替米沙坦联合复方牛胎肝提取物治疗非酒精性脂肪性肝炎的临床研究

摘要

Objective: To investigate the effects of combined therapy with Telmisartan and compound cow fetal liver extracts on nonalcoholic steatohepatitis ( NASH) . Methods: Sixty and four patients with NASH were divided into 2 groups at random, 28 in the control group and 36 in the experimental group. Patients in the experimental group were treated with Telmisartan and compound cow fetal liver extracts, and patients in the control group were treated with compound cow fetal liver extracts. Twelve weeks were one treatment course. Serum ALT, AST, GGT, TG, TCh, HCL-Ch, LDL-Ch, HA, LN, CⅣ, PCⅢ, fasting plasma glucose and insulin were detected before and after treatment Results:The levels of serum ALT, AST, GGT and insulin resistance index were decreased significantly both in experimental group and control group at the end point (P ＜ 0. 05, P ＜ 0.01) , especially in the former group (P ＜0.05, P ＜0.01) ; the level levels of serum TG, TCh and LDL-Ch were decreased markedly in experimental group (P ＜0.05, P ＜0.01) , the level level of serum HDL-Ch was increased markedly (P＜0.05), but in control group, only the levels of serum TG and LDL-Ch were decreased markedly ( P ＜ 0.05, P ＜ 0. 01) ; the level levels of serum HA, LN, CⅣ and PC Ⅲ were decreased markedly in experimental group ( P ＜ 0.05, P ＜ 0. 01) , but in control group, only the levels of serum HA were decreased markedly (P ＜0.01) . Conclusion; The treatment of Telmisartan combined with compound cow fetal liver extracts was effective for nonalcoholic steatohepatitis patients. It was not only improved Glu-colipid metabolism and insulin resistance level, but also relieved fibrosis in liver.%观察替米沙坦联合复方牛胎肝提取物对非酒精性脂肪性肝炎(NASH)的治疗作用.方法:64例NASH患者随机分成治疗组36例和对照组28例,对照组患者给予复方牛胎肝提取物片,治疗组患者给予替米沙坦联合复方牛胎肝提取物治疗,疗程均为12周.治疗前后分别测定两组患者肝功能指标:ALT(丙氨酸转氨酶)、AST(天门冬氨酸转氨酶)、GGT(γ-谷氨酰转肽酶),血脂指标:TG(甘油三酯)、TCh(总胆固醇)、HDL-Ch(高密度脂蛋白胆固醇)、LDL-Ch(低密度脂蛋白胆固醇),血清肝纤维化指标:HA(透明质酸)、LN(层粘蛋白)、CⅣ(Ⅳ型胶原)、PCⅢ(Ⅲ型前胶原),空腹血糖(FBG)及胰岛素(TBIn)水平.结果:治疗后两组患者血清ALT、AST、GGT水平及胰岛素抵抗指数均明显下降(P＜0.05,P＜0.01),治疗组下降尤为明显(P＜0.05,P＜0.01);治疗后对照组患者仅血清TG及LDL-Ch明显下降(P＜0.05,P＜0.01);治疗组患者血清TG、TCh及LDL-Ch均较治疗前明显下降(P＜0.05,P＜0.01),HDL-Ch明显上升(P＜0.05),与对照组比较差异有显著性意义(P＜0.05,P＜0.01);治疗后对照组患者仅HA明显下降(P＜0.01),而治疗组患者血清HA、LN、CⅣ及PCⅢ均较治疗前明显下降(P＜0.05,P＜0.01),与对照组比较,治疗组下降更为显著(P＜0.05,P＜0.01).结论:替米沙坦联合复方牛胎肝提取物能改善NASH患者糖、脂代谢及胰岛素抵抗程度,抗肝纤维化,是治疗NASH的较好选择.