水飞蓟素联合二甲双胍治疗肥胖型非酒精性脂肪肝疗效分析  

Clinical effect of silymarin combined with metformin on obesity patients with non-alcoholic fatty liver disease

作　　者：余小虎[1] 朱金水[2] 朱祖明[2] 朱励[2] 

机构地区：[1]上海市南汇区中心医院消化科,上海201300 [2]上海交通大学附属第六人民医院消化科

出　　处：《胃肠病学和肝病学杂志》2006年第5期485-487,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析水飞蓟素联合二甲双胍对肥胖型非酒精性脂肪肝患者的治疗作用。方法符合诊断标准的肥胖型非酒精性脂肪肝患者48例分为两组，试验组24例联合水飞蓟素及二甲双胍治疗，对照组24例服用水飞蓟素及维生素C片治疗，疗程均为4～6月。治疗前后测定各组患者血清转氨酶水平（ALT、AST）、血脂水平（TG、TC、LDL-C及HDL-C）、血清TNFα水平、胰岛素抵抗指数（IRI）及肝／脾CT比值并作统计学处理，同时观察实验过程中出现的不良反应。结果治疗后两组患者血清ALT均明显降低，其中尤以试验组降低明显（P〈0．01）；试验组患者治疗后各项血脂水平均显著改善；试验组胰岛素抵抗指数于治疗后明显下降（P〈0．05），而对照组无明显改变（P〉0．05）；两组患者治疗后血清TNFα均明显下降，尤以试验组下降明显（P〈0．01）；同时试验组治疗后肝／脾CT比值显著升高（P〈0．01）。用药期间两组患者均未出现显著不良反应。结论水飞蓟素联合二甲双胍对肥胖型非酒精性脂肪肝有显著疗效且用药安全。Objective To assess the therapeutic effect of silymarin combined with metformin on obesity patients with non-alcoholic fatty liver disease. Methods Forty eight obesity patients with non-alcoholic fatty liver disease were randomly divided into experiment group treated with silymarin combined with metformin （n = 24） and control group treated with silymarin combined with Vitamin c （n = 24） respectively for consecutive 4 - 6 months, and serum transaminase level（ALT, AST）, triglyceride（TG）, cholesterol（TC, LDL-C and HDL-C）, TNF-α lpha, insulin resistance index（IRI） and liver/spleen CT index were detected preand post-treatment, respectively. Side-effect was also observed during the experiment. Results The levels of serum ALT in experiment group and control group were all obviously reduced at the end point compared with the baseline, especially the former（ P 〈 0.01 ） ; the abnormity of TG, TC, LDL-C and HDL-C were all markedly ameliorated in experiment group compared with control group after treatment, and the level of IRI in experiment group was significantly decreased at the end point compared with the baseline（ P 〈 0.05） ,while the change was not obvious in control group（ P 〉 0.05） ; The levels of serum TNFα in experiment group and control group were all obviously reduced at the end point compared with the baseline, especially the former （ P 〈 0.01 ）, meanwhile, liver/spleen CT index in experiment group were obviously increased after treatment（ P 〈 0.01 ）, and no severe side-effects occurred during the experiment. Conclusion Silymarin combined with metformin is an effective and safe remedy for obesity patients with non-alcoholic fatty liver disease .

关 键 词：水飞蓟素 二甲双胍 非酒精性脂肪肝 肥胖 

分 类 号：R575[医药卫生—消化系统]