双歧杆菌三联活菌联合多烯磷脂酰胆碱在非酒精性脂肪性肝病中的疗效观察

Efficacy of Bifid-triple viable capsule combined with polyene phosphatidyl choline in patients with non-alcoholic fatty liver disease

目的探讨双歧杆菌三联活菌联合多烯磷脂酰胆碱对非酒精性脂肪性肝病(NAFLD)的治疗效果。方法选择2012年6月至2016年6月在原海军总医院消化科就诊的NAFLD患者共160例,随机分为两组,每组80例,观察组口服多烯磷脂酰胆碱(456 mg,3次/d)联合双歧杆菌三联活菌(2粒,3次/d),对照组单纯口服多烯磷脂酰胆碱(456 mg,3次/d),疗程3个月。比较两组患者治疗前后临床症状评分,肝功能、血脂、血糖及炎性介质变化,并评价治疗效果。结果同组患者治疗后肝功能(ALT、AST、GGT、TBIL、IBIL)、血糖(FBG、IR)、血脂(TG、TC、HDL-C、LDL-C)、炎性介质(TNF-α、IL-6、IL-8、IL-10)、CRP、临床症状评分均较治疗前明显改善(P<0.05);两组治疗后各指标比较,观察组肝功能(AST、ALT、GGT)、血脂TC以及TNF-α、IL-6、IL-8明显低于对照组(P<0.05);而IBIL、IL-10、HDL-C明显高于对照组(P<0.05),TBIL、FBG、IR、TG、LDL-C、CRP治疗后两组比较,差异无统计学意义(P>0.05)。两组患者治疗前后临床症状比较,观察组治疗有效率为95%,明显高于对照组85%(P<0.05),同组治疗后症状评分明显低于治疗前(P<0.05);两组治疗后症状比较,观察组治疗后恶心、腹泻、腹胀症状评分明显低于对照组(P<0.05),厌食、乏力和便秘两组比较,差异无统计学意义(P>0.05)。结论双歧杆菌三联活菌联合多烯磷脂酰胆碱能够明显缓解NAFLD患者临床症状,改善肝功能、血糖、血脂水平,维持炎性细胞因子平衡,治疗效果满意。

Objective To explore the efficacy of Bifid-triple viable capsule combined with polyene phosphatidyl choline in patients with non-alcoholicfatty liver disease(NAFLD). Methods From Jun. 2012 to Jun. 2016, 160 patients with NAFLD in the Sixth Medical Center of PLA General Hospital were chosen as research objects. All patients were randomly divided into observation group(n=80) and control group(n=80). Patients received Bifid-triple viable capsule(2 pills, 3/d) and polyene phosphatidyl choline(0.456 g,3/d) in observation group, while patients only received polyene phosphatidyl choline(0.456 g,3/d) in control group. After 3 months of treatment, the differences of liver function, serum lipid levels, inflammatory cytokines, blood glucose and score of clinical symptoms before and after treatment were compared in observation group and control group. Results After treatment, the liver function, serum lipid levels, inflammatory cytokines, blood glucose and scores of clinical symptoms were all obviously improved in the same group(P<0.05) compared with the pre-treatment. After treatments, the levels of liver function(AST, ALT, GGT, TC) and inflammatory cytokines(TNF-α,IL-6,IL-8) were all visibly decreased in observation group compared with the control group(P<0.05), meanwhile, the levels of IBIL, IL-10 and HDL-C were all increased in observation group(P<0.05);the other observation targets(TBIL, FBG, IR, TG, LDL-C and CRP) had no significant differentce after treatment between two groups(P>0.05). The effective rate of treatment in observation group(95%) was higher than that in control group(85%). The scores of nausea, diarrhea and distention were distinctly lower in observation group than those in control group after treatment(P<0.05), though the scores of anorexia, fatigue and constipation between two groups had no different significance(P>0.05). Conclusion Bifid-triple viable capsule combined with polyene phosphatidyl choline can improve clinical symptoms, liver function, blood glucose and lipid levels and keep the balance of pro-and anti-inflammatory cytokines, its efficacy of treatment is significant.