双歧杆菌三联活菌胶囊治疗慢性乙型肝炎合并肝硬化疗效及对肝功能、肝纤维化的影响

摘要

目的 观察双歧杆菌三联活菌胶囊治疗慢性乙型肝炎合并肝硬化的疗效及对肝功能、肝纤维化指标的影响.方法 选择2015年1月-2017年1月湖北医药学院附属随州医院感染科收治慢性乙型肝炎合并肝硬化患者104例作为研究对象,采用随机数字表法分为2组,观察组和对照组各52例.对照组予常规治疗,观察组在对照组的基础上予双歧杆菌三联活菌胶囊,治疗8周后,观察2组患者的疗效、肝功能、肝纤维化指标的变化及不良反应.结果 观察组总有效率为92.31%,高于对照组的69.23%(χ2=8.910,P=0.003).治疗后2组患者的血清总胆红素(TB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)较治疗前均显著降低(P均<0.01),且观察组优于对照组(t=2.465、4.282、2.966,P均<0.01);2组患者治疗后胆碱酯酶(CHE)较治疗前显著升高,层黏连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)较治疗前显著降低(P均<0.01),且观察组较对照组CHE显著提高,LN、HA、PCⅢ显著降低(t=4.535、14.583、16.257、14.773,P均<0.05).结论 双歧杆菌三联活菌胶囊可改善乙型肝炎合并肝硬化患者体内的细胞因子,减少炎性反应的发生,可改善肝功能,在临床上可广泛使用.%Objective To investigate the curative effect of Bifidobacterium triple viable capsule on chronic hepatitis B and cirrhosis of cholinesterase,LN(laminin),PCⅢ(former III collagen),HA(hyaluronic acid). Methods From Januar-y 2015 to January 2017,104 cases in our hospital for treatment of chronic hepatitis B with cirrhosis were included,they were randomly divided into observation group and control group by using random number table method, each had 52 cases. The control group was received routine treatment;the observation group was received Bifidobacterium triple viable capsule. After 8 weeks of treatment,observed the curative effect,liver function(TB,AST,ALT),cytokines(LN,PCⅢ,HA) and the elec-trocardiogram, blood routine examination and other adverse reactions. Results The total effective rate of the observation group was 92.308%,and that of the control group was 69.231%,the difference between the two groups was statistically sig-nificant (χ2=8.910,P=0.003). After treatment,the two groups of patients' TB,AST, ALT were significantly lower than before treatment,the difference was statistically significant(P<0.01). The control group after treatment,TB was(44.055 ± 10.528)mol/L,AST was (50.802 ± 15.746) U/L, ALT was (49.959 ± 13.243) U/L, the observation group's TB was (39.426 ± 8.513) mol/L, AST was (42.384 ± 13.075) U/L, ALT was (39.634 ± 11.267)U/L, the observation group were significantly lower than the control group,the difference was statistically significant(P<0.01). After treatment,the two groups' LN,HA,PC III were significantly lower than before treatment,cholinesterase was significantly increased,the differ-ence was statistically significant(all P=0.000),the observation group' LN was(78.815 ± 5.737) g/L,HA was(98.365 ± 7.271)g/L,PCⅢ was (108.435 ± 12.057)g/L,which was significantly lower than the control group,cholinesterase was (8 011.306 ± 2 704.828)U/L,which was significantly increased,the difference was statistically significant(all P=0.000). Conclusion Bifidobacterium triple viable capsule can improve the cytokines in patients with hepatitis B and cirrhosis,reduce inflammation,improve liver function,and can be widely used in clinic.