目的：评价肝硬化患者肠黏膜屏障功能、血氨和血内毒素的变化特点及地衣芽孢杆菌胶囊对肝硬化患者的影响。方法：选择60例肝硬化患者进行随机开放性对照试验，使用随机数字表法分为治疗组和对照组，给予保肝、利尿、支持治疗，治疗组在此基础上加用地衣芽孢杆菌胶囊（整肠生）治疗两周。比较两组治疗前后血二胺氧化酶（DAO）、D-乳酸（D-L）、内毒素（ETX）、氨及肝功能变化情况。结果：肝硬化患者血DAO、D-L、ETX、氨四项指标与标准参考值相比增高，并且都随肝硬化Child-Pugh评分升高而升高（0.40.05）。在14天的观察期内，治疗组与对照组并发症发生率差异无统计学意义（13.3% vs 3.3%，P>0.0.5）。结论：地衣芽孢杆菌短期内治疗具有潜在保护肝硬化患者肠黏膜屏障的作用，从而降低循环血中的内毒素和氨水平。%Objective: To investigate the function of intestinal mucosal barrier in patients with liver cir-rhosis (LC) and explore the clinical efficacy and safety of Bacillus licheniformis in the treatment of LC pa-tients. Methods: In a randomized open study, 60 participants with LC, in accordance with the random number table, were divided into experimental group and control group. Patients in the control group re-ceived hepatoprotective, diuretic and supporting treatment, and patients in the experimental group were giv-en probiotic capsules containing Bacillus licheniformis (Zhengchangsheng capsules) besides the same general therapy for a period of 14 days. The changes of DAO, D-L, EXT and ammonia levels and liver function before or after treatment between the 2 groups were compared. Results: The levels of DAO, D-L, EXT and ammonia were higher in patients with LC than the reference values. The levels were also positively correlated with the Child-Pugh scores. The levels of DAO and D-L were significantly higher with alcoholic cirrhosis than with liver cirrhosis of hepatitis (P0.05). Conclusions: Bacillus licheniformis could improve the function of intestinal mu-cosal barrier, reduce the absorption of enterological EXT and ammonia.
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