中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
5期
555-558
,共4页
张冬%郝秀仙%杨婷%娄渊贵
張鼕%郝秀仙%楊婷%婁淵貴
장동%학수선%양정%루연귀
肝疾病,酒精性%肠道菌群%肝酶学%双歧三联活菌
肝疾病,酒精性%腸道菌群%肝酶學%雙歧三聯活菌
간질병,주정성%장도균군%간매학%쌍기삼련활균
Liver disease,alcoholic%Bowel flora%Liver enzymes%Live combined bifidobacterium,lactobacillus and enterrococcus
目的 研究酒精性肝病(ALD)患者肠道菌群的变化以及双歧三联活菌对酒精性肝病的治疗作用.方法 66例住院ALD患者完全随机分为标准治疗组(34例)和试验治疗组(32例),分别接受7 d的标准治疗和试验治疗(双歧三联活菌+标准治疗).治疗前后做大便细菌培养和肝酶学测定.以24名健康不饮酒者为对照组.结果 与对照组相比,ALD患者肠道菌群数量显著(10g CFU/g)减少[双歧杆菌(6.30±0.17)比(7.50±0.32);乳酸杆菌(3.15±0.19)比(4.59 ±0.34);肠球菌(4.43±0.20)比(5.50±0.30),P<0.05];并有显著的肝酶学增高[AST:(104.1±0.95)U/L比(29.15±2.03)U/L;ALT:(50.49±5.90)U/L比(22.96±2.40)U/L:谷氨酸转肽酶(GGT):(161.50 ±13.50)U/L 比(51.90±6.20)U/L;TBil(22.56 ±1.17)比(16.78±0.79),P<0.05].在7 d治疗后,试验治疗组患者肠道菌群数量(10g CFU/g)明显高于标准治疗组[双歧杆菌(7.90±0.39)比(6.81±0.27);乳酸菌(4.20 ±0.27)比(3.20±0.27);肠球菌(5.3±0.31)比(4.30±0.30),P<0.05].尽管治疗前2组患者的肝酶学改变与对照组相比差异都有统计学意义,但是治疗后试验治疗组AST.ALT下降更明显,与标准治疗组相比差异有统计学意义[AST:(54.67 ±7.71)U/L比(76.43±5.06)U/L;ALT:(36.69±4.67)U/L比(51.26±2.25)U/L,P<0.05].在26例酒精性肝炎的亚组中,试验治疗后只有AST下降明显,与标准治疗组相比差异有统计学意义[(56.38±9.47)U/L比(88.54±15.16)U/L,P<0.05].结论 ALD患者与健康对照组相比肠道菌群显著减少,短期经口补充双歧三联活菌不但有利于肠道菌群的恢复,而且有利于肝功能的恢复.
目的 研究酒精性肝病(ALD)患者腸道菌群的變化以及雙歧三聯活菌對酒精性肝病的治療作用.方法 66例住院ALD患者完全隨機分為標準治療組(34例)和試驗治療組(32例),分彆接受7 d的標準治療和試驗治療(雙歧三聯活菌+標準治療).治療前後做大便細菌培養和肝酶學測定.以24名健康不飲酒者為對照組.結果 與對照組相比,ALD患者腸道菌群數量顯著(10g CFU/g)減少[雙歧桿菌(6.30±0.17)比(7.50±0.32);乳痠桿菌(3.15±0.19)比(4.59 ±0.34);腸毬菌(4.43±0.20)比(5.50±0.30),P<0.05];併有顯著的肝酶學增高[AST:(104.1±0.95)U/L比(29.15±2.03)U/L;ALT:(50.49±5.90)U/L比(22.96±2.40)U/L:穀氨痠轉肽酶(GGT):(161.50 ±13.50)U/L 比(51.90±6.20)U/L;TBil(22.56 ±1.17)比(16.78±0.79),P<0.05].在7 d治療後,試驗治療組患者腸道菌群數量(10g CFU/g)明顯高于標準治療組[雙歧桿菌(7.90±0.39)比(6.81±0.27);乳痠菌(4.20 ±0.27)比(3.20±0.27);腸毬菌(5.3±0.31)比(4.30±0.30),P<0.05].儘管治療前2組患者的肝酶學改變與對照組相比差異都有統計學意義,但是治療後試驗治療組AST.ALT下降更明顯,與標準治療組相比差異有統計學意義[AST:(54.67 ±7.71)U/L比(76.43±5.06)U/L;ALT:(36.69±4.67)U/L比(51.26±2.25)U/L,P<0.05].在26例酒精性肝炎的亞組中,試驗治療後隻有AST下降明顯,與標準治療組相比差異有統計學意義[(56.38±9.47)U/L比(88.54±15.16)U/L,P<0.05].結論 ALD患者與健康對照組相比腸道菌群顯著減少,短期經口補充雙歧三聯活菌不但有利于腸道菌群的恢複,而且有利于肝功能的恢複.
