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目的探讨双歧三联活菌胶囊辅助治疗对乙肝后肝硬化患者肠黏膜屏障功能及细胞免疫功能的影响。方法选取78例门诊或住院治疗的乙肝后肝硬化患者,随机分为两组,其中观察组和对照组各39例。两组患者予以护肝利尿、控制门脉压和营养支持等基础治疗。观察组加用双歧三联活菌胶囊630mg/次,2次/d,温水口服,连用6周。观察两组治疗前后肝功能指标[丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)和总胆红素(TBIL)]、肠黏膜屏障功能[前降钙素(PCT)和二胺氧化酶(DAO)]及细胞免疫功能[T淋巴细胞亚群]的变化。结果治疗6周后,两组血清ALT、AST和TBIL指标较前均明显下降(P<0.05或P<0.01),且观察组下降幅度较对照组更明显(P<0.05);两组血清PCT和DAO指标较前明显下降(P<0.05或P<0.01),且观察组下降幅度较对照组更明显(P<0.05);同时两组CD4+水平和CD4+/CD8+比值均较前明显上升(P<0.05),且观察组上升幅度较对照组更明显(P<0.05),而两组治疗前后CD8+水平无明显变化(P>0.05)。结论双歧三联活菌胶囊辅助治疗乙肝后肝硬化患者能更有效降低ALT、AST和TBIL水平,保护其肝功能;降低血清PCT和DAO水平,修复肠黏膜屏障功能;还能纠正T淋巴细胞亚群紊乱,增加其细胞免疫功能。
Objective To investigate the effects of adjuvant bifidus triple active capsule on intestinal mucosal barrier function and cellular immune function in patients with posthepatitic cirrhosis. Methods 78 cases of outpatient or hospitalized patients with hepatitis B cirrhosis were randomly divided into two groups, 39 cases in the observation group and the control group. Two groups of patients with liver and diuretic control of portal pressure and nutritional support and other basic treatment. The observation group plus bifid triple viable capsule 630mg / time, 2 times / d, warm water oral, once every 6 weeks. The liver function indexes (ALT, AST and TBIL), intestinal mucosal barrier function (procalcitonin (PCT) and diamine Oxidase (DAO)] and cellular immune function [T lymphocyte subsets]. Results After 6 weeks of treatment, the levels of serum ALT, AST and TBIL in both groups were significantly lower than those in the control group (P <0.05 or P <0.01), and the decrease in the observation group was more significant than that in the control group (P <0.05) (P <0.05 or P <0.01), and the decline rate of the observation group was more obvious than that of the control group (P <0.05). At the same time, the ratio of CD4 + and CD4 + / CD8 + <0.05), and the increase rate of the observation group was more obvious than that of the control group (P <0.05). There was no significant difference in the level of CD8 + between the two groups before and after treatment (P> 0.05). Conclusions Bifid triple viable capsule can effectively reduce the levels of ALT, AST and TBIL in patients with posthepatitic cirrhosis and protect their liver function, reduce serum PCT and DAO levels, repair intestinal mucosal barrier function, and correct T lymphocyte subsets Disorder, increase their cellular immune function.