不同肠道菌群调节剂联合保肝药辅助治疗非酒精性脂肪性肝病效果观察  

Effects of different intestinal flora regulators combined with liver protecting drugs treatment nonalcoholic fatty liver disease

作　　者：张卫欢[1] 王珊[1] 李晓庆[1] 杨春伟[1] 李秋云[1] Zhang Weihuan;Wang Shan;Li Xiaoqing(Department of Endocrinology,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院内分泌科,唐山063000

出　　处：《中华保健医学杂志》2022年第5期396-398,共3页Chinese Journal of Health Care and Medicine

基　　金：河北省医学科学研究课题计划(20191449)。

摘　　要：目的观察双歧杆菌三联活菌胶囊、酪酸梭菌活菌散联合多烯磷脂酰胆碱胶囊辅助治疗非酒精性脂肪性肝病(NAFLD)的效果。方法选取2018年10月~2021年10月期间开滦总医院诊断的非酒精性脂肪性肝病患者156例,平均分为3组,每组各52例。A组采用运动及饮食干预;B组在A组基础上,口服双歧杆菌三联活菌胶囊联合多烯磷脂酰胆碱胶囊;C组在A组基础上,口服酪酸梭菌散剂联合多烯磷脂酰胆碱胶囊。3组均持续治疗6个月。所有患者入组时及治疗6个月后抽取外周静脉血,检测空腹血糖(FPG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰胺转移酶(GGT)、总胆固醇(TC)、三酰甘油(TG)、血游离脂肪酸(FFA);超声测定肝脏脂肪含量;NAFLD纤维化评分(NFS)评估肝纤维化程度。结果剔除脱落病例后,A组48例,B组50例,C组49例。治疗前,3组的FPG、ALT、AST、GGT、TC、TG、FFA、肝脏脂肪含量及NFS组间两两比较,差异无统计学意义(P>0.05),治疗6个月后,3组的上述指标均降低,与同组治疗前比较,差异有统计学意义(P<0.05),治疗后B组和C组的ALT、AST、TC、TG、FFA、肝脏脂肪含量均低于A组,B组的ALT、TC、FFA、肝脏脂肪含量低于C组,组间差异均有统计学意义(P<0.05)。结论对于NAFLD患者,双歧杆菌三联活菌胶囊和酪酸梭菌活菌散联合多烯磷脂酰胆碱胶囊均能起到辅助治疗作用,双歧杆菌三联活菌胶囊降低胆固醇、减少NAFLD肝内脂肪沉积效果更佳。Objective To observe the effect of bifidobacterium triple viable capsule and clostridium butyricum viable powder combined with polyene phosphatidyl choline in the adjuvant treatment of nonalcoholic fatty liver disease.Methods Patients with nonalcoholic fatty liver disease diagnosed in our hospital from October 2018 to October 2021 were divided into three groups,with 52 cases in each group.Group A was treated with exercise and diet intervention;Group B took Bifidobacterium triple viable capsule combined with polyene phosphatidyl choline on the basis of group A;Group C took clostridium butyricum powder orally combined with polyene phosphatidyl choline on the basis of group A.The three groups were treated for 6 months.Peripheral venous blood was taken from all patients at the time of enrollment and 6 months after treatment,and FPG,ALT,AST,GGT,TC,TG,FFA;The fat content of liver was measured by ultrasound;NAFLD fibrosis score(NFS)was used to evaluate the degree of liver fibrosis.Results After excluding the shedding cases,there were 48 cases in group A,50 cases in group B and 49 cases in group C.Before treatment,there was no significant difference in FPG,alt,AST,GGT,TC,TG,FFA,liver fat content and NFS between the three groups(P>0.05).After 6 months of treatment,the above indexes of the three groups decreased,which was statistically significant compared with that before treatment(P<0.05).After treatment,the alt,AST,TC,TG,FFA and liver fat content of group B and group C were lower than that of group A,and the alt,TC,FFA and liver fat content of group B were lower than that of group C,There was significant difference between the two groups(P<0.05).Conclusion For patients with NAFLD,bifidobacterium triple viable capsule and clostridium butyricum powder combined with polyene phosphatidyl choline can play an adjuvant therapeutic effect.Bifidobacterium triple viable capsule has a better effect on reducing cholesterol and intrahepatic fat deposition of NAFLD.

关 键 词：肠道菌群 非酒精性脂肪性肝病 双歧杆菌三联活菌 酪酸梭菌 

分 类 号：R575[医药卫生—消化系统]