多烯磷脂酰胆碱联合复方丹参滴丸对非酒精性脂肪肝的临床研究

Effect of Compound Danshen Dripping Pill combined with polyene phosphatidyl choline in treatment of nonalcoholic fatty liver disease

目的研究多烯磷脂酰胆碱联合复方丹参滴丸对非酒精性脂肪肝患者的临床治疗效果。方法选择2012年1月—2015年12月在西安医学院附属宝鸡医院进行诊治的非酒精性脂肪肝患者116例,随机分为观察组与对照组,每组58例。对照组采用复方丹参滴丸治疗,观察组采用多烯磷脂酰胆碱联合复方丹参滴丸治疗,均治疗3个月。比较两组的临床有效率;分别于治疗前后检测肝功能指标:天氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBIL);血脂指标:总胆固醇(TC)、三酰甘油(TG);肝纤维化指标:层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、IV型胶原(IV-C);并进行上腹部CT平扫,计算肝/脾CT比值。结果观察组的有效率为91.4%(53/58),明显高于对照组的72.4%(42/58)(P<0.05);与同组治疗前比较,治疗后两组的AST、ALT、γ-GT、TBIL、TC、TG水平均明显降低,肝/脾CT比值明显升高(P<0.05),且观察组的改善程度明显优于对照组(P<0.05);与治疗前比较,两组治疗后的LN、PCIII、IV-C和HA水平均明显降低(P<0.05),且观察组的降低程度明显优于对照组(P<0.05)。结论多烯磷脂酰胆碱联合复方丹参滴丸可以明显改善非酒精性脂肪肝患者的肝功能和肝纤维化,降低血脂。

Objective To investigate the clinical effect of Compound Danshen Dripping Pill （CDCP） combined with polyene phosphatidyl choline in the treatment of nonalcoholic fatty liver disease. Methods Patients with nonalcoholic fatty liver disease （116 cases） treated in Xi＇an Medical University Affiliated Baoji Hospital from January 2012 to December 2015 were selected and divided into two groups randomly. Control group was treated with CDDP, and observation group was treated with CDDP combined with polyene phosphatidyl choline, the two groups were treated for 3 months. The clinical efficiency of two groups was compared. The following indicators were detected before and after treatment respectively, such as liver function indicators： aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, ^-glutamyltransferase （7-GT） and total bile acid （TBIL）; blood lipid indicators： total cholesterol （TC）, triacylglycerol （TG）; and liver triglyceride fibrosis indicators： laminin （LN）, hyaluronic acid （HA）, procollagen III （PC III）, and type IV collagen （IV-C）, and carried on the upper abdomen CT plain scan, the liver/spleen CT ratio were calculated. Results After treatment, the effective rate of the observation group was 91.4% （53/58）, significantly higher than that of the control group 72.4% （42/58） （P 〈 0.05）. After treatment, the levels of AST, ALT, y-GT, TBIL, TC and TG in two groups were decreased significantly compared with the same group before treatment and lower in the observation group （P 〈 0.05）, and liver/spleen CT ratio was increased significantly and higher in the observation group （P 〈 0.05）. After treatment, the levels of LN, PC III, IV-C and HA in two groups were decreased significantly compared with the same group before treatment and lower in the observation group （P 〈 0.05）. Conclusion CDDP combined with polyene phosphatidyl choline can significantly improve the liverfunction and liver fibrosis in patients with nonalcoholic fatty liver disease, and lower blood lipid, which has high clinical value.