香砂六君子汤联合枯草杆菌二联活菌肠溶胶囊治疗脾胃气虚型乙肝肝硬化合并小肠细菌过度生长的临床疗效观察

Clinical observation of Xiangsha Liujunzi Decoction combined with Bacillus Subtilis Living Bacteria Enteric-coated Capsule in the treatment of hepatitis B cirrhosis complicated with intestinal bacterial overgrowth in spleen-stomach qi deficiency syndrome

关键词:  香砂六君子汤  益生菌  乙肝肝硬化  小肠细菌过度生长

Key words:  Xiangsha Liujunzi Decoction  probiotics  hepatitis B cirrhosis  bacterial overgrowth in the small intestine

摘要:

[目的] 探讨香砂六君子汤联合枯草杆菌二联活菌肠溶胶囊治疗脾胃气虚型乙肝肝硬化合并小肠细菌过度生长（SIBO）的疗效。[方法] 连续性招募2020年12月至2022年12月收治的80例乙肝肝硬化合并SIBO患者，采用随机数字表法将其分为两组，每组各40例。对照组给予枯草杆菌二联活菌肠溶胶囊治疗，观察组给予香砂六君子汤联合枯草杆菌二联活菌肠溶胶囊治疗。观察两组疗效、SIBO转阴率、中医证候积分、肝功能、免疫功能、炎症因子和不良反应。[结果] 观察组总有效率和治疗14dSIBO转阴率高于对照组（P＜0.05）。两组治疗后食欲不振，脘腹痞胀食后尤甚，大便溏泄，神疲肢倦，头晕乏力证候积分较治疗前降低（P＜0.05），血清谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBiL）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平，外周血CD⁸⁺占比较治疗前降低（P＜0.05），总蛋白（TP）、外周血CD³⁺、CD⁴⁺占比较治疗前增高（P＜0.05），观察组治疗后中医证候积分，血清ΑST、ALT、IL-6、TNF-α水平，外周血CD⁸⁺占比低于对照组（P＜0.05），外周血CD³⁺、CD⁴⁺占比、CD⁴⁺/CD⁸⁺高于对照组（P＜0.05）。[结论] 香砂六君子汤联合枯草杆菌二联活菌肠溶胶囊可更显著改善临床症状，提高T淋巴细胞免疫功能和抑制炎症反应，在治疗乙肝肝硬化合并SIBO方面具有更显著的临床疗效。

Abstract:

[Objective] To investigate the curative effect of Xiangsha Liujunzi Decoction combined with Bacillus Subtilis Living Bacteria Enteric-coated Capsule on hepatitis B cirrhosis complicated with intestinal bacterial overgrowth(SIBO) in spleen-stomach qi deficiency syndrome. [Methods] A total of 80 patients with hepatitis B cirrhosis complicated with SIBO admitted to the inpatient department of gastroenterology of our hospital from December 2020 to December 2022 were continuously recruited and divided into two groups with 40 cases in each group by random number table method. The control group was given Bacillus Subtilis Living Bacteria Enteric-coated Capsule and the observation group was given Xiangsha Liujunzi Decoction combined with Bacillus Subtilis Living Bacteria Enteric-coated Capsule. The efficacy of the two groups,SIBO negative conversion rate,traditional Chinese medicine symptom score,liver function, immune function,inflammatory factors and adverse reactions were observed. [Results] The effective rate of 14 d SIBO in the observation group was higher than that in the control group(P<0.05). After treatment,loss of appetite,especially after abdominal distension and eating,loose stool,fatigue,dizziness and fatigue score were decreased compared with before treatment(P<0.05),serum aspartate aminotransferase (AST),alanine aminotransferase (ALT),total bilirubin (TBiL),interleukin-6 (IL-6),tumor necrosis factor-A (TNF-α) levels,and peripheral blood CD⁸⁺ ratio were decreased compared with before treatment(P<0.05). The total protein(TP),proportion of CD³⁺ and CD⁴⁺ in peripheral blood increased before treatment(P<0.05). After treatment,the traditional Chinese medicine syndrome score,serum AST,ALT,IL-6 and TNF-α levels,the proportion of CD⁸⁺ in peripheral blood in the observation group was lower than that in control group(P<0.05),and the proportion of CD³⁺ and CD⁴⁺,CD⁴⁺/CD⁸⁺ in peripheral blood was higher than that in control group(P<0.05). [Conclusion] Xiangsha Liujunzi Decoction combined with Bacillus Subtilis Living Bacteria Enteric-coated Capsule can significantly improve clinical symptoms,improve immune function and inhibit inflammatory response,and has more significant clinical efficacy in the treatment of hepatitis B cirrhosis complicated with SIBO.