Vleggaar Frank P, Monkelbaan Jan F, van Erpecum Karel J
Department of Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur J Gastroenterol Hepatol. 2008 Jul;20(7):688-92. doi: 10.1097/MEG.0b013e3282f5197e.
Beneficial effects of probiotics have been reported in liver disease. Inflammatory bowel disease concurs in 90% of primary sclerosing cholangitis (PSC) patients, suggesting that substances originating from the inflamed gut may damage the biliary tree.
To assess potential beneficial effects of probiotics on serum liver tests, pruritus and fatigue in PSC.
Fourteen patients (13 male/one female, mean age 45 years), with concurrent inflammatory bowel disease were randomized to treatment with probiotics (Ecologic 641, containing four Lactobacillus and two Bifidobacillus strains; Winclove Bio Industries, Amsterdam, The Netherlands) or placebo during 3 months in a double-blind fashion. After a 1-month washout period, crossover was made.
No changes in pruritus, fatigue and stool frequency were noted during placebo or probiotics. No significant differences were observed between treatment with probiotics and placebo in bilirubin (at end of probiotic vs. placebo period: -13 vs. -15% change from baseline; P=0.89), alkaline phosphatase (-9 vs. -9%; P=0.99), gamma glutamyl transpeptidase (-11 vs. -5%; P=0.60), aspartate aminotransferase (-16 vs. -15%; P=0.99), alanine aminotransferase (-27 vs. -26%; P=0.97), prothrombin, albumin or bile salts.
Our data do not support beneficial effects of probiotics on symptoms, liver biochemistry or liver function in PSC.
益生菌对肝脏疾病的有益作用已有报道。90%的原发性硬化性胆管炎（PSC）患者并发炎症性肠病，这表明源自发炎肠道的物质可能会损害胆管树。
评估益生菌对PSC患者血清肝功能检查、瘙痒和疲劳的潜在有益作用。
14例（13例男性/1例女性，平均年龄45岁）并发炎症性肠病的患者被随机分为两组，以双盲方式在3个月内分别接受益生菌（Ecologic 641，含4种乳酸杆菌和2种双歧杆菌菌株；荷兰阿姆斯特丹的Winclove生物工业公司）或安慰剂治疗。经过1个月的洗脱期后，进行交叉治疗。
在接受安慰剂或益生菌治疗期间，瘙痒、疲劳和大便频率均无变化。益生菌治疗与安慰剂治疗在胆红素（益生菌治疗期末与安慰剂治疗期末：较基线变化分别为-13%和-15%；P=0.89）、碱性磷酸酶（-9%和-9%；P=0.99）、γ-谷氨酰转肽酶（-11%和-5%；P=0.60）、天冬氨酸转氨酶（-16%和-15%；P=0.99）、丙氨酸转氨酶（-27%和-26%；P=0.97）、凝血酶原、白蛋白或胆盐方面均未观察到显著差异。
我们的数据不支持益生菌对PSC患者的症状、肝脏生物化学或肝功能有有益作用。
