熊去氧胆酸与易善复治疗非酒精性脂肪性肝炎的对比观察

Study of ursodeoxycholic acid (UDCA) and Essentiale Forte N in the treatment of non-alcoholic steatohepatitis

目的对比观察熊去氧胆酸与易善复治疗非酒精性脂肪性肝炎（NASH）的疗效。方法将52例确诊为NASH患者随机分为治疗组（n=26）与对照组（n=26），治疗组口服熊去氧胆酸15～20mg／kg，每日3次。对照组口服易善复2粒，每日3次。疗程均为半年。结果治疗组治愈4例，好转20例，未愈2例，总有效率为92．3％；对照组治愈0例，好转23例，未愈2例，总有效率88．5％。两组疗效比较差异无统计学意义（Hc=1．166，P〉0．05）。两组治疗后的血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酸转肽酶（GGT）、甘油三酯（TG）、胆固醇（CHOL）、C-反应蛋白（CRP）水平均比治疗前明显下降（P〈0．01），且治疗组的TG、CHOL改善程度优于对照组（P〈0．01）。结论熊去氧胆酸与易善复对治疗NASH均有效，但熊去氧胆酸的降TG、CHOL作用更为明显，且其费用低，有较好的经济成本效益，值得临床应用。

Objective To observe the effect of ursodeoxycholic acid （UDCA） and Essentiale Forte N on the treatment of non-alcoholic steatohepatitis. Methods 52 patients with non-alcoholic steatohepatitis were randomly divided into the treated group （n =26, treated with UDCA 15-20mg/kg, three times a day） and the control group （n =26, treated with Essentiale Forte N, two capsules, three times a day）. The therapeutic course lasted 6 months. Results The effective rates were 92.3 % in the treated group and 88.5 % in the control group, no significant difference between the two groups （ Hc = 1. 166, P 〉 0.05）. After the treatment, both groups significantly decreased the plasma levels of ALT, AST, GGT, TG, CHOL and CRP （ P〈0. 01）, among which the TG and CHOL levels decreased more in the treated group than in the control group （ P〈0.01）. Conclusion UDCA and Essentiale Forte N both might effect on treating non-alcoholic steatohepatitis, while UDCA might be better than Essentiale Forte N in decreasing TG and CHOL levels and in the economic cost.