地衣芽胞杆菌联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎临床观察

摘要

[Objective]To evaluate the efficacy and safety of bacillus licheniformis and polyene phos-phatidylcholine in the treatment of nonalcoholic steatohepatitis .[Methods]Fifty patients w ere enrolled in treatment group or control group in 1∶1 ratio .Patients in treatment group received bacillus licheniformis 500 mg tid po and polyene phosphatidylcholine capsules 456 mg tid po .Patients in control group received polyene phosphatidylcholine capsules 456 mg tid po only .The course was 12 weeks .Clinical symptoms and blood biochemistry test were asseted in all patients before treatment ,at the every 2 week duration and at the end of therapy .Ultrasound examinations were performed in all patients before treatment and at the end of therapy by the same doctor .[Results]After the treatment ,the clinical symptoms ameliorated in both the-atment and control treatment and control groups(P<0 .05) .Whereas the treatment group was superior to control group in aspect of amelioration of inappetite ,diarrhea and constipation (P<0 .05) .After the treat-ment ,the levels of liver function ,blood glucose ,serum triglyceride and cholesterol decreased in both group were decreased(P<0 .05) .Compared with control group ,improvement of liver function test was found in treatment group .Ultrasonic examination showed that the steatohepatitits was improved significantly in two groups(P<0 .05) .[Conclusion]Based on the therapy ,bacillus licheniformis combined with polyene phos-phatidylcholine capsules can improve the symptoms of inappetite ,diarrhea and constipation and modify the liver function of NASH .There was no side effect during the therapeutic process .%[目的]评价地衣芽胞杆菌联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎的临床疗效和安全性。[方法]50例非酒精性脂肪性肝炎患者按1∶1的比例分为治疗组和对照组。对照组口服多烯磷脂酰胆碱胶囊，每日3次，每次456 mg；治疗组在对照组基础上加服地衣芽胞杆菌活菌胶囊，每日3次，每次500 mg。2组疗程均为12周。治疗过程中所有患者需改善饮食结构，进行中等量有氧运动，控制体质量。治疗前、治疗过程中每2周及治疗后观察症状体征、血常规、尿常规和肝肾功能、血糖、血脂；治疗前、治疗结束时进行B超检查。[结果]治疗后，治疗组和对照组的乏力、肝区不适、腹胀、恶心纳差、腹泻便秘症状均较治疗前有所好转，差异显著（P＜0．05）。治疗组与对照组相比腹胀、腹泻便秘症状评分下降更明显，差异显著（P＜0．05）。治疗后，2组患者的丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、谷氨酰转肽酶（GGT）、血糖、三酰甘油、总胆固醇均较治疗前降低，差异显著（P＜0．05）。治疗组患者的ALT、AST、GGT较对照组降低，但差异不显著（P＞0．05）。治疗后，治疗组与对照组患者的B超评分较治疗前降低，差异显著（P＜0．05）。2组之间治疗后B超评分差异不显著（P＞0．05）。[结论]地衣芽孢杆菌活菌胶囊联合多烯磷脂酰胆碱胶囊治疗可有效改善NASH患者消化道症状和肝功能。