Effect of entecavir combined with Meichang'an on the intestinal flora and intestinal mucosal permeability in patients with hepatitis B cirrhosis

Objective To investigate the effect of entecavir in combination with Meichang'an(Live Combined Bacillus Subtilis and Enterococcus Faecium Enteric-coated Capsules)on intestinal flora and intestinal mucosal permeability in patients with hepatitis B cirrhosis. Methods Totally 126 patients with hepatitis B cirrhosis were randomly divided into control group and study group, with 63 cases in each group. The patients in both groups were treated with conventional symptomatic therapy and entecavir, while the patients in the study group were treated with additional Meichang'an. The efficacy indexes(improvement of symptoms and signs, changes in liver function, changes in liver fibrosis and abdominal ultrasound results)and changes in intestinal flora and intestinal mucosal permeability before and after treatment were compared between two groups. Results The rate of improvement in fatigue, anorexia and bloating after treatment was significantly higher in the study group than the - control group(P<0.05). After treatment, the liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase(AST)and total bilirubin(TBIL)in both groups were significantly lower than those before treatment, and the above indexes of the study group were significantly lower than the control group(P<0.05). After treatment, the levels of hyaluronic acid(HA), laminin(LN), type Ⅲ pre-collagen(PCⅢ)and type Ⅳ collagen(Ⅳ-C)were significantly lower than those before treatment, and the above indexes of liver fibrosis in the study group were significantly lower than the control group(P<0.05). After treatment, the internal diameter of the portal vein and spleen thickness in both groups decreased significantly, and the internal diameter of the portal vein and spleen thickness after treatment in the study group were significantly smaller than those in the control group(P<0.05). After treatment, there was no significant difference in the negative conversion rate of HBV-DNA between two groups(P>0.05). After treatment, the number of enterobacteriaceae in the study group was significantly lower than that before treatment, and the number of bacteroides, enterococcus, bifidobacterium and lactobacillus were significantly higher than those before treatment. There was a significant difference in the number of enterobacteriaceae after treatment between the two groups(P<0.05). After treatment, the ratios of urinary lactose exclusion rate to mannitol exclusion rate in both groups were significantly lower than those before treatment, and the ratio in study group was significantly lower than that in the control group(P<0.05). Conclusion The clinical effect of entecavir in combination with Meichang'an is significant in the treatment of patients with hepatitis B cirrhosis, which can significantly improve the clinical symptoms and indicators of liver function, liver fibrosis and splenomegaly thickness, and it also can effectively promote the recovery of intestinal flora, improve the function of the intestinal barrier and increase the efficacy.