Study On The Correlation In The Intestinal Flora,the Plasma Levels Of Endotoxin And The Jaundice Of Hepatitis B-associated Liver Failure

Objectives:1. Comparison with the clinical features in jaundice syndromes of hepatitis B-associated liver failure.2. Comparison with the intestinal flora characteristics in aundice syndromes of hepatitis B-associated liver failure.3. Comparison with the Plasma level of endotoxin in jaundice syndrome type of hepatitis B-associated liver failure.Methods:1. Study on common symptoms signs,Tongue and pulse condition of hepatitis B-associated liver failure; Study on the spleen deficiency syndrome scores to the different jaundice patients and the in different stages of the patients with the evolution process of jaundice. 2. Stool cultures on patients with hepatitis B-associated liver failure, determination of intestinal flora:enterococci, enteric bacilli, Bacteroides, Bifidobacterium, Lactobacillus number.3. Determination of the plasma endotoxin levels to these patients.Results:1. there are some symptoms, signs and tongue and pulse condition of hepatitis B-associated liver failure, the probability is more than50%.2. Jaundice distribution to the yang yellow card is55.6%; yin yang card is2.8%; not yellow or not yin card is41.6%.3. The different jaundice patients with spleen deficiency syndrome scoring of hepatitis B-associated liver failure is discrepant.The not Yang yellow card is higher than Yang yellow card, the difference was statistically significant (P<0.05); to The same patient with the different phases of jaundice,spleen deficiency syndrome scoring is different, the not Yang huangstage is higher than Yang yellow stage, the difference was statistically significant (P<0.05).4.36patients for basic lesions of hepatitis B-associated liver failure patients Yin yellow rate of15%, and for patients with liver cirrhosis based lesions Yin yellow was60%, and both are significant difference (P <0.05); The incidence of patients with early Yin yellow is17%, and in the late Yin yellow/patients was68%, and both are significant difference (P<0.05); Antibiotic use>2weeks of Yin yellow rate of75%, and did not use/<2weeks of antibiotics Yin yellow was29%, and both are significant difference (P<0.05).5. Yang huang group compared with healthy, intestinal change the performance for the bowel coccus, enterbacteriaceae significantly increased (P<0.05;P<0.01); Yin and Yang huang group and health group compared, the bowel coccus further increased significantly (P<0.01), and enterbacteriaceae compared with healthy people, but increases slightly not statistically significant (P=0.067). Reduce colon bacillus obvious (P<0.01), lactic acid bacteria also reduce (P<0.05); Yang huang group and Yin-Yang huang group compared, the bowel aureus increased significantly (P<0.01); And the number of enterbacteriaceae instead minus (P<0.05) between the two groups, compared with a statistical significance. The further reduce colon bacillus (P<0.05), a significant statistical significance. Lactic acid bacteria downward trend, but this was not statistically significant.6. compared with healthy people, plasma endotoxin levels were significantly increased (P<0.05; P<0.01).7. Negative correlation between plasma endotoxin and Bifidobacterium (r=-0.508P=0.001), and positive correlation between plasma endotoxin and Enterobacteriaceae (r=0.527p=0.000)to patients with hepatitisB-as sociated liver failure. It isstatistically significant. No significant correlations with other species.Conclusions:1. The thinking train in syndrome differentiation of yin-toxin and yang-toxin syndrome of hepatitis B-associated liver failure takes toxin, stasis, weak spleen and deficiency as the core of pathogenesis.2. There is a special stage-Yin and Yang yellow stage in hepatitis B-associated liver failure. Throughout the course of weak spleen factors of always. Foundation for disease of liver cirrhosis,/late course of the disease and long-term use of antibiotics is the leading cause of the transformation of Yin yellow jaundice related factors.3. In the"Yang yellow-Yin and Yang yellow-Yin yellow" process of hepatitis B-associated liver failure, along with the increase in the spleen deficiency symptoms, the degree of imbalance of intestinal flora is more and more obvious, plasma endotoxin level gradually heighten. It is a Pathophysiological basis of Yin Huang mechanism.