强肝胶囊对非酒精性脂肪性肝病患者胰岛素抵抗指数和肝纤维化评分的影响  

Effect of Qianggan capsules on insulin resistance index and liver fibrosis score in patients with nonalcoholic fatty liver disease

作　　者：欧强[1] 徐燕华[1] 曲立娟[1] 黄玲[1] 

机构地区：[1]上海市第八人民医院感染科,上海200235

出　　处：《临床肝胆病杂志》2016年第10期1951-1954,共4页Journal of Clinical Hepatology

摘　　要：目的观察强肝胶囊对非酒精性脂肪性肝病(NAFLD)患者肝纤维化评分和胰岛素抵抗指数的影响。方法选取2014年8月-2015年7月在上海市第八人民医院就诊的NAFLD患者85例,随机分为治疗组(n=45)和对照组(n=40)。治疗组给予强肝胶囊,对照组给予多烯磷脂酰胆碱胶囊,2组疗程均为24周。观察2组治疗前后血清转氨酶(AST、ALT)、稳态模型胰岛素抵抗指数(HOMA-IR)以及NAFLD肝纤维化评分(NAFLDFS)的变化。计量资料组间比较采用成组t检验,组内治疗前后比较采用配对t检验;计数资料组间比较采用χ2检验。结果 2组治疗后ALT、AST水平均较同组治疗前明显改善,差异均有统计学意义(P值均<0.05);与治疗前比,治疗组HOMA-IR、NAFLDFS治疗后均明显下降,差异均有统计学意义(3.58±0.85 vs 2.48±0.78,t=6.40,P<0.05;-1.78±1.24 vs-2.35±0.98,t=2.40,P<0.05)。2组间治疗后比较,治疗组HOMA-IR、NAFLDFS较对照组显著下降,差异均有统计学意义(2.48±0.78 vs 3.09±0.89,t=3.36,P<0.01;-2.35±0.98 vs-1.48±1.08,t=3.80,P<0.01)。整个疗程未见明显不良反应。结论强肝胶囊不仅能降低血清转氨酶水平,还可改善胰岛素抵抗和减轻NAFLD患者肝纤维化程度。Objective To investigate the effect of Qianggan capsules on liver fibrosis score and insulin resistance index in patients with nonalcoholic fatty liver disease（ NAFLD）. Methods A total of 85 NAFLD patients who were treated in the Eighth People＇s Hospital of Shanghai from August 2014 to July 2015 were enrolled and randomly divided into treatment group（ 45 patients） and control group（ 40 patients）.The patients in the treatment group were given Qianggan capsules,and those in the control group were given polyene phosphatidylcholine capsules. The course of treatment was 24 weeks for both groups. The changes in serum aminotransferases [aspartate aminotransferase（ AST）and alanine aminotransferase（ ALT） ],homeostasis model assessment of insulin resistance（ HOMA-IR）,and NAFLD fibrosis score（ NAFLDFS） after treatment were observed in both groups. The t-test was used for comparison of continuous data between groups,before-after comparison within each group was made by paired t-test; and the chi-square test was used for comparison of categorical data between groups. Results Both groups showed significant improvements in ALT and AST levels after treatment（ all P〈0. 01）. After treatment the treatment group showed significant reductions in HOMA-IR and NAFLDFS（ 3. 58 ± 0. 85 vs 2. 48 ± 0. 78,t = 6. 40,P〈0. 01;-1. 78 ±1. 24 vs-2. 35 ± 0. 98,t = 2. 40,P〈0. 01） and the treatment group had significantly lower HOMA-IR and NAFLDFS than the control group（ 12. 48 ± 0. 78 vs 3. 09 ± 0. 89,t = 3. 36,P〈0. 01;-2. 35 ± 0. 98 vs-1. 48 ± 1. 08,t = 3. 80,P〈0. 01）. No serious adverse events were observed during the course of treatment. Conclusion Qianggan capsules not only reduce the levels of serum aminotransferases,but also improve insulin resistance and reduce fibrosis degree in NAFLD patients.

关 键 词：脂肪肝 强肝胶囊 胰岛素抗药性 肝纤维化评分 

分 类 号：R575.5[医药卫生—消化系统]