牛磺酸联合水飞蓟宾葡甲胺治疗非酒精性脂肪性肝炎

Combination of taurine with silybin meglumine in treatment of patients with non-alcohlic steatohepatitis

目的 评价牛磺酸联合水飞蓟宾葡甲胺治疗非酒精性脂肪性肝炎（NASH）的疗效.方法 100例NASH患者均分为2组.治疗组每日3次,每次予牛磺酸2 g＋水飞蓟宾葡甲胺100mg口服.对照组每日3次,每次予多烯磷脂酰胆碱456 mg＋水飞蓟宾葡甲胺100 mg口服.疗程均为24周.所有患者均禁酒,改善饮食结构,进行中等量有氧运动,控制体重.结果 治疗后两组临床症状、肝功能均获改善,B超和CT示脂肪肝程度减轻,血糖、血脂（三酰甘油和总胆固醇）、体重指数也较治疗前下降（P值均〈0.05）.其中乏力、纳差、呕吐症状的改善情况和三酰甘油下降程度治疗组优于对照组（P值均〈0.05）.治疗组未出现明显不良反应.结论 在饮食控制、加强运动等基本治疗基础上,牛磺酸联合水飞蓟宾葡甲胺治疗可有效改善NASH患者肝功能、血糖、血脂代谢,减轻脂肪肝程度,耐受性较好,不良反应较少,值得临床进一步研究.

Objective To evaluate the therapeutic effects of taurine combined with silybin meglumine in patients with non-alcoholic steatohepatitis （NASH）. Methods One hundred patients with NASH were divided into two groups with 50 for each. The patients in the control group received polyene phosphatidyl choline （456 mg） combined with silybin meglumine （100 mg） 3 times daily for 24 weeks. While those in the treatment group received taurine （2 g） combined with silybin meglumine （100 mg） 3 times daily for 24 weeks. All patients were asked to take up basic therapy including drinking without alcohol, restricting sugary and fatty intake, improving food structure, carrying moderate aerobics and lightening body weight. Results At the end of 24 weeks, the clinical symptoms and the liver function ameliorated in two groups. Ultrasonic or CT examination showed that the steatohepatitits was improved significantly in two groups. Additionally, the levels of blood glucose, serum triglyceride and cholesterol as well as BMI decreased simultaneously （all P value 〈0. 05）. Whereas the treatment group was superior to control group in aspect of amelioration of inappetite, nausea and vomiting as well as lever of serum triglyceride （all P value 〈0. 05）. There was no side effect in the treatment group. Conclusion Based on the basic therapy, taurine combined with silybin meglumine can mitigate the degree of NASH, improve the metabolism of blood glucose and lipid with few side-effects.