摘要
目的观察微生态制剂（整肠生）对重型肝炎的治疗效果及炎性细胞因子的影响。方法回顾分析符合入组标准的重型肝炎患者的病例资料，共计人组100例患者，按治疗方法不同分为观察组50例和对照组50例，对照组进行常规综合治疗，观察组在对照组的基础上再给予地衣芽孢杆菌活菌胶囊（整肠生），1次2粒，1天3次，治疗4周。治疗前后观察患者临床症状变化情况，进行肠道菌群、总胆红素、肝功能及炎性细胞因子检测。结果观察组症状总有效率为86％，明显高于对照组的56％（x2=11．409，P〈0．01）。观察组治疗后肠杆菌为（6．71±1．30）lgn／g，较治疗前下降（t=3．602，P〈0．05），双歧杆菌、乳杆菌、拟杆菌分别为（7．88±1．18）lgn／g、（8．08±1．65）lgn／g、（8．30±1．20）lgn／g，较治疗前明显升高（t=3．772、3．707、3．523，均P〈0．05），对照组治疗前后肠道菌群无明显变化。观察组和对照组治疗后总胆红素、谷氨酸氨基转移酶、血浆内毒素分别为（195．0±25．4）μmol／L和（307．6±40．5）μmol／L，（58．2±11．5）U／L和（90．2±10．5）U／L，（0．18±0．06）EU／mL和（0．29±0．08）EU／mL，较治疗前明显下降（t=16．307、9．408、10．157和4．032、8．075、5．076，均P〈0．01），观察组治疗后血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）_6分别为（106．2±12．5）pg／mL、（82．3±18．9）pg／mL较治疗前明显降低（t=3．732，4．017，均P〈0．05），对照组为（130．5±20．6）pg／mL，和（110．2±17．8）pg／mL，与治疗前无明显变化。观察组治疗后血清IL-2、IL-10分别为（60．7±10．0）pg／mL、（31．7±6．6）pg／mL，较治疗前明显降低（t=3．757、3．877，均P〈0．05），对照组为（46。2±5，8）pg／mL、（23．4±5．1）pg（mL，与治疗前差异均无统计学意义，观察组治疗后总胆红素、谷氨酸氨基转移酶、血浆内毒素、血清TNF-α、IL-6明显低于对照组（t=7．653、8．104、3．309、3．511、3．787，均P〈0．05），血清IL-2、IL-10明显高于对照组（t=3．487、3．428，均P〈0．05）。结论微生态制剂（整肠生）能够纠正肠道菌群失调，降低血浆内毒素，抑制炎性介质产生，减轻肝脏炎症损伤，肝功能改善及临床症状缓解效果确切，值得在重型肝炎治疗中推广使用。
Objective To investigate effect of probiotics in the treatment of patients with severe hepatitis and its influence on inflammatory cytokines. Methods A retrospective analysis of the data of patients with severe hepati- tis were maded. There were 100 patients, which including 50 cases of the observation group and 50 cases of control group, the control group was given conventional treatment, the observation group was given Bacillus viable capsule （Zhengchangsheng） for 4 weeks,2 granule a time and three times a day. The clinical symptoms were observed before and after treatment, the blood was exsanguinated for detecting bowel flora, total bilirubin,liver function and inflamma- tory cytokines. Results The total effective rate of the observation group was 86% ,which was significantly higher than 56% of the control group （ X2 = 11. 409, P 〈 0.01 ）. The enterobacter of the observation group after treatment was （6. 71 ± 1.30） lgn/g, which was lower than before treatment （ t = 3. 602, P 〈 0. 05 ）, the bifidobacter/um, lactobacillus, bacteroides were （ 7.88 ±1.18 ） lgn/g, （ 8.08 ± 1.65 ） lgn/g, （ 8.30 ± 1.20） lgn/g, respectively, which were higher than before treatment（ t = 3. 772,3. 707,3. 523, all P 〈 0. 05 ）. The intestinal flora in the control group had no differ- ence before and after treatment. After treatment, the total bilirubin, ALT, plasma endotoxin of the observation group aud the control group were （ 195.0 ± 25.4） μmol/L and （307.6 ± 40.5 ） μmol/L, （58.2 ± 11.5 ） U/L and （90.2 ±10.5 ） U/L, （0.18±0. 06） EU/mL and （0.29± 0.08 ） EU/mL, respectively, which were lower than before treatment （ t = 16.307,9.408,10. 157 and 4. 032,8. 075,5. 076, all P 〈 0.01 ）. The serum TNF - a, IL - 6 levels of the obser-vation group were （ 106.2 ±12.5 ） pg/mL, （ 82.3 ± 18.9 ） pg/mL, which were lower than before treatment（ t = 3. 732, 4.017, all P 〈 0.05 ）, which of the control group were （ 130.5 ± 20.6 ） pg/mL, （ 110.2 ± 17.8 ） pg/mL, there was no difference before and after treatment. The IL -2, IL - 10 levels of the observation group were （60.7 ± 10.0） pg/mL, （31.7 ± 6.6）pg/mL, which were significantly higher than before treatment （t = 3. 757,3. 877, all P 〈 0.05 ）, which of the control group were （ 46.2 ±5.8 ） pg/mL, （ 23.4 ± 5.1 ） pg/mL, which bad no difference before and after treat- ment. The total bilirubin, ALT, plasma endotoxin, serum TNF - α, IL - 6 levels of the observation group were lower than the control group （ t = 7. 653,8. 104,3. 309,3.511,3. 787, all P 〈 0.05 ）. The IL - 2, IL - 10 levels of the obser- vation group were higher than the control group （ t = 3. 487,3. 428, all P 〈 0.05 ）. Conclusion Probiotics can correct intestinal flora, reduce plasma endotoxin, inhibit inflammatory mediators, reduce inflammation of the liver damage, improve liver function and clinical symptoms and should be introduced in the treatment of severe hepatitis.
出处
《中国基层医药》
CAS
2016年第5期719-723,共5页
Chinese Journal of Primary Medicine and Pharmacy
