摘要
Objective:To explore the safety and therapeutic effect of probiotics combined with ornithine aspartate on patients with liver cirrhosis complicated by hepatic encephalopathy.Methods:72 patients with hepatic encephalopathy hospitalized in the Affiliated Hospital of North China University of Technology from January 2017 to December 2021 were randomly. According to the principle of comparability between groups in terms of gender and age, the group was divided into an observation group (36 cases) and a control group (36 cases) using a random number table method. The control group was treated with ornithine aspartate, while the case group was treated with probiotics combined with ornithine aspartate. The curative effect of the two groups of patients and the changes of serum inflammatory factors, intestinal flora and intestinal mucosal barrier function were observed.Results:The total effective rate of the case group was higher than that of the control group [97.22%(35/36) vs 83.33%(30/36)], The difference between groups is statistically significant (χ 2=2.53, P=0.112). After treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), blood ammonia, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor (TNF) in the two groups-α (TNF-α)、C-reactive protein (CRP), enterobacter, enterococcus content, endotoxin, D-lactic acid, diamine oxidase, and digital connection test (NCT) time were lower than before treatment [(-130.89±31.67) U/L vs (-98.64±43.41) U/L,(-137.81±31.92) U/L vs (-79.58±45.42) U/L, (-57.13±21.07) μmol/L vs (-45.92±18.11) μmol/L,(-164.06±19.30) μmol/L vs (-148.98±12.97) μmol/L, (-5.35±2.30) ng/L vs (2.18±2.77) ng/L,(-5.51±2.07) μmol/L vs (-3.72±1.50) ng/L, (-12.60±3.65) ng/L比(-7.97±5.86) ng/L, (-45.95±20.34) mg/L vs (-21.14±19.09) mg/L, (-2.70±1.53) vs (-1.31±2.47), (-2.50±1.26) vs (-1.39±1.97),(-0.32±0.09) EU/ml vs (-0.19±0.09) EU/ml, (-47.58±18.52) nmol/L vs (-32.31±22.21) nmol/L,(-3.44±1.06) U/ml vs (-1.86±1.30) U/ml, (-31.75±10.09) s vs (-14.58±10.10) s] and the scores of bifidobacterium, lactobacillus, and digital sign test (DST) were higher than before treatment [(2.77±1.76) vs (1.13±2.06), (3.23±1.61) vs (1.06±2.31), (32.58±5.72) vs (16.33±6.16)]. After treatment, ALT, AST, TBIL, blood ammonia, IL-6, IL-8, TNF in the case group-α, CRP, Enterobacter, Enterococcus content, endotoxin, D-lactic acid, diamine oxidase, NCT time were lower than those in the control group, and bifidobacterium, lactobacillus, DST scores were higher than those in the control group, with statistically significant differences(t-values of 3.60, 6.29, 2.42, 3.89, 5.28, 4.21, 4.03, 5.34, 2.87, 2.86, 6.11, 3.17, 5.63, 7.21, 3.61, 4.64 and 11.59. P-values of 0.001, <0.001, 0.018, <0.001, <0.001, <0.001, <0.001, <0.001, 0.005, 0.006, <0.001, 0.002, <0.001, <0.001, 0.001, <0.001, and <0.001). Conclusions:Micro-ecological preparation combined with ornithine aspartate has a significant therapeutic effect on patients with hepatic encephalopathy, which can significantly improve liver function and cognitive function of patients, reduce blood ammonia level, inhibit inflammatory reaction, improve intestinal flora and intestinal mucosal barrier function, with good safety, and is worthy of clinical promotion.
摘要
Objective:To explore the effects of different courses of Bifidobacterium combined with bismuth on the eradication rate, ulcer healing rate and adverse reactions in the initial eradication treatment of Helicobacter pylori positive gastric ulcer patients.Methods:From September 2018 to September 2021, 219 patients with gastric ulcer were selected from the outpatient department of gastroenterology department of Kailuan General Hospital Affiliated,all of whom were positive for 13C or 14C-urea breath test and were not treated with Helicobacter pylori eradication. Group A, B and C were randomly divided by Excel, Group A was the control group (73 patients): 14-day bismuth quadruple therapy (Eprazole + colloidal bismuth pectin + amoxicillin + furazolidone); group B (73 patients): 7 days Bifidobacterium tetravaccine tablets (live) was given in the second week of treatment in group A; group C (73 patients): Bifidobacterium tetravaccine tablets (live) was given 14 days on the basis of treatment in group A. 13C or 14C-urea breath test and gastroscope were reexamined after all treatments, to compare the eradication rate, ulcer healing rate and the incidence of adverse reactions.Results:The eradication rates in three groups were 90.8%(59/65), 91.2% (62/68)and 91.0%(61/67) respectively, there was no significant difference among the three groups (χ 2=0.01, P=0.997). The ulcer healing rate in three groups were 93.8%(61/65), 94.1%(64/68) and 95.5%(64/67) respectively, group B and group C were compared with group A, and the difference was not statistically significant(group B: group A P=1.000, group C: group A P=0.716).The incidence of adverse reactions in three groups was 21.4%(15/70), 7.1%(5/70) and 7.0%(5/71) respectively, the difference was statistically significant (χ 2=9.21, P=0.010). The incidence of adverse reactions in group B and C was significantly lower than that in group A (group B: group A χ 2=5.83, P=0.016; group C: groups A χ 2=5.99, P=0.014). Compare means of measurement data among the three groups use analysis of variance. Chi square test, Fisher exact probability method and split chi square test were used to compare the three groups of counting data. Conclusion:14-day Bifidobacterium tetravaccine tablets (live) and the second half of the treatment lasted for 7-day Bifidobacterium Bifidobacterium tetravaccine tablets (live), they are combined separately with bismuth quadruple therapy in the first eradication of Helicobacter pylori positive gastric ulcer patients can significantly reduce adverse reactions, but Bifidobacterium tetravaccine tablets (live) could not significantly improve the eradication rate, and had no promoting effect on the healing of gastric ulcer.