Your browser doesn't support javascript.
loading
Lactulose improves cognition, quality of life, and gut microbiota in minimal hepatic encephalopathy: A multicenter, randomized controlled trial.
Wang, Ji Yao; Bajaj, Jasmohan S; Wang, Jiang Bin; Shang, Jia; Zhou, Xin Min; Guo, Xiao Lin; Zhu, Xuan; Meng, Li Na; Jiang, Hai Xing; Mi, Yu Qiang; Xu, Jian Ming; Yang, Jin Hui; Wang, Bai Song; Zhang, Ning Ping.
Afiliación
  • Wang JY; Department of Gastroenterology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
  • Bajaj JS; Center of Evidence-based Medicine, Fudan University, Shanghai, China.
  • Wang JB; Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA.
  • Shang J; Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
  • Zhou XM; Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China.
  • Guo XL; Department of Gastroenterology, Xijing Hospital Affiliated to Air Force Medical University, Xi'an, Shaanxi Province, China.
  • Zhu X; Department of Gastroenterology, First Hospital of Jilin University, Changchun, Jilin Province, China.
  • Meng LN; Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
  • Jiang HX; Department of Gastroenterology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China.
  • Mi YQ; Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Guilin, Guangxi Zhuang Autonomous Region, China.
  • Xu JM; Department of Hepatology, Tianjin Second People's Hospital, Tianjin, China.
  • Yang JH; Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
  • Wang BS; Department of Hepatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
  • Zhang NP; Department of Pharmacology and Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Dig Dis ; 20(10): 547-556, 2019 Oct.
Article en En | MEDLINE | ID: mdl-31448533
OBJECTIVE: Lactulose is effective in the treatment and prevention of overt hepatic encephalopathy (OHE), but there are limited data on its use on microbiota in relations to minimal hepatic encephalopathy (MHE) recovery. The present study aimed to assess the efficacy of lactulose in recovery of MHE in aspects of cognitive function, quality of life, and impact on intestinal microbiota. METHODS: This multicenter, open-label randomized controlled trial was conducted in 11 teaching hospitals in China. Participants were randomly allocated on a 2:1 basis to receive lactulose (Gp-L) or no therapy as control (Gp-NL) for 60 days. The primary endpoint was the MHE reversal rate. Gut microbiota were compared between MHE patients and healthy volunteers, as well as lactulose-responders and non-responders. RESULTS: A total of 98 cirrhotic patients were included in the study, with 31 patients in the Gp-NL group and 67 patients in the Gp-L group. At day 60, the MHE reversal rate in Gp-L (64.18%) was significantly higher than that in Gp-NL (22.58%) (P = .0002) with a relative risk of 0.46 (95% confidence interval 0.32-0.67). Number needed to treat was 2.4. Further, there was significantly more improvement in physical functioning in Gp-L (4.62 ± 6.16) than in Gp-NL (1.50 ± 5.34) (P = .0212). Proteobacteria was significantly higher in MHE patients compared with healthy volunteers (12.27% vs 4.65%, P < .05). Significant differences were found between lactulose responders and non-responders in Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria. CONCLUSIONS: Treatment with lactulose significantly improves MHE recovery rate, and gut microbiota change in MHE patients can modulate the effectiveness of this therapy. Chinese Clinical Trial Register (ChiCTR) (ID: ChiCTR-TRC-12002342).
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Fármacos Gastrointestinales / Encefalopatía Hepática / Cognición / Microbioma Gastrointestinal / Lactulosa Tipo de estudio: Clinical_trials / Etiology_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Dig Dis Año: 2019 Tipo del documento: Article País de afiliación: China Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Fármacos Gastrointestinales / Encefalopatía Hepática / Cognición / Microbioma Gastrointestinal / Lactulosa Tipo de estudio: Clinical_trials / Etiology_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Dig Dis Año: 2019 Tipo del documento: Article País de afiliación: China Pais de publicación: Australia