生活干预和水飞蓟宾治疗对非酒精性脂肪性肝病患者治疗效果及体质量的影响  

Effect of life intervention and silybin therapy on patients with non-alcoholic fatty liver disease

作　　者：常越 刘沁雨 杨梅[1] 丁玉平[1] 荣亚梅[1] 李海[1,2] CHANG Yue;LIU Qin-yu;YANG Mei;DING Yu-ping;RONG Ya-mei;Li Hai(Department of Hepatopancreatobiliary and Splenic Medicine, Affiliated Hospital of Logistics University of People’s Armed Police, Tianjin 300162, China;Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital,Tianjin 300380, China)

机构地区：[1]中国人民武装警察部队后勤学院附属医院肝胆胰脾科,天津300162 [2]天津市西青医院消化内科,天津300380

出　　处：《中国肝脏病杂志（电子版）》2019年第2期48-53,共6页Chinese Journal of Liver Diseases：Electronic Version

基　　金：天津市慢性病防治科技重大专项项目(17ZXMFSY00200)

摘　　要：目的比较生活干预和水飞蓟宾治疗对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者的治疗效果.方法收集2017年9月至2018年6月于中国人民武装警察部队后勤学院附属医院就诊的NAFLD患者.根据治疗方式不同分为生活干预组和生活干预+水飞蓟宾组,同组内再根据患者入组时的体质量指数(body mass index,BMI)分为肥胖组和非肥胖组,比较两组患者治疗前后体质量、BMI、腰围、臀围、肝功能生物化学指标、空腹血糖(fasting blood glucose,FBG)、胰岛素及血脂等指标.结果共纳入符合条件的NAFLD患者284例,其中生活干预组129例,生活干预+水飞蓟宾组155例.入组时同组内肥胖组的体质量、腰围、腰臀比及糖尿病患病率显著高于非肥胖组(P<0.05),生活干预+水飞蓟宾组患者的ALT和稳态胰岛素抵抗指数显著高于生活干预组(P<0.05).治疗3个月后,两组患者的ALT、AST、血糖、血脂及CAP值均较治疗前有所下降,生活干预+水飞蓟宾组患者ALT、FBG及CAP值较生活干预组改善更显著,且体质量降低更多(P<0.05).结论经生活干预+水飞蓟宾治疗的NAFLD患者较单纯生活干预组患者体质量降低及ALT和肝脂肪变改善更好.Objective To compare the effects of life intervention and silybin on patients with non-alcoholic fatty liver disease (NAFLD). Methods Patients with NAFLD in Affiliated Hospital of Logistics University of People’s Armed Police were collected and divided into life intervention group and life intervention + Silybin group according to different intervention methods. The patients in the same group were divided into obese NAFLD patients and nonobese NAFLD patients according to their body mass index (BMI). The body mass, BMI, waist circumference, hip circumference, biochemistry of liver, fasting blood glucose (FBG), fasting insulin and blood lipid level were compared before and after treatment. Results A total of 284 patients with NAFLD were enrolled, 129 cases in life intervention group and 155 cases in life intervention + Silybin group. The body mass, waist circumference, waisthip ratio and diabetes prevalence of obese NAFLD patients were significantly higher than those of thin NAFLD patients in the same group (P < 0.05). The levels of ALT and homeostasis model assessment for insulin resistance indexes of patients in life intervention + Silybin group were significantly higher than those in life intervention group (P < 0.05). After 3 months of treatment, the ALT, AST, blood glucose, blood lipid level and CAP value of patients in both groups improved. The ALT, CAP value and fasting blood glucose level of patients in life intervention + Silybin group improved and the body weight decreased more significantly than those in life intervention group (P < 0.05). Conclusion The body mass of patients with NAFLD who underwent life intervention + Silybin treatment decreased more and the liver function and steatosis improved better than those who undewent life intervention treatment.

关 键 词：脂肪性肝病 非酒精性 生活干预 水飞蓟宾 治疗效果 

分 类 号：R575.5[医药卫生—消化系统]