水飞蓟宾葡甲胺联合维生素E治疗非酒精性脂肪性肝炎临床疗效观察

Clinical Observation of the Treatment of Nonalcoholic Steatohepatitis with Silybin and Meglumine Combined with Vitamin E

目的观察水飞蓟宾葡甲片胺联合维生素E滴丸治疗非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)的疗效。方法 91例NASH患者分为两组:联合治疗组47例(水飞蓟宾葡甲胺片+维生素E胶丸)和单药治疗组44例(水飞蓟宾葡甲胺片),治疗12周后,观察两组治疗前后随访患者生物化学指标及肝纤维化测定的动态变化。结果联合治疗组治疗前后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、r-谷氨酰基转移酶(GGT)、总胆固醇(TC)和甘油三酯(TG)差异均有统计学意义(P均<0.01),单药治疗组治疗前后血清ALT、AST、GGT差异均有统计学意义(P均<0.01),而单药治疗组治疗前后血清TC、TG差异均无统计学意义(P均>0.05),两组血清ALT、AST、GGT、TC、TG治疗后比较差异均有统计学意义(P均<0.05)。联合治疗组治疗后脏硬度弹性值(liver stiffness measurement,LSM)和受控衰减参数(controlled attenuation parameter,CAP)值均下降(P均<0.05)。结论水飞蓟宾葡甲胺片联合天然维生素E治疗非酒精性脂肪肝可有效改善机体肝功能指标,提高临床疗效。

Objective Non-alcoholic steatohepatitis was treated with silybin and a vitamin E drop pill to observe the clinical efficacy of the treatment.Methods Total 91 patients with non-alcoholic steatohepatitis were divided into two groups: 47 patients in the combined treatment group (silybin meglumine tablets + vitamin E capsules) and 44 patients in the single drug treatment group (silybin meglumine tablets).The course of treatment was 3 months.The dynamic changes of biochemical indexes and liver fibrosis were observed before and after treatment.Results The levels of serum ALT,AST,GGT,TC and TG were compared before and after treatment in the combined treatment group (P all<0.01).The levels of serum ALT,AST and GGT were compared before and after treatment in the single-drug control group.There were statistical differences(P all<0.01),but there was no significant difference in serum TC and TG between the control group and the control group(P all>0.05).The levels of serum ALT,AST,GGT,TC and TG in the two groups were statistically significant after treatment(P all < 0.05).Both the LSM and CAP values of the combination group were significantly decreased after treatment (P all <0.05).Conclusion Clinical treatment of patients with nonalcoholic fatty liver disease can be considered to give silybin and meglumine tablets combined with natural vitamin E,which can effectively improve liver function indicators and clinical efficacy.