| Objective:To explore the effect and prognosis of adding probiotics or lactulose on the basis of routine therapy as a comparison of routine way in the treatment of HE.Methods:Selected HE patients who were admitted to the digestive system department of the second hospital of Jilin University from January 2013 to December 2017(type C),all patients were in conformity with the diagnostic criteria of the "Consensus Opinion for Diagnosis and Treatment of Hepatic Encephalopathy in China" established in 2013,and there are 75 cases of patients who meet the criteria of inclusion and exclusion.According to different treatment methods,on the basis of routine treatment,it was divided into control group(group A),lactose group(group B)and probiotics group(group C)based on whether they were given probiotics or lactose.There were 31 cases in group A,13 males and 18 females.Age 61.29 ± 11.16 years old;There were 16 cases of hepatitis cirrhosis,7 cases of autoimmune liver disease,4 cases of cryptogenic liver disease,4 cases of other reasons.HE stage I in 17 cases,Ⅱ14 cases;There were 22 cases in group B,13 males and 9 females.Age 60.23 ± 10.04 years;There were 13 cases of hepatitis cirrhosis,2 cases of autoimmune liver disease,3 cases of cryptogenic diseases and 4 other reasons.HE stage I in 12 cases,Ⅱ10 cases;There were 22 cases in group C,15 males and 7 females.Age: 54.41 ±9.92;There were 12 cases of hepatitis cirrhosis,3 cases of autoimmune liver disease,3 cases of cryptogenic liver disease,4 cases of other reasons.HE stage I in 10 cases,Ⅱ12 cases.There was no significant difference in age,sex and HE stage of primary disease among the three groups(P > 0.05),which was comparable.Results:1.Clinical efficacy The short-term clinical efficacy of probiotics or lactulose on the basis of routine treatment is similar,which is significantly better than that of the routine treatment group.In terms of long-term efficacy,the addition of probiotics on the basis of routine treatment can not reduce mortality,but it has important benefits in reducing HE recurrence and prolonging the interval between HE recurrence.Also adding lactulose on the basis of routine treatment cannot reduce mortality rate,but it is superior to the control group in reducing the recurrence of HE and prolonging the interval of HE recurrence,but it is not as effective as the addition of probiotics on the basis of routine treatment.2.Changes of biochemical indicator before and after treatment According to statistics,TBIL、PT and endotoxin Level were all abnormal in the 3 groups before treatment,but there was no significant difference between each other(P> 0.05).After 1 month and 3 months’ treatment,the biochemical indicator of the three groups decreased to varying degrees.The TBIL and PT of The lactulose group and the probiotic group decreased significantly,especially in the probiotic group,and there was a significant difference,with statistical significance(P< 0.05).And endotoxin level in 1 month after treatment,probiotics and lactulose group,there was no significant difference compared with no statistical significance(P > 0.05),and 3 months after treatment,probiotics and lactulose group decreased more significantly,compared with a statistical significance(P < 0.05).it is indicated that the addition of probiotics based on routine treatment can improve the recovery of liver function compared to routine treatment plus lactulose or routine treatment,and thus improve the clinical symptoms and prevent the development of HE.3.Hospital related The awakening time of lactulose group and probiotic group was significantly lower than that of the control group(p< 0.05).There was no significant difference in resuscitation time between lactulose group and probiotic group(p > 0.05).There was no significant difference in hospital stay between the three groups(p> 0.05).4.Ionic index There was no difference in sodium ion between the 3 groups before treatment.There was no statistical significance(P > 0.05).After 1 month,3 groups of sodium ions decreased,but there was no significant difference compared with that before treatment(P > 0.05).3 months after treatment,there was no difference in sodium ion index between control group and lactulose group before treatment and one month after treatment.There was no significant difference(P> 0.05),while 3 groups were treated with probiotics.There was a significant difference between months after treatment and one month after treatment,which was statistically significant(P< 0.05).There was also a significant difference between the three months after treatment and three months after treatment in the lactulose group,which was statistically significant(P< 0.05).This suggests that the continuous use of probiotics for 3 months appears to have modulating ion function,but further large-scale clinical validation is required.Conclusion:The addition of probiotics or lactulose on the basis of routine therapy can significantly promote the recovery of liver function.It is of great significance for reducing HE symptoms,improving prognosis and improving quality of life,and adding probiotics to conventional treatment is more important than conventional one.It is more beneficial to add lactulose on the basis of treatment,so it is worthy of clinical application. |
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