中药复方通腑颗粒对失代偿期肝硬化患者肠黏膜屏障的保护作用

作者	单位
姜春燕	首都医科大学附属北京友谊医院
王宝恩	首都医科大学附属北京友谊医院
陈丹	中国协和医科大学药物研究所
王建成	首都医科大学附属北京友谊医院

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中文摘要:

目的探讨中药复方通腑颗粒对失代偿期肝硬化患者肠黏膜屏障的保护作用。方法选取失代偿期肝硬化患者50例,随机分为标准治疗组(26例)和通腑颗粒组(24例),疗程2周,并以30名健康成年人作为正常对照。观察治疗前后两组患者的肠黏膜通透性(尿中乳果糖/甘露醇排出率)、血浆内毒素水平及肠道菌群变化,并与正常对照组进行比较。结果肝硬化患者治疗前与正常对照组比较,肠黏膜通透性、血浆内毒素水平显著升高,肠道双歧杆菌数量减少,肠杆菌数量增多(P<0.05,P<0.01)。治疗2周后,通腑颗粒组血浆内毒素水平、尿中乳果糖排出率较治疗前显著降低,与标准治疗组比较差异有统计学意义(P<0.05),同时通腑颗粒组肠道双歧杆菌较治疗前数量增多,肠杆菌数量减少(P<0.05,P<0.01),达到正常对照组水平。结论通腑颗粒可以改善肠黏膜屏障功能,纠正肠道茵群紊乱,减轻失代偿期肝硬化患者的肠源性内毒素血症。

英文摘要:

Objective To explore the intestinal mucosal barrier protective effect of herbal medicine Com- pound Tongfu Granule (CTG) in patients with liver cirrhosis of decompensation stage.Methods Fifty patients en- rolled were randomly assigned to the control group (26 cases) and the CTG group (24 cases),and 30 healthy a- dults were set up as normal control.After 2-week treatment,the intestinal permeability (IP,represented by urinary lactulose/mannitol excretion rate),plasma endotoxin (EDT) level,and change of enteric bacteria (EB) in pa- tients were observed before and after treatment,and compared with those in the normal control.Results Before treatment,cirrhotic patients showed significantly higher levels of IP,EDT,and intestinal bacilli,but a lower a- mount of enteric bifidobacteria as compared with those the normal control.After 2-week treatment,levels of EDT and urinary excretion rate of lactulose in the CTG group were lowered more significantly than those in the control group (P<0.05),while the amount of bifidobacteria in the CTG group increased accompanied with intestinal ba- cilli significantly lowered to near the levels in the normal control (P<0.05,P<0.01).Conclusion CTG can improve the intestinal barrier function,correct the intestinal bacteria disturbance,and significantly reduce the ente- ro-derived endotoxemia in cirrhotic patients of decompensation stage.

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