自拟降脂护肝方联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的临床研究

Clinical Research of Self-Prepared Decoction of Lipid-Decreasing and Liver Protection Combined Polyene Phosphatidylcholine for Treatment of Nonalcoholic Fatty Liver Disease

目的:观察自拟降脂护肝方联合多烯磷脂酰胆碱对非酒精性脂肪肝的临床疗效及部分作用机制。方法:将本院收治的60例非酒精性脂肪肝患者根据入院顺序随机分为对照组(30例)和观察组(30例),对照组静脉注射多烯磷脂酰胆碱(易善复),5 m L/次,每日1次;观察组在对照组治疗方案基础上口服自拟降脂护肝方,每日1剂;两组均以12周为1个疗程,观察两组患者治疗前后肝脏彩超评分、血清丙氨酸氨基转移酶(ALT)、血清谷氨酸氨基转移酶(AST)、超氧化物歧化酶(SOD)、血浆中Bcl-2、Bax与Caspase-3蛋白水平等变化情况。结果:(1)两组治疗后肝脏彩超评分、血清SOD表达水平均较治疗前提高,与对照组比较,观察组提高的程度较为明显(P<0.05);(2)两组治疗后血清ALT、AST表达水平均较治疗前降低,其中与对照组比较,治疗组患者血清ALT,AST水平差异无统计学意义(P>0.05);(3)两组治疗后血浆中Bcl-2表达水平均较治疗前提高,与对照组比较,观察组提高的程度较为明显(P<0.05);血浆中Bax、Caspase-3表达水平均较治疗前降低,其中与对照组比较,治疗组表达水平降低幅度大于对照组(P<0.05)。结论:自拟降脂护肝方具有明显的保肝降酶疗效,还可以改善非酒精性脂肪肝的肝脏组织脂肪变性、炎症及纤维化的程度,这可能与调控肝细胞凋亡有关。

Objective ： To observe the clinical curative effect and part of the mechanism of self - prepared decoction of lipid - decreasing and liver protection combined polyene phosphatidylcholine on the nonalcoholic fatty liver disease. Methods ： 60 patients with nonalcoholic fatty liver disease treated in our hospital were randomly divided into control group （30 ca- ses） and observation group （30 cases） according to admission order. The control group had polyene phosphatidylcholine （ESSENTIALE） in intravenous,5 mL/time,once a day. The observation group took self- prepared decoction of lipid- decreasing and liver protection on the basis of the control group, 1 agent a day. Both groups had 12 weeks as a period of treatment, observing liver color Doppler ultrasound score, serum alanine aminotransferase（ ALT）, serum glutamic oxalace- tic transaminase（AST）,superoxide dismutase （SOD） and the Bcl -2, Bax and Caspase 3 protein level changes in the plasma of the wo groups before and after treatment. Restdts ： （ 1 ） After the treatment, the liver Color Doppler Ultrasound Scores and Superoxide Dismutase （SOD） of the two groups increased than before and the observation group improved more obviously than the control group （ P 〈 0.05 ）. （2） The serum ALT and AST expression levels were reduced in both of the two groups after the treatment. The serum ALT and AST levels in the treatment group had no statistical significance differences compared to those of the control group （ P 〉 0.05 ）. （3） The Bcl - 2 expression level in plasma improved in both of the two groups ＇after treatment and the observation group improved evidently than the control group （ P 〈 0.05 ）. Bax and Caspase -3 expression level in plasma reduced and the expression level in the treatment group had larger reduc- tion range than that of the control group （ P 〈 0.05 ）. Conclusion ： Self - prepared decoction of lipid - decreasing and liver protection had obvious curative effect for protecting liver and lowering transaminase and also could improve fatty degenera- tion of liver tissue, the degree of inflammation and fibrosis in nonalcoholic fatty liver disease, which might be related toregulating the liver cell apoptosis.