酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎患者的疗效观察

摘要

Objective To investigate the clinical efficacy of lived combined clostridium butyricum and bifidobacterium capsules combined with polyene phosphatidyl choline in treatment of patients with non-alcoholic steatohepatitis (NASH). Methods Total of 84 cases with NASH in Qingdao Municipal Hospital from January 2014 to December 2015 were selected and randomly divided into treatment group and control group, 42cases in each group. Patients in treatment group were given lived combined clostridium butyricum and bifidobacterium capsules in combination with polyene phosphatidyl choline orally, and patients in control group were given polyene phosphatidyl choline only. The treatment course was 24 weeks. The liver founction indexes (ALT, AST and GGT), serum lipid (TG, TC), serum endotoxin and Fibroscan-CAP were compared before and after treatment. Results After treatment, the level of ALT, AST, GGT, TG, TC, serum endotoxin and Fibroscan-CAP in both groups improved significantly (P < 0.001). The decline level of ALT, AST, GGT, TG, TC, serum endotoxin and Fibroscan-CAP in treated group were better than those in control group, the difference was statistically significant (t = -4.600, -4.039, -2.655, -4.500, -4.151, -4.886, -2.723; P < 0.05). Conclusions Lived combined clostridium butyricum and bifidobacterium capsules, which can decrease the level of serum lipid, relieve fatty deposition and injury of liver by regulating intestinal microflora and attenuating intestinal endotoxemia, is an effective assistant treatment of NASH.%目的 探讨酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱对非酒精性脂肪性肝炎(NASH)的疗效.方法 选取2014年1月至2015年12月于青岛市市立医院门诊及住院治疗的非酒精性脂肪性肝炎患者84例为研究对象,随机分为观察组和对照组,每组42例,观察组患者给予酪酸梭菌二联活菌胶囊联合多烯磷脂酰胆碱胶囊口服,对照组患者单独给予多烯磷脂酰胆碱胶囊口服,疗程均为24周,比较两组患者治疗前后肝功能(ALT、AST、GGT)、血脂(TG、TC)、血清内毒素及Fibroscan-CAP值的变化.结果 观察组和对照组患者的ALT、AST、GGT、TG、TC、血清内毒素及Fibroscan-CAP值均较治疗前降低,差异有统计学意义(P均<0.001).治疗后观察组患者的ALT、AST、GGT、TG、TC、血清内毒素及Fibroscan-CAP值的下降水平优于对照组,差异有统计学意义(t值分别为4.600、4.039、2.655、4.500、4.151、4.886和2.723,P均<0.05).结论 酪酸梭菌二联活菌胶囊通过调节NASH患者肠道菌群,减轻肠源性的内毒素血症,从而降低血脂水平、减轻肝脏脂肪沉积及肝功能损伤,可用于NASH的辅助治疗.