CAJ | 학술논문

目的观察酪酸梭菌活菌片治疗乙型肝炎肝硬化腹泻的临床疗效.方法选择2011年1月至2013年5月浙江省浦江县人民医院87例乙型肝炎肝硬化腹泻患者.采用数表法将患者随机分为治疗组(44例)和对照组(43例).两组均予抗病毒、护肝、退黄、补液对症处理,治疗组在此基础上加用酪酸梭菌片(2片/次,3次/d,连用4周).观察两组腹泻缓解的时间,肝功能改善情况以及并发症的发生.计量资料采用t检验,计数资料采用x2检验或秩和检验.结果酪酸梭菌治疗组总有效率为95.45％ (42/44),对照组总有效率为74.4％ (32/43),二组有效率差异有统计学意义(Z=2.82,P＜0.05).治疗4周时治疗组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)、白蛋白(Alb)和Child-Pugh (CTP)评分与对照组相比差异有统计学意义(t=2.13,2.57,4.83,5.93和3.30,P值均＜0.01).对照组有2例出现肝性脑病.结论酪酸梭菌片治疗乙型肝炎肝硬化腹泻疗效确切,且能明显改善患者肝功能,减少肝性脑病的发生,值得临床推广.
목적 관찰락산사균활균편치료을형간염간경화복사적림상료효.방법 선택2011년1월지2013년5월절강성포강현인민의원87례을형간염간경화복사환자.채용수표법장환자수궤분위치료조(44례)화대조조(43례).량조균여항병독、호간、퇴황、보액대증처리,치료조재차기출상가용락산사균편(2편/차,3차/d,련용4주).관찰량조복사완해적시간,간공능개선정황이급병발증적발생.계량자료채용t검험,계수자료채용x2검험혹질화검험.결과 락산사균치료조총유효솔위95.45％ (42/44),대조조총유효솔위74.4％ (32/43),이조유효솔차이유통계학의의(Z=2.82,P＜0.05).치료4주시치료조병안산전안매(ALT)、천동안산전안매(AST)、총담홍소(TBil)、백단백(Alb)화Child-Pugh (CTP)평분여대조조상비차이유통계학의의(t=2.13,2.57,4.83,5.93화3.30,P치균＜0.01).대조조유2례출현간성뇌병.결론 락산사균편치료을형간염간경화복사료효학절,차능명현개선환자간공능,감소간성뇌병적발생,치득림상추엄.
Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.