牛磺酸联合水飞蓟宾治疗非酒精性脂肪性肝炎100例

Therapeutic Effects of Taurine Combined with Silibinin in 100 Patients with Non-alcoholic Steatohepatitis

目的评价牛磺酸联合水飞蓟宾治疗非酒精性脂肪性肝炎(NASH)的疗效。方法将200例NASH患者随机分为治疗组(100例)和对照组(100例)。治疗组采用牛磺酸联合水飞蓟宾治疗,对照纽单用牛磺酸治疗,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。观察患者治疗前后临床症状、血压、体质量指数(BMl)和腰围变化,检测患者治疗前后肝功能、血脂、空腹血糖水平,并行B超和CT检查。结果治疗后两组临床症状及相关化验检查明显改善,B超和CT提示脂肪肝程度减轻(P<0.05):其中乏力、肝区不适、恶心、呕吐症状改善情况,收缩压、舒张压、BMI、ALT、GGT、三酰甘油、总胆固醇下降程度,B超和CT提示脂肪肝减轻程度等治疗组优于对照组(P<0.05)。对照组女性、治疗组男性和女性治疗后腰围较治疗前明显减小(P<0.05)。结论牛磺酸对NASH患者有明显的疗效,牛磺酸联合水飞蓟宾治疗NASH患者疗效优于单用牛磺酸患者。

Objective To evaluate the therapeutic effects of taurine combined with silibinin in patients with non-alcoholic steatohepatitis（NASH）. Methods 200 cases of NASH patients were randomly divided in the treatment group （ 100 cases） and the control group （100 cases）. Patients in the treatment group received taurine combined with silibinin for 24 weeks, and patients in thecontrol group received silibinin for 24 weeks. All patients were recommended to abstain from alcohol, improve dining structure, take moderate aerobic exercises, and keep body weight. Clinical symptoms, blood pressures, body mass indexes （BMI） and waist circumferences were observed before and after treatment in all patients ;liver functions, blood lipid and fasting glucose levels were tested, type-B ultrasonic and CT images were evaluated before and after treatment in all panents. Results After treatment,the significant improvement of clinical symptoms and laboratory tests ; type- B ultrasonic and CT examination showed that steatohepatitits were ameliorated in both groups （ P 〈 0.05 ）. Therapeutic effects in the treatment group were superior to those in the control group in aspect of symptoms amelioration including asthenia, liver area discomfort, nausea and vomiting, decrease of systolic and diastolic blood pressure, BMI, serum ALT, GGT, triglyceride and cholesterol levels ; in addition, ultrasonic or CT examination showed that extents of steatohepatitits amelioration were better in the treatment group （ P 〈 0.05 ）.Waist circumferences reduced significantly after treatment in women in the control group, men and women in the treatment group （P 〈 0.05 ）. Conclusion Taurine is effective in patients with NASH, and combination of taurine and silibiniu has superior treatment efficacy compared with taurine alone in patients with NASH.