乳果糖和枯草杆菌屎球菌二联活菌治疗轻微性肝性脑病疗效观察

目的:探讨乳果糖和枯草杆菌屎球菌二联活菌治疗肝硬化所致轻微性肝性脑病(MHE)的疗效。方法:将患有MHE的患者84例随机分为四组,对照组(A组,仅接受肝硬化综合治疗),乳果糖组(B组,在A组基础上加用乳果糖口服液),枯草杆菌屎球菌二联活菌组(C组,在A组基础上加用枯草杆菌屎球菌二联活菌胶囊),联合组(D组,在A组基础上联合应用乳果糖和枯草杆菌屎球菌二联活菌胶囊),每组均治疗4周。分别于治疗后第一周,第二周,第四周观察患者的数字连接实验(NCT)、数字符号实验(DST)结果,血氨变化及不良反应的发生情况。结果:B、C、D组NCT时间,DST分数及血氨均较A组改善明显,其中以D组最显著(P0.05),且随着治疗时间延长,B、C、D组以上各指标逐渐改善,其中D组以治疗后2周效果最明显(P0.05)。四组均无明显不良反应,其中D组不良反应率最低。结论:单用乳果糖与单用枯草杆菌二联活菌均可改善MHE患者的病情,但联合用药效果明显优于单药治疗,且随用药时间延长,疗效明显,安全性高,值得在临床推广。

Lactulose Bacillus Subtilis and Enterococcus Faecim for Minimal Hepatic Encephalopathy

Objective:To investigate the effect of lactulose and Bacillus subtilis and Enterococcus faecim in the treatment of minimal hepatic encephalopathy (MHE) induced by cirrhosis.Methods:A total of 84 patients with MHE were randomly divided into control group(group A,treated with comprehensive treatment of cirrhosis), lactulose group (group B,added lactulose on the basis of group A),Bacillus subtilis and Enterococcus faecim group (group C, added Bacillus subtilis and Enterococcus faecim on the basis of group A), combination group (group D, added lactulose and Bacillus subtilis and Enterococcus faecim on the basis of group A). The course of treatment of each group was 4 weeks. The result of number connection test (NCT), digital symbol test (DST), blood ammonia level and adverse reactions were observed respectively at 1 week,two weeks, four weeks after treatment.Results:NCT time, DST score and blood ammonia levels in group B, C and D were improved better than those in group A, among which, group D, best 2 weeks after treatment (P<0.05). There were no serious adverse reactions in the four groups, among which, group D had the lowest incidence of adverse reactions.Conclusion:Using lactulose or Bacillus subtilis and Enterococcus faecim can alone in the treatment of patients with MHE can improve the condition of patients, but the effect of their combination is significantly better than monotherapy, furthermore, the effect of combination therapy will be much better with the prolongation of treatment time, with high safety, which is worth of clinical application.