摘要
目的探讨门冬氨酸鸟氨酸联合双歧三联活菌胶囊对亚临床肝性脑病(SHE)患者内毒素血症及肠道微生态的影响。方法将108例SHE患者随机分为观察组和对照组。两组患者均予以低盐软食、保肝、降转氨酶、维持水电解质平衡及防治并发症等基础治疗。观察组予以双歧三联活菌胶囊(420.0mg/次,3次/d,口服)联合门冬氨酸鸟氨酸颗粒(3.0g/次,2次/d,口服)治疗,对照组予以单用门冬氨酸鸟氨酸颗粒治疗,两组均连用8周。观察并比较两组治疗前后血氨、丙氨酸转氨酶(ALT)、数字连接试验(NCT)、内毒素(ET)及肠道菌群的变化,并比较肝性脑病(HE)的发病率。结果治疗8周后,两组患者血氨、ALT、NCT及ET水平均较治疗前明显下降(P<0.05或P<0.01),且观察组下降的幅度较对照组更大(P<0.05);同时两组患者乳杆菌、双歧杆菌及肠球菌数量较治疗前增加,肠杆菌和酵母菌数量较治疗前减少(P<0.05和P<0.01),且观察组变化幅度较对照组更大(P<0.05)。观察组与对照组分别发生HE 5例和18例,观察组HE的发病率明显低于对照组(χ2=9.34,P<0.01)。结论门冬氨酸鸟氨酸联合双歧杆菌三联活菌治疗SHE的疗效确切,能改善其智力测验结果,降低HE的发病率。
Objective To discuss the influence of ornithine aspartate combined with Bifid Triple Viable capsules on endotoxemia and intestinal microecology of patients with subclinical hepatic encephalopathy（SHE）. Methods 108 patients with SHE were divided into observation group or control group at random. The patients in two groups were given basic treatments, including low salty soft diet, protecting liver, lowering transaminase,maintenance of water-electrolyte balance and Prevention and treatment of complications,etc.The patients in observation group were additionally given Bifid Triple Viable Capsules （420.0 mg per time, three times a day） and ornithine aspartate（3.0 g per time, twice a day） for 8 weeks, while the patients in control group were given ornithine aspartate alone. The changes of blood ammonia, alanine aminotransferase（ALT）, number connection test （NCT）, endotoxin （ET） and intestinal flora before and after treatments were observed and compared, and the morbidity of SHE morbidity was compared between the two groups. Results After 8 weeks’ treatment, the levels of blood ammonia, ALT, NCT and ET of patients in both groups were obviously declined than before（P〈0.05 or P〈0.01）, and the changes in observation group was much higher than those in control group （P〈0.05）. The amounts of Lactobacilli, Bifidobacteria and Enterococci were increased while those of enterobacteriaceae and yeasts were decreased than before in both groups （P〈0.05 and P〈0.01）, and the changes in observation group was much higher than those in control group （P〈0.05）. 5 vs 18 cases of HE were appeared in observation group vs control group respectively, no statistical differences were appeared（χ2=9.34, P〈0.01）. Conclusion Ornithine aspartate combined with Bifid Triple Viable capsules has reliable curative effect on SHE, which can improve the result of intelligence test and reduce HE morbidity.
作者
钱见楚
吴一鸣
QIAN Jianchu WU Yiming(Department of Gastroenterology, the Second Peoplets Hospital of Tongxiang, Tongxiang , Zhejiang 314511, China)
出处
《中国微生态学杂志》
CAS
CSCD
2017年第6期700-703,共4页
Chinese Journal of Microecology
关键词
亚临床肝性脑病
门冬氨酸鸟氨酸
双歧三联活菌胶囊
内毒素血症
肠道微生态
Subclinical hepatic encephalopathy
Ornithine aspartate
Bifid Triple viable capsules
Endo- toxemia
Intestinal microeeology
