嗜酸乳杆菌联合还原性谷胱甘肽治疗非酒精性脂肪肝的临床研究

Clinical study of lactobacillus acidophilus combined with glutathione in the treatment of nonalcoholic fatty liver disease

目的探讨嗜酸乳杆菌联合还原性谷胱甘肽治疗非酒精性脂肪肝的临床疗效。方法选取非酒精性脂肪肝患者120例，以随机数字表法分为对照组（60例）和观察组（60例），分别给予还原性谷胱甘肽单用和在此基础上加用嗜酸乳杆菌辅助治疗；比较两组临床疗效，治疗前后肝脏功能指标、血脂指标及脂肪肝超声分度情况等。结果对照组和观察组治疗总有效率为76．67％、91．67％；观察组临床治疗有效率显著高于对照组（χ2=10．52，P〈0．05）；观察组治疗后AST、ALT及GGT水平均显著低于治疗前及对照组[（36．89±7．14）U／L、（36．89±7．14）U／L、（36．89±7．14）U／L比（49．36±11．08）U／L、（45．91±10．24）U／L、（90．28±20．70）U／L；（36．89±7．14）U／L、（36．89±7．14）U／L、（36．89±7．14）U／L比（92．90±24．3）U／L、（81．11±17．37）U／L，（147．27±34．19）U／L，t=2．88，2.54，2．91；3．01，3．36；3．18，3．48；3．41，3．87；均P〈0．05]；观察组治疗后TG、TC、HDL—C及LDL—C水平均显著优于治疗前及对照组[（1．66±0．42）mmol／L、（4．05±0．77）mmol／L、（1．69±0．60）mmol／L、（2．44±0．38）mmol／L比（2．13±0．80）mmol／L、（4．64±0．94）mmol／L、（1．45±0．48）mmol／L、（2．97±0．57）mmol／L；（1．66±0．42）mmol／L、（4．05±0．77）mmol／L、（1．69±0．60）mmol／L、（2．44±0．38）mmol／L比（2．71±1．33）mmol／L、（5．42±1．27）mmol／L，（1．08±0．36）mmol／L、（3．49±0．71）mmol／L，t=2．43，2．13，2．55，2．07；3．02，3．41；3．11，3．65；2．81，3．30；2．87，3．15，均P〈0．05）；同时对照组治疗后脂肪肝超声分度正常6例，轻度24例，中度21例，重度9例；观察组治疗后脂肪肝超声分度正常13例，轻度30例，中度13例，重度4例；观察组治疗后脂肪肝超声分度情况显著优于治疗前、对照组（U=3．74、5．20，均P〈0．05）。结论嗜酸乳杆菌联合还原性谷胱甘肽治疗非酒精性脂肪肝可有效促进肝脏功能恢复，调节血脂水平，且有助于改善影像学分级。

Objective To investigate the clinical effects of lactobacillus acidophilus combined with glutathione in the treatment of nonalcoholic fatty liver disease. Methods 120 patients with nonalcoholic fatty liver disease were selected,and they were randomly divided into control group （60 patients used glutathione alone） and observation group （60 patients received lactobacillus acidophilus on the basis of control group ）. The clinical efficacy, liver function index,blood lipid index and the ultrasonography grading of fatty liver before and after treatment of the two groups were compared. Results The clinical total effective rates of the control group and the observation group were 76.67% ,91.67% ,respectively. The total effective rate of the observation group was significantly higher than that of the control group（ χ2 = 10.52 ,P 〈 0.05 ）. The levels of AST, ALT and GGT of the observation group after treatment were significantly lower than those of the control group and before treatment [ （ 36. 89 ± 7. 14 ） U/L, （ 36. 89 ± 7.14） U/L, （ 36.89 ± 7. 14） U/L vs. （49.36 ± 11.08 ） U/L, （45.91 ±10.24） U/L, （90.28 ± 20.70） U/L; （ 36.89 ±7.14） U/L, （36.89 ± 7.14） U/L, （ 36.89 ±7.14 ） U/L vs. （92.90 ± 24.3 ） U/L, （ 81.11 ±17.37 ） U/L, （ 147.27± 34.19 ） U/L, t = 2.88,2.54,2.91 ; 3.01,3.36; 3.18,3.48; 3.41,3.87; all P 〈 0.05 ）. The levels of TG, TC, HDL - C and LDL - C of the observation group after treatment were significantly better than those of the control group and before treatment [ （ 1.66 ± 0.42 ） mmol/L, （4.05 ±0.77 ） mmol/L, （ 1.69 ± 0.60 ） retool/L, （ 2.44 ± 0.38 ） retool/L vs. （2. 13 ± 0.80 ） mmol/L, （4.64 ± 0.94 ） mmoL/L, （ 1.45 ± 0.48 ） mmol/L, （ 2.97±0.57 ） mmoL/L ; （ 1.66 ±0.42 ） mmol/L, （4.05± 0.77 ） mmol/L, （ 1.69 ± 0.60） mmol/L, （ 2.44 ± 0.38 ） mmol/L vs. （ 2.71 ±1.33 ） mmol/L, （5.42 ± 1.27 ） mmol/L, （ 1; 08 ± 0.36 ） mmol/L, （ 3.49 ± 0.71 ） mmol/L, t = 2.43,2.13,2.55,2.07 ; 3.02,3.41 ; 3.11,3.65 ; 2.81,3.30 ;2.87,3.15 ; all P 〈 0.05 ）. In the control group, normal in 6 cases, mild in 24 cases, moderate in 21 eases and severe in 9 cases as fatty liver degree;in the observation group, normal in 13 cases, mild in 30 cases, moderate in 13 cases and severe in 4 cases as fatty liver degree. The ultrasonography grading of fatty liver of the observation group after treatment were significantly better than those of control group and before treatment（ U = 3.74, 5.20, all P 〈 0. 05 ）. Conclusion Lactobaeillus aeidophilus combined with glutathione in the treatment of nonalcoholic fatty liver disease can efficiently promote the recovery process of liver function, regulate blood lipid levels and is helpful to improve the imaging grading.