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目的探讨乳果糖联合双歧杆菌四联活菌片对慢性重型乙型肝炎患者肠黏膜屏障功能的保护作用。方法选择内科住院治疗的慢性重型乙型肝炎早中期患者68例,分为观察组和对照组。两组患者予以保肝利尿、补充白蛋白、抗病毒及防治并发症等基础治疗。观察组患者在此基础上加用乳果糖口服液(10mL,2~3次/d,口服)联合双歧杆菌四联活菌片(1.5g/次,3次/d,温水送服)治疗,连用8周;对照组患者予以单纯的乳果糖口服液治疗,剂量、方法及疗效同观察组。观察并记录两组患者治疗前后肝功能、HBV-DNA和肠黏膜屏障功能指标的变化。结果治疗8周后,两组患者ALT、AST、TBIL及HBV-DNA水平[(97.3±26.2)U/L、(102.3±27.4)U/L、(132.2±26.9)μmol/L、(2.1±0.6)log copies/mL、(62.0±15.2)U/L、(64.2±16.8)U/L、(87.4±15.2)μmol/L、(3.0±0.7)log copies/mL]均较前明显下降(P<0.05或P<0.01),且观察组下降幅度明显大于对照组(P<0.05);两组患者血清内毒素、DAO和尿L/M比值[(0.24±0.06)EU/mL、(5.42±1.06)μg/L、(0.018±0.004),(0.18±0.04)EU/mL、(7.82±1.47)μg/L、(0.029±0.07)]均较治疗前明显下降(P<0.05或P<0.01),且观察组下降幅度明显大于对照组(P<0.05)。结论乳果糖联合双歧杆菌四联活菌片治疗慢性重型乙型肝炎能加速其肝功能恢复的作用,有效抑制病毒复制,降低其肠黏膜通透性,促进肠黏膜的修复,改善肠黏膜屏障功能。
Objective To explore the protective effect of lactoferrin combined with Bifidobacterium quadrulmus on intestinal mucosal barrier function in patients with chronic severe hepatitis B Methods Sixty-eight patients with chronic severe hepatitis B were enrolled in this study. They were divided into observation group and control group. Two groups of patients to liver protection and diuresis, albumin, anti-virus and prevention and treatment of complications and other basic treatment. On the basis of this, patients in the observation group were treated with Lactobacillus oral solution (10 mL, 2 to 3 times / d orally) in combination with Bifidobacterium quadriceps (1.5 g / time, 3 times / d, warm water delivery) , Once every 8 weeks; the control group patients were treated with simple lactulose oral solution, the dose, method and efficacy with the observation group. Observed and recorded before and after treatment in patients with liver function, HBV-DNA and intestinal mucosal barrier function index changes. Results After 8 weeks of treatment, the levels of ALT, AST, TBIL and HBV-DNA in the two groups were significantly higher than those in the control group (97.3 ± 26.2 U / L, 102.3 ± 27.4 U / L, 132.2 ± 26.9 μmol / L, (64 ± 16.8) U / L, (87.4 ± 15.2) μmol / L, (3.0 ± 0.7) log copies / mL] P <0.05 or P <0.01), and the decrease in the observation group was significantly greater than that in the control group (P <0.05). The serum endotoxin, DAO and urinary L / M ratio [(0.24 ± 0.06) EU / (P <0.05 or P <0.05 or P <0.05), and the difference was statistically significant (P <0.05 or P < 0.01), and the observation group decreased significantly more than the control group (P <0.05). Conclusion Lactulose combined with Bifidobacterium quadriceps could effectively accelerate the recovery of liver function in patients with chronic severe hepatitis B, effectively inhibit virus replication, reduce the intestinal mucosal permeability, promote the repair of intestinal mucosa and improve the intestinal mucosal barrier Features.