双歧杆菌四联活菌片联合甘草酸二铵肠溶胶囊治疗非酒精性脂肪性肝病的疗效

Therapeutic effect of Bifidobacterium Tetravaccine Tablets combined with Diammonium Glycyrrhizinate Enteric-Coated Capsules on nonalcoholic fatty liver disease

目的探究双歧杆菌四联活菌片联合甘草酸二铵肠溶胶囊治疗非酒精性脂肪性肝病(NAFLD)的疗效及对患者血清核转录因子κB(NF-κB)、脂多糖(LPS)水平的影响。方法将153例NAFLD患者根据治疗方法的不同分为观察组(78例)和对照组(75例)。对照组给予甘草酸二铵肠溶胶囊治疗,观察组在对照组治疗的基础上予以双歧杆菌四联活菌片治疗,2组均连续治疗4周。观察2组治疗后的疗效,检测并比较2组治疗前、后的血清肝功能指标、血脂、NK-κB、LPS、白细胞介素-6(IL-6)水平及肠道菌群变化情况,统计2组治疗期间的不良反应发生情况。结果治疗后,观察组的总有效率为89.7%,高于对照组(75.3%,P<0.05)。治疗后,观察组血清总胆固醇(TC)水平、血清三酰甘油(TG)水平低于对照组(P<0.05);血清高密度脂蛋白胆固醇(HDL-C)水平高于对照组(P<0.05);血清低密度脂蛋白胆固醇(LDL-C)、血清丙氨酸氨基转移酶(ALT)、血清碱性磷酸酶(ALP)、血清天门冬氨酸氨基转移酶(AST)、血清总胆红素(TBiL)、血清谷氨酰转肽酶(GGT)、血清NK-κB、血清LPS、血清IL-6水平均低于对照组(P<0.05);乳酸菌、双歧杆菌水平高于对照组(P<0.05);大肠杆菌、肠球菌水平低于对照组(P<0.05)。治疗期间,观察组不良反应发生率为19.2%,与对照组(18.7%)比较差异无统计学意义(P>0.05)。结论双歧杆菌四联活菌片联合甘草酸二铵肠溶胶囊治疗NAFLD可有效降低患者血清NK-κB、LPS、IL-6水平,改善患者肠道屏障功能、肝功能及血脂代谢,抑制机体炎症反应,并提高临床疗效,安全性良好。

Objective To investigate the therapeutic effect of Bifidobacterium Tetravaccine Tablets combined with Diammonium Glycyrrhizinate Enteric-Coated Capsules on nonalcoholic fatty liver disease(NAFLD)and its effect on the levels of serum nuclear factor kappa B(NF-κB),lipopolysaccharide(LPS)in patients.Methods 153 patients with NAFLD were divided into the observation group(78 cases)and the control group(75 cases)according to different treatment methods.The control group was treated with Diammonium Glycyrrhizinate Enteric-Coated Capsules orally on the basis of basic treatment,while the observation group was treated with Bifidobacterium Tetravaccine Tablets orally on the basis of the control group.The two groups were treated continuously for 4 weeks.The therapeutic effects of the 2 groups after 4 weeks of treatment were observed,and the serum liver function indexes,blood lipid,NK-κB,LPS and interleukin-6(IL-6)levels and intestinal flora before and after 4 weeks of treatment were detected and compared,and the occurrence of adverse reactions during the treatment of the 2 groups was counted.Results After treatment,the total effective rate of observation group was 89.7%,which was higher than that of control group(75.3%,P<0.05).After treatment,the levels of serum total cholesterol(TC)and triglyceride(TG)in the observation group were lower than those in the control group(P<0.05).The serum high density lipoprotein cholesterol(HDL-C),the serum low density lipoprotein cholesterol(LDL-C),the serum alanine aminotransferase(ALT),the serum alkaline phosphatase(ALP),serum aspartate aminotransferase(AST),the serum total bilirubin(TBiL),the serum glutamyltranspeptidase(GGT),serum NK-κB,serum LPS and serum IL-6 level were all lower than that of control group(P<0.05).The lactic acid bacteria and the Bifidobacterium level were higher than that of control group(P<0.05).The Escherichia coli and the enterococcus level were lower than that of control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 19.2%,and there was no significant difference compared with the control group(18.7%)(P>0.05).Conclusion Bifidobacterium Tetravaccine Tablets combined with Diammonium Glycyrrhizinate Enteric-Coated Capsules in the treatment of NAFLD can effectively reduce the levels of NK-κB,LPS and IL-6 in patients′serum,improve the intestinal barrier function,liver function and lipid metabolism,inflammatory reaction of patients,and improve the clinical efficacy with good safety.