目的 探讨枯草杆菌二联活菌肠溶胶囊对肝脏储备功能不同的肝硬化患者的肠道屏障功能与 Th9 细胞表达的影响。方法 在我院选取 172 例肝硬化患者作为研究对象，根据肝脏储备功能不同分为 Child⁃Pugh A 级（观察组）72 例与 Child⁃Pugh B⁃C 级（对照组）100 例，所有患者都在常规治疗手段的基础上加用美常安（枯草杆菌二联活菌肠溶胶囊）治疗，都治疗观察 14 d。结果 对比治疗后两组患者总有效率观察组与对照组的分别为 98.6%和 89.0%，观察组优于对照组（P < 0.05）。两组治疗前肠道菌群比较 无明显差异（P > 0.05）；双歧杆菌属及乳酸杆菌属在观察组中治疗后较治疗前有明显增加（P < 0.05），但和治疗前相比，白色念珠菌属有明显的降低（P < 0.05），比较对照组治疗前后肠道菌群变化无明显差异 （P > 0.05）。对比两组治疗后血清 IL⁃6 与 TNF⁃α 值，观察组与对照组均低于治疗前（P < 0.05），且治疗后观 察组低于对照组（P < 0.05）。治疗后观察组与对照组的 Th9 细胞分别为（0.11 ± 0.05）%和（0.32 ± 0.10）% （P < 0.05），都低于治疗前的（0.82 ± 0.32）%和（0.83 ± 0.24）%，观察组治疗后Th9细胞低于对照组（P < 0.05）。 结论 相对于肝脏储备功能差的患者，枯草杆菌二联活菌肠溶胶囊在肝脏储备功能良好的肝硬化患者中的应用能改善肠道屏障功能，抑制Th9细胞表达，抑制炎症因子的表达，从而更好的发挥治疗效果。

Objective To investigate the effects of Bacillus subtilis and enterococcus faecium enteric⁃coated capsules on intestinal barrier function and Th9 cell expression in cirrhotic patients with different liver reserve func⁃ tion. Methods A total of 172 patients with liver cirrhosis in our hospital were selected and assigned to observation group（72 children Pugh A grad）and control group（100 children Pugh B⁃C grade）based on different liver reserve functions. All patients were treated with conventional treatment in addition to the use of metoprolol（Bacillus subtil⁃ is enteric coated capsules），and both were observed for 14 days. Results After treatment，the total effective rates in the observation group and the control group were 98.6% and 89%，and the observation group was better than that of the control group（P < 0.05）. there was no significant difference in intestinal flora between the two groups before treatment（P > 0.05），the Bifidobacterium and Lactobacillus in the observation group after treatment were significantly increased（P < 0.05），Candida albicans was significantly lower than that before treatment（P < 0.05）. after treatment，the serum IL⁃6 and TNF⁃α in the observation group and the control group were lower than before treatment（P < 0.05），and the serum IL ⁃6 and TNF ⁃α in the observation group after treatment were lower than those in the control group（P < 0.05）. after treatment，the Th9 cells in the observation group and the control group were（0.11 ± 0.05）% and（0.32 ± 0.10）%（P < 0.05），respectively，which were lower than（0.82 ± 0.32）% and （0.83 ± 0.24）% before treatment，and the Th9 cells in the observation group after treatment was lower than those in the control group（P < 0.05）. Conclusion Compared with patients with poor hepatic reserve function，application of Bacillus subtilis and enterococcus faecium enteric⁃coated capsule in the better hepatic reserve function patients with liver cirrhosis could improve the intestinal barrier function，inhibit the expression of Th9 cells，inhibit the expression of inflammatory cytokines，which play a better therapeutic effect.