeⅣcollagen(CⅣ),alanine aminotransferase(ALT),total bilirubin(TBiL),HBV deoxyribonucleotide(DNA)and liver hardness(LSM)in the 2 groups decreased,and the combination group was lower the combination group(P<0.05).During treatment,the incidence of adverse reactions was similar.Conclusion Bifidobacterium Triple Live Capsules have definite clinical efficacy in the treatment of decompensated cirrhosis of HBV infection.It could reduce HBV load,regulate intestinal flora balance,reduce liver fibrosis index,and finally improve liver function with good safety.