酪酸梭菌活菌片联合多烯磷脂酰胆碱对酒精性肝病患者肠道菌群及炎症因子的影响

目的 探讨酪酸梭菌活菌片联合多烯磷脂酰胆碱对酒精性肝病（ALD）患者肠道菌群及炎症因子的影响。方法 选取2015年1月至2018年1月进行治疗的ALD患者80例，随机分为观察组和对照组。两组患者均予以严格戒酒、高蛋白高热量低脂饮食、维生素及门冬氨酸钾镁等常规治疗。观察组患者在此基础上加用酪酸梭菌活菌片（0.7 g/次，3次/d，口服）和多烯磷脂酰胆碱胶囊（456 mg/次，3次/d，口服）联合治疗8周。对照组患者在常规治疗基础上单纯加用多烯磷脂酰胆碱片治疗，其剂量、用法及疗程与观察组相同。观察并比较治疗前后患者肝功能指标、肠道菌群数量及炎症因子的变化。结果 治疗8周后，两组患者血清ALT、AST和TBiL水平均较治疗前显著下降（P<0.05），且观察组下降幅度较对照组更大（P<0.05）。两组患者肠道双歧杆菌和乳杆菌数量较治疗前明显上升，大肠埃希菌数量较治疗前明显下降（P<0.05），且观察组变化幅度较对照组更大（P<0.05）。两组患者血清IL-6和TNF-α水平较治疗前明显下降（P<0.05），且观察组下降幅度较对照组更大（P<0.05）。结论 酪酸梭菌活菌片联合多烯磷脂酰胆碱能有效改善ALD患者肝功能指标，促进肝功能恢复，其作用机制可能与其能纠正肠道菌群失调，促进有益菌的繁殖，同时下调血清炎症因子水平，抑制肝内炎症反应密切相关。

Influence of Clostridium Butyricum Tablets Combined with Polyene Phosphatidyl Choline on intestinal flora and inflammatory factors of patients with alcoholic liver disease

Objective To discuss the effects of Clostridium Butyricum Tablets combined with polyene phosphatidyl choline on intestinal flora and inflammatory factors of patients with alcoholic liver disease (ALD). Methods 80 patients with ALD in our hospital from January 2015 to January 2018 were randomly divided into observation group or control group. Both groups were given routine medical treatment. The observation group was additionally given Clostridium Butyricum Tablets (0.7g tid orally) and Polyene Phosphatidyl Choline Capsules (456mg tid orally) for 8 weeks, while the control group was given Polyene Phosphatidyl Choline Capsules alone with the same dose, method and course of treatment. The changes of liver function indexes, quantities of intestinal flora and inflammatory factors before and after treatment were observed and compared between groups. Results After 8 weeks of treatment, the levels of serum ALT, AST and TBiL in both groups obviously declined (Ps<0.05), and the declining rates in observation group were much higher than those in control group (Ps<0.05). The quantities of Bifidobacteria and Lactobacilli obviously increased, while that of Escherichia coli obviously declined (P<0.05), and the declining rate in observation group was much higher than that in control group (P<0.05). The levels of serum IL-6 and TNF-α in both groups obviously declined (Ps<0.05), and the declining rates in observation group were much higher than those in control group (Ps<0.05) respectively. Conclusion Clostridium Butyricum Tablets combined with Polyene Phosphatidyl Choline can effectively improve the liver function indexes and speed the recovery of liver function, the mechanism of action of which may have close relation with its effects of not only adjusting the disorder of intestinal flora and speeding the reproduction of probiotics but also down-regulating the levels of serum inflammatory factors and inhibiting inflammatory reactions.