목적 연구주정성간병(ALD)환자장도균군적변화이급쌍기삼련활균대주정성간병적치료작용.방법 66례주원ALD환자완전수궤분위표준치료조(34례)화시험치료조(32례),분별접수7 d적표준치료화시험치료(쌍기삼련활균+표준치료).치료전후주대편세균배양화간매학측정.이24명건강불음주자위대조조.결과 여대조조상비,ALD환자장도균군수량현저(10g CFU/g)감소[쌍기간균(6.30±0.17)비(7.50±0.32);유산간균(3.15±0.19)비(4.59 ±0.34);장구균(4.43±0.20)비(5.50±0.30),P<0.05];병유현저적간매학증고[AST:(104.1±0.95)U/L비(29.15±2.03)U/L;ALT:(50.49±5.90)U/L비(22.96±2.40)U/L:곡안산전태매(GGT):(161.50 ±13.50)U/L 비(51.90±6.20)U/L;TBil(22.56 ±1.17)비(16.78±0.79),P<0.05].재7 d치료후,시험치료조환자장도균군수량(10g CFU/g)명현고우표준치료조[쌍기간균(7.90±0.39)비(6.81±0.27);유산균(4.20 ±0.27)비(3.20±0.27);장구균(5.3±0.31)비(4.30±0.30),P<0.05].진관치료전2조환자적간매학개변여대조조상비차이도유통계학의의,단시치료후시험치료조AST.ALT하강경명현,여표준치료조상비차이유통계학의의[AST:(54.67 ±7.71)U/L비(76.43±5.06)U/L;ALT:(36.69±4.67)U/L비(51.26±2.25)U/L,P<0.05].재26례주정성간염적아조중,시험치료후지유AST하강명현,여표준치료조상비차이유통계학의의[(56.38±9.47)U/L비(88.54±15.16)U/L,P<0.05].결론 ALD환자여건강대조조상비장도균군현저감소,단기경구보충쌍기삼련활균불단유리우장도균군적회복,이차유리우간공능적회복.
Objective To investigate the character of bowel flora and the therapeutic role of live combined bifidobacterium,lactob-acillus and enterrococcus(LCBLE)in alcoholic liver disease(ALD).Methods Sixty-six adult males admitted with a diagnosis of ALD were enrolled in this randomized,clinical study in 32 weeks.Patients were randomized to 7 days of LCBLE plus standard therapy and standard therapy(abstinence,hish caloric,protein low fat diet.vitamins,etc)only.Stool cultures and liver enzymes were performed before the trail and were repeated after the therapy.Results Compared to healthy controls,ALD patients had significantly reduced numbers of bifidobacteria.1actobacilli,and enteroeocci.Liver enzymes were significantly elevated in the alcohofic group compared to the healthy control group,indicating that these patients did have alcohol-induced liver injury.After 7 days of therapy of LCBLE,ALD patients had significantly increased quantity of bifidobacteria,lactobacilli and enterococci compared to the standard therapy arm.Despite similar values at study initiation,patients treated with LCBLE had significandy lower AST and ALT activity at the end of treatment than those treated with standard therapy alone.In a subgroup of 26 subjects with diagnosis alcoholic hepatitis,therapy of LCBLE was associated with a significant reduction in liver enzymes and TB. In this subgroup,there was a mean AST reduction in the LCBLE therapy compared with the standard therapy arm.Conlusions ALD patients have significantly altered bowel flora compared to healthy controls.Short-term oral supplementation with LCBLE is associated with restoration of the bowel flora and improvement in alcohol-induced liver injury than standard therapy alone.
