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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(P<0.05),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(P<0.05)。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。
Objective: To investigate the efficacy of lactulose and B. subtilis viable viable bacteria in the treatment of mild hepatic encephalopathy (MHE) caused by cirrhosis. Methods: Eighty-four patients with MHE were randomly divided into four groups: control group (group A, only receiving liver cirrhosis), lactulose group (group B, lactose plus group A) Bacillus subtilis feces diarrhea live viable group (C group, on the basis of group A plus Bacillus subtilis fecalis viable capsule), combined group (D group, based on the combination of A group of lactulose and Bacillus subtilis feces Cocci second live viable capsule), each treatment for 4 weeks. The digital connection test (NCT), digital sign experiment (DST) results, blood ammonia changes and adverse reactions were observed in the first week, the second week and the fourth week after treatment respectively. Results: The NCT time, DST score and blood ammonia in groups B, C and D were significantly improved compared with those in group A, especially in group D (P <0.05). With the prolongation of treatment time, Indicators gradually improved, of which D group 2 weeks after treatment the most obvious effect (P <0.05). No significant adverse reactions in the four groups, including the lowest adverse reaction rate in group D. CONCLUSION: Both lactulose alone and viable Bacillus subtilis alone can improve the condition of patients with MHE. However, combination therapy is superior to monotherapy, and with the prolonged use of drugs, the curative effect is obvious and the safety is high, so it is worth clinical treatment Promotion.