title: [Clinical research on microecologic treatment combined enteral nutrition for hepatic encephalopathy].
abstract: OBJECTIVE
  To evaluate the effect of microecologic treatment combined enteral nutrition on serum endotoxin, tumor necrosis factor-α (TNF-α), interleukin-18 (IL-18), blood ammonia levels and nutritional status in patients with hepatic encephalopathy.
  
  
  METHODS
  60 patients with hepatic encephalopathy were allocted randomly into 3 groups, on the basis of conventional liver protective therapy and uragogue with one group given probiotics plus enteral nutrition, one given probiotics only, and the 3rd group given intravenous nutrition. The whole course of treatment was four weeks. Serum levels of endotoxin, TNF-α, IL-18, ammonia and albumin were determined before and on the 7th and 14th day after treatment.
  
  
  RESULTS
  The levels of serum endotoxin, TNF-α, IL-18 and blood ammonia in the combined treatment group decreased remarkably after treatment, while the level of serum albumin elevated markedly. The difference was significant at statistics as compared with the only probiotics group and intravenous nutrition group (P < 0.05).
  
  
  CONCLUSIONS
  Microecologic treatment combined enteral nutrition could effectively reduce blood ammonia and serum endotoxin levels, protect intestinal mucosal barrier, as well as improve nutritional status of patients with hepatic encephalopathy, which was considered as a safe and efficient therapy.
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China; Zhejiang Provincial Cancer Hospital.
authors.forename: Gaiguo
authors.initials: G
authors.lastname: Dai
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China. Email: wudenghai2008@sina.com.
authors.forename: Denghai
authors.initials: D
authors.lastname: Wu
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
authors.forename: Jianan
authors.initials: J
authors.lastname: Lian
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Ma
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
authors.forename: Binhua
authors.initials: B
authors.lastname: Jiang
mesh_terms: D003131:Combined Modality Therapy; D004731:Endotoxins; D004750:Enteral Nutrition; D005765:Gastrointestinal Agents; D006501:Hepatic Encephalopathy / Q000276:immunology / Q000628:therapy*; D006801:Humans; D009752:Nutritional Status; D019936:Probiotics / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha
chemical_list: D004731:Endotoxins; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha