Tactics for the correction of intestinal microbiocenotic disorders in the combination therapy of patients with chronic liver diseases

AIM: To evaluate the efficacy of the symbiotic Linex used in the combination therapy of liver cirrhosis (LC). SUBJECTS AND METHODS: Seventy-four patients with LC, including 44 who received additionally the symbiotic Linex and 30 who had conventional therapy, were examined. All the patients underwent clinical and biochemical blood tests, abdominal ultrasonography, fecal test for bacteria, gas chromatography-mass spectrometry of the blood composition of microbial markers, number connecting test, and quality-of-life assessment (SF-36). RESULTS: The symbiotic-treated patients showed a significant improvement in biochemical parameters (decreases in transaminase activities, bilirubin levels, hepatic protein-synthetic function--there were elevations in the concentrations of total protein from 74.0 +/- 0.50 to 78.1 +/- 0.80 g/l (p < 0.05) and albumin from 30.6 +/- 1.7 to 35.5 +/- 1.6 g/l (p < 0.05). There were also increases in the count of bifidobacteria from 8.7 +/- 0.1 to 9.1 +/- 0.1 Ig CFU/g (p < 0.05), lactobacilli from 5.0 +/- 0.2 to 5.2 +/- 0.2 Ig CFU/g (p < 0.05) and in the total count of Escherichia coli from 7.6 +/- 0.3 to 7.9 +/- 0.3 Ig CFU/g (p < 0.05); a tendency for normalization of microbial markers was revealed by mass spectrometry; the manifestations of hepatic encephalopathy were alleviated (the number connecting test showed a reduction from 51.0 +/- 3.58 to 29.7 +/- 4.10 sec (p < 0.05)), and the quality of life improved. CONCLUSION: By normalizing enteric microbiocenosis, the symbiotic Linex positively affects the course and prognosis of LC and it is both a symptomatic and pathogenetic agent for the treatment of patients.