【摘要】 目的：探讨益生菌干预对胆总管结石ERCP术后患者临床效果的影响，为胆总管结石的防治提供临床依据。方法：选取60例胆总管结石ERCP术后患者随机分为观察组和对照组，各30例；两组均于行ERCP后给予常规治疗，观察组在此基础上口服益生菌（双歧杆菌三联活菌胶囊420mg/次，3次/d）,4周后比较两组临床疗效、菌群失调率、肝功、血胆汁酸、血脂、血清CXCL-16及CCK-18的变化及不良反应发生率。结果：治疗后，观察组总有效率高于对照组（P<0.05）；肠道菌群失调率低于对照组（P<0.05）；两组血清ALT、AST、TBiL、TBA水平均降低，同时观察组低于对照组（P<0.05）；观察组血清甘油三酯（TG）、总胆固醇（TC）水平均降低（P<0.05），对照组血清甘油三酯（TG）、总胆固醇（TC）水平无变化（P>0.05）；观察组血清CXCL-16、CCK-18水平较治疗前降低（P<0.05），对照组血清CXCL-16、CCK-18水平无改变（P>0.05）。两组患者治疗期间未出现不良反应。结论：益生菌可以改善胆总管结石ERCP术后患者临床症状、肝功、血胆汁酸及血脂水平，降低肠道菌群失调率和血清CXCL-16、CCK-18表达水平，为胆总管结石患者的预防及治疗提供新的靶点。更多还原

【Abstract】 Objective:To explore the effect of probiotics intervention on the clinical effect of patients with choledocholithiasis after ERCP, and to provide clinical basis for the prevention and treatment of choledocholithiasis.Methods:60 patients with choledocholithiasis after ERCP were randomly divided into observation group and control group, 30 cases in each group; After ERCP, the two groups were given routine treatment, and the observation group was given probiotics(Bifidobacterium triple live capsule 420mg/time,3 times/day). After 4 weeks, the clinical efficacy,flora imbalance rate, liver function, blood bile acid, blood lipid, serum CXCL-16 and CCK-18 changes and the incidence of adverse reactions were compared between the two groups.Results:After treatment, the total effective rate of the observation group was higher than that of the control group(P<0.05). The imbalance rate of intestinal flora was lower than that of control group(P<0.05). Serum levels of ALT, AST, TBiL and TBA in both groups were lower than those in control group(P<0.05); The levels of serum triglyceride(TG) and total cholesterol(TC)in the observation group decreased(P<0.05),while the levels of serum triglyceride(TG) and total cholesterol(TC)in the control group did not change(P>0.05);The levels of serum CXCL-16 and CCK-18 in the observation group were lower than those before treatment(P<0.05),while the levels of serum CXCL-16 and CCK-18 in the control group did not change(P>0.05).No adverse reactions occurred in the two groups during treatment.Conclusions: Probiotics can improve the clinical symptoms, liver function, blood bile acid and blood lipid levels of patients with choledocholithiasis after ERCP, reduce the imbalance rate of intestinal flora and the expression level of CXCL-16 and CCK-18 in serum, and provide a new target for the prevention and treatment of patients with choledocholithiasis.更多还原