多种益生菌联合双环醇治疗脂肪肝所致肝损伤的临床疗效观察

Clinical efficacy observation of multiple probiotics combined with bicyclol in the treatment of liver injury caused by fatty liver

目的观察多种益生菌联合双环醇片治疗脂肪肝所致肝损伤的临床疗效。方法收集2016年10月～2017年10月在本院住院治疗的非酒精性脂肪肝(NAFLD)和酒精性脂肪肝(ALD)肝损伤患者,随机分为联合治疗组(予以复方嗜酸乳酸杆菌1.0 g/次,3次/d、双歧杆菌乳杆菌三联活菌片2.0 g/次,2次/d和双环醇片50 mg/d,3次/d)与双环醇治疗组(双环醇片50 mg/d,3次/d),观察治疗1周前后ALT、AST、T-Bil、γ-GT、CHOL、TC水平及无创肝纤维化评分的变化。结果 86例肝损伤患者纳入研究。治疗1周后BMI、T-Bil、γ-GT、CHOL、TC水平较治疗前下降不明显。NAFLD组49例,其中联合组25例、双环醇组24例,两组NAFLD-FS评分均<0.676,未提示有明显肝纤维化者;两组治疗后ALT、AST水平较治疗前明显下降,差异有统计学意义(P<0.05);两组治疗后比较,联合组较双环醇组ALT、AST水平明显下降,差异有统计学意义(P<0.05)。ALD组37例,其中联合组20例、双环醇组17例,两组治疗后ALT、AST水平及MDF评分较治疗前明显下降,差异具有统计学意义(P<0.05);两组治疗后比较,联合组较双环醇组AST水平明显下降,差异具有统计学意义(P<0.05)。结论在脂肪肝肝功能损伤期,益生菌"鸡尾酒"疗法联合双环醇治疗可在短期内有效改善肝功能,显著提高抗炎保肝疗效。

Objective To observe the clinical efficacy of multiple probiotics combined with bicyclol tablets in the treatment of liver injury caused by fatty liver.Methods Patients with non-alcoholic fatty liver disease(NAFLD)and alcoholic fatty liver disease(ALD)with liver injury who were hospitalized in our hospital from October2016to October2017were randomly divided into the combined treatment group(treated with compound Lactobacillus acidophilus1.0g/time,3times/day,Bifidobacterium bifidum triple live bacteria tablets2.0g/time,2times/day and bicyclol tablets50mg/day,3times/day)and the bicyclol treatment group(bicycloalcohol tablets50mg/day,3times/day).The changes of ALT,AST,T-Bil,γ-GT,CHOL,TC and non-invasive liver fibrosis scores were observed before and after treatment for1week.Results86patients with liver injury were included in the study.After1week of treatment,the levels of BMI,T-Bil,γ-GT,CHOL,and TC were not significantly lower than those before treatment.There were49patients in the NAFLD group,including25patients in the combined group and24patients in the bicyclol group.The NAFLD-FS scores of the two groups were all<0.676,and no obvious liver fibrosis was found.The levels of ALT and AST decreased significantly after treatment compared with those before treatment.The difference was statistically significant(P<0.05).The levels of ALT and AST in the combined group were significantly lower than those in the bicyclic group after treatment,and the difference was significant(P<0.05).There were37patients in the ALD group,including20patients in the combination group and17patients in the bicyclol group.The levels of ALT,AST and MDF in the two groups were significantly lower after treatment than those before treatment,and the difference was significant(P<0.05).The AST level of the combined group was significantly lower than that of the bicyclol group after treatment,and the difference was statistically significant(P<0.05).Conclusion In the period of fatty liver and liver function damage,probiotic"cocktail"therapy combined with bicyclol treatment can effectively improve liver function in a short period of time and significantly improve the anti-inflammatory and liver-protecting effects.