水飞蓟宾胶囊联合常规治疗对酒精性肝病伴早期肝纤维化病变患者血清氧化损伤和肝功能的影响

Effects of Silibinin Capsules Combined with Routine Therapy on Serum Oxidative Injury and Liver Function of Patients with Alcoholic Liver Disease Complicated with Early Liver Fibrosis

目的:探讨水飞蓟宾胶囊联合常规治疗对酒精性肝病(ALD)伴早期肝纤维化病变患者血清氧化损伤和肝功能的影响。方法:选取2013年4月-2015年1月到我院就诊的ALD伴早期肝纤维化病变患者,按随机数字表法分为对照组和研究组,每组38例。对照组予以常规对症治疗措施[戒酒、口服肌苷片(0.4 g/次,每日2次)、补充维生素和微量元素等];研究组在对照组治疗基础上口服水飞蓟宾胶囊(70 mg/次,每日2次),持续治疗48周。比较两组患者临床疗效及不良反应发生率差异,记录治疗前、后血清氧化损伤指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、肝纤维化指标[层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)]及肝功能指标[血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]变化情况。结果:治疗前两组患者基线资料比较差异无统计学意义(P>0.05)。治疗后,研究组患者总有效率明显高于对照组(P<0.05),两组患者不良反应发生率差异无统计学意义(P>0.05)。与治疗前比较,两组患者血清MDA水平、肝纤维化指标和肝功能指标水平均明显降低(P<0.05),SOD水平明显升高(P<0.05),其中研究组改善效果较对照组更明显(P<0.05)。结论:水飞蓟宾胶囊联合常规治疗可增强ALD伴早期肝纤维化病变患者的临床疗效,主要表现为改善氧化应激、调节肝功能、抑制肝纤维化病变进程。

OBJECTIVE:To investigate the effects of Silibinin capsules combined with routine therapy on serum oxidative injury and liver function of patients with alcoholic liver disease(ALD)complicated with early liver fibrosis.METHODS:The patients with ALD complicated with early liver fibrosis selected from our hospital during Apr.2013-Jan.2015 were divided into control group and study group according to random number table,with 38 cases in each group.Control group received routine symptomatic treatment[temperance,oral administration of Inosine tablets(0.4 g/times,bid),vitamin and microelement supplementation,etc.].Study group was additionally given Silibinin capsule(70 mg/time,bid)orally,for consecutive 48 weeks,on the basis of control group.The clinical efficacies and the incidence of ADR were compared between 2 groups.The changes of serum oxidative injury indexes(SOD,MDA),liver fibrosis indexes[laminin(LN),hyaluronic acid(HA),typeⅣcollagen(Ⅳ-C),typeⅢprocollagen(PCⅢ)]and liver function indexes(ALT,AST)were recorded before and after treatment.RESULTS:Before treatment,there was no statistical significance in baseline information between 2 groups(P>0.05).After treatment,total response rate of study was significantly higher than that of control group(P<0.05),but there was no statistical significance in the incidence of ADR between 2 groups(P>0.05).Compared with before treatment,serum levels of MDA,liver fibrosis indexes and liver function indexes in 2 groups were decreased significantly(P<0.05),while SOD levels were increased significantly(P<0.05);the improvement of study group was more significant than control group(P<0.05).CONCLUSIONS:Silibinin capsules combined with routine treatment can enhance clinical efficacy of ALD patients with early liver fibrosis,mainly manifesting as improving oxidative stress,regulating liver function and inhibiting the development of liver fibrosis.