水林佳联合二甲双胍治疗非酒精性脂肪性肝炎疗效观察

Effect of Metformin Combined with Silybinin in the Treatment of Non-alcoholic Steatohepatitis NASH

目的：观察水林佳联合二甲双胍对非酒精性脂肪性肝炎（non-alcoholic steatohepatitis，NASH）的临床疗效。方法：将2006年2月～2007年10月收治的56例NASH随机分为治疗组和对照组，每组28例，两组均予水林佳70mg每日3次口服，治疗组加用二甲双胍250mg每日3次口服，疗程均为3个月。观察治疗前后生化指标、肝脏B超及CT变化，药物不良反应。结论：两组疗程结束后丙氨酸转氨酶、天冬氨酸转氨酶均较治疗前明显下降（P〈0．01，P〈0．05），组间比较，治疗组显著低于对照组（P〈0．05）；治疗组治疗后血脂较治疗前显著降低（P〈0．01），治疗后与对照组比较显著降低（P〈0．01）；对照组治疗前后血脂无显著差异（P〉0．05）。两组有少数患者出现轻度食欲缺乏等不适，可自行恢复。结论：水林佳联合二甲双胍对于NASH具有良好疗效，且无明显不良反应。

Objective： To investigate the therapeutic effects and mechanism of metformin combined with silybinin on non-alcoholic steatohapatitis. Methods：56 patients with NASH were randomly divided into two groups, treatment group received silybinin tablet and metformin enteric tablet, control group only received silybinin tablet. 3 months later, clinical manifestation, biochemical indicator, B-ultrasonic examination and CT scanning in liver results and the side-effect reaction were reviened. Results：The level of ALT and AST got a obviously decrease after the treatment of the 2 groups （P 〈 0.01 or P 〈 0.05 ）, but still had a statistical significance between the 2 groups （ P 〈 0.05 ）. The level of TG,TC decreased obviously in treatment group （ P 〈 0.01 ） . After the therapy,the insulin resistance index of treatment group decreased obviously （P 〈 0.05）and the diversity of control group was not obviously. Conclusion：The curative effect of metformin combined with silybinin in NASH is obvious and has no side-effect.