壳脂胶囊联合吡格列酮治疗非酒精性脂肪肝的临床研究

Clinical study on Kezhi Capsules combined with pioglitazone in treatment of non-alcoholic fatty liver

目的探讨壳脂胶囊联合吡格列酮治疗非酒精性脂肪肝的临床疗效。方法选取2015年5月—2016年5月在广州市花都区人民医院接受治疗的非酒精性脂肪肝病患者86例,根据治疗方案的差别分为对照组(43例)和治疗组(43例)。对照组口服盐酸吡格列酮片,1片/次,1次/d。治疗组在对照组的基础上口服壳脂胶囊,5粒/次,3次/d。两组患者均连续治疗2个月。评价两组患者临床效果,同时比较两组治疗前后血脂、肝功能、血清炎性因子和氧化应激水平变化。结果治疗后,对照组的总有效率为81.40%,显著低于治疗组的95.35%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,两组患者三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和γ-谷氨酰转移酶(γ-GT)均比同组治疗前显著降低,而高密度脂蛋白胆固醇(HDL-C)水平均明显升高,同组比较差异具有统计学意义(P<0.05);且治疗组上述指标改善程度优于对照组(P<0.05)。治疗后两组患者血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)均较同组治疗前明显降低(P<0.05);且治疗组上述指标降低的更显著(P<0.05)。治疗后两组血清丙二醛(MDA)水平均降低,超氧化物歧化酶(SOD)活性升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组上述指标改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论壳脂胶囊联合吡格列酮治疗非酒精性脂肪肝病效果显著,可明显改善患者肝功能,降低血脂、炎性反应及氧化应激水平,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Kezhi Capsules combined with pioglitazone in treatment of non-alcoholic fatty liver. Methods Patients（86 cases） with non-alcoholic fatty liver in Huadu District People＇s Hospital of Guangzhou from May 2015 to May 2016 were divided into control（43 cases） and treatment（43 cases） groups according to different treatments. Patients in the control group were po administered with Pioglitazone Hydrochloride Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Kezhi Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and blood lipid, liver function, serum inflammatory factors, and oxidative stress levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.40%, which was significantly lower than 95.35% in the treatment group, and there were differences between two groups（P〈 0.05）. After treatment, TG, TC, LDL-C, ALT, AST, and γ-GT in two groups was significantly decreased, but HDL-C level was increased, the difference was statistically significant in the same group（P〈 0.05）. And these indicators in the treatment group were significantly better than those in the control group（P〈 0.05）. After treatment, the serum hs-CRP, TNF-α, and IL-6 in two groups were significantly decreased（P〈 0.05）. And these indexes in the treatment group were decreased with significant difference between two groups（P〈 0.05）. Compared with those before treatment, MDA level in two groups after treatment was significantly decreased, but SOD was increased, and the difference was statistically significant in the same group（P〈 0.05）. And the improvement of these indicators in the treatment group was better than that in the control group, with significant difference between two groups（P〈 0.05）. Conclusion Kezhi Capsules combined with pioglitazone has a significant effect in treatment of non-alcoholic fatty liver, can significantly improve the liver function and reduce blood lipid, inflammatory reaction and oxidative stress level, which has a certain clinical application value.