30例非酒精性脂肪性肝炎饮食运动治疗观察

Clinical study on behavior intervention for nonalcoholic fatty liver disease

目的探讨运动饮食治疗非酒精性脂肪性肝炎的疗效。方法采用开放、随机、对照试验将60例非酒精性脂肪性肝炎患者随机分为试验组和对照组,每组30例,试验组进行生活方式干预(健康教育+饮食+运动),口服多烯磷脂酰胆碱胶囊456 mg,3次/d;对照组口服多烯磷脂酰胆碱胶囊456 mg,3次/d;根据治疗前后血清酶学(ALT、AST)、血脂(TG、HDL-C)、空腹血糖(FPG)、人体质量指数(BMI)、肝脏B超的影像变化,评价疗效。结果试验组和对照组治疗12、24周后血清酶学(ALT、AST)、血脂(TG、HDL-C)较治疗前明显下降(P<0.05),两组间比较,试验组下降明显;试验组治疗12、24周后空腹血糖、BMI较治疗前明显下降(P<0.05),对照组无变化,两组间比较差异有统计学意义;治疗前与治疗24周肝脏B超影像结果比较,试验组和对照组脂肪肝的程度均较治疗前明显改善,但试验组较对照组更加明显(P<0.05)。结论运动饮食治疗非酒精性脂肪性肝炎有良好的疗效,治疗后血清酶学、血脂、空腹血糖、BMI下降,肝内脂肪沉积改善。

Objective To observe the clinical efficacy of diet and sport intervention on nonalcoholic fatty liver disease. Methods An open, randomized, controlled clinical study was carried out. 60 patients were divided into two groups ,30 patients in each group. The life style of treatment group was intervented by healthy education,dietary and ex- ercise. Every patient was treated with polyene phosphatidylcholine capsules at dose of 456 mg, 3 times per day. The therapeutic effects were evaluated by change in serum enzymes, lipidemia, fasting plasma glucose, body-mass index and the degree of sonographic fatty liver. Results Significant improvements of serum enzyme, lipidemia after treatment were found in the two grouPs. However, in treatment groups, the degree of improvements was more obvious. Significant improvement of fasting plasma glucose, body-mass index after treatment were found in treatment group, the same change was not discoverd in control group. The severity of fatty liver improved obviously in the two groups after treat- ment by ultrasonic image. However, in treatment group, liver fatty was obviously relieved. Conclusion Diet and sport intervention has significant therapeutic effect on nonalcoholic fatty liver disease. It can improve serum parameters of liv- er function, lipidemia, fasting plasma glucose and body-mass index, and the fat deposition in liver is improved.