乳果糖联合双歧杆菌三联活菌胶囊在轻微性肝性脑病患者中的应用效果

目的 探讨乳果糖联合双歧杆菌三联活菌胶囊在轻微性肝性脑病(MHE)患者中的应用效果。 方法 选择2015年1月至2019年4月在我院消化科住院就诊的94例MHE患者为研究对象,随机分为观察组和对照组各47例。两组患者均予基础治疗。观察组患者在基础治疗上加用双歧杆菌三联活菌胶囊(630 mg/次,2次/d,温开水送服)联合乳果糖口服液(20 mL/次,3次/d,口服)治疗,连用8周。对照组患者单用乳果糖口服液治疗,剂量、用法及疗程同观察组。观察两组患者治疗前后血氨、血清内毒素(ET)、数字连接试验(NCT)时间和数字符号实验(DST)评分及肠道菌群数量的变化,并比较肝性脑病(HE)的转变率。 结果 治疗8周后,两组患者血氨、ET和NCT时间均较治疗前明显下降,DST评分较治疗前明显上升,且观察组变化幅度大于对照组(均P2=3.89,P=0.049)。 结论 乳果糖联合双歧杆菌三联活菌胶囊能显著改善MHE患者智力测验结果,降低HE转化率,其作用机制可能与其能纠正患者肠道菌群紊乱,降低血氨水平,控制内毒素血症相关。

Effect of Lactulose combined with Triplet Viable Bifidobacteria Capsules on mild hepatic encephalopathy patients

Objective To investigate the regulatory effect of Lactulose combined with Triplet Viable Bifidobacteria Capsules on patients with mild hepatic encephalopathy (MHE) . Methods A total of 94 patients with MHE who were treated in our hospital from January 2015 to April 2019 were randomly divided into observation group or control group, 47 cases in each group. All the patients were given basic treatments. The patients in observation group were additionally given Triplet Viable Bifidobacterium capsules (630 mg bid) combined with Lactulose oral solution (20 mL tid) for 8 weeks, while those in control group were treated with Lactulose oral solution alone. The changes of blood ammonia, serum endotoxin (ET), NCT time, DST score and intestinal flora were observed before and after treatment, and the conversion rate of HE was compared between two groups. Results After 8 weeks′ treatment, the blood ammonia, serum ET and NCT time were significantly lower than before, while the DST score were significantly higher than before in two groups, with the change range in observation group was more obviously than that in control group (all P2=3.89, P=0.049). Conclusion Lactulose combined with Triplet Viable Bifidobacteria capsules can significantly improve the intelligence test results and reduce the HE conversion rate in MHE patients. The mechanism may be related to the effect of correcting the intestinal micro ecological balance disorder, reducing blood ammonia levels and controlling endotoxemia.