熊去氧胆酸与牛磺熊去氧胆酸联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的疗效比较

Comparison of Therapeutic Efficacy of Ursodesoxycholic Acid or Tauro-ursodesoxycholic Acid Combined with Polyene Phosphatidylcholine for Non-alcohol Fatty Liver Disease

目的:观察并比较熊去氧胆酸(UDCA)与牛磺熊去氧胆酸(TUDCA)联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的临床疗效。方法:将180例非酒精性脂肪肝患者随机均分为3组:对照组采用多烯磷脂酰胆碱治疗,UDCA组采用UDCA+多烯磷脂酰胆碱治疗,TUDCA组采用TUDCA+多烯磷脂酰胆碱治疗。3组疗程均为2个月。治疗后对3组患者的临床疗效、相关生理指标变化、体质量指标以及不良反应情况进行比较。结果:经过2个月的治疗,UDCA组和TUDCA组总有效率分别为83.3%和85.0%,2组比较差异无统计学意义(P>0.05),但均显著优于对照组(70.0%,P<0.05)。3组患者的丙胺酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转肽酶、甘油三酯、总胆固醇以及体质量指数较治疗前均有较大幅度的下降(P<0.05),而UDCA组与TUDCA组的下降幅度相当(P>0.05),但均优于对照组(P<0.05)。3组均未见严重不良反应发生。结论:UDCA与TUDCA联合多烯磷酸胆碱用于非酒精性脂肪肝的治疗临床效果理想,二者疗效相当,且安全性较好。

OBJECTIVE：To observe and compare therapeutic efficacy of ursodeoxycholic acid（UDCA）or tauro-ursodeoxycholic acid（TUDCA）combined with polyene phosphatidylcholine for non-alchohol fatty liver disease（NAFLD）.METHODS：180 patients with NAFLD were randomly divided into 3 groups：control group only received polyene phosphatidylcholine,and UDCA group and TUDCA group were treated with UDCA ＋ polyene phosphatidylcholine and TUDCA ＋ polyene phosphatidylcholine for 2 months,respectively.Clinical efficacy,related physiological indexes,body weight indexes and adverse drug reactions were compared among 3 groups after the treatment.RESULTS：After 2 months of treatment,the total effective rates of UDCA group and TUDCA group were 83.3% and 85.0%,and there was no statistical significance（P0.05）;those of 2 groups were better than control group（70.0%,P0.05）.The levels of ALT,AST,GGT,TG,TC and BMI were decreased remarkable in the 3 groups after the treatment（P0.05）;the differences of decrease in UDCA group and TUDCA group were not statistical significance（P 0.05）but were superior to control group（P0.05）.No severe adverse drug reaction was found in 3 groups.CONCLUSION：UDCA or TUDCA combined with polyene phosphatidyl choline are effective and safe in the treatment of NAFLD,and therapeutic efficacies of them are almost same.