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目的研究多烯磷脂酰胆碱联合复方丹参滴丸对非酒精性脂肪肝患者的临床治疗效果。方法选择2012年1月—2015年12月在西安医学院附属宝鸡医院进行诊治的非酒精性脂肪肝患者116例,随机分为观察组与对照组,每组58例。对照组采用复方丹参滴丸治疗,观察组采用多烯磷脂酰胆碱联合复方丹参滴丸治疗,均治疗3个月。比较两组的临床有效率;分别于治疗前后检测肝功能指标:天氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBIL);血脂指标:总胆固醇(TC)、三酰甘油(TG);肝纤维化指标:层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、IV型胶原(IV-C);并进行上腹部CT平扫,计算肝/脾CT比值。结果观察组的有效率为91.4%(53/58),明显高于对照组的72.4%(42/58)(P<0.05);与同组治疗前比较,治疗后两组的AST、ALT、γ-GT、TBIL、TC、TG水平均明显降低,肝/脾CT比值明显升高(P<0.05),且观察组的改善程度明显优于对照组(P<0.05);与治疗前比较,两组治疗后的LN、PCIII、IV-C和HA水平均明显降低(P<0.05),且观察组的降低程度明显优于对照组(P<0.05)。结论多烯磷脂酰胆碱联合复方丹参滴丸可以明显改善非酒精性脂肪肝患者的肝功能和肝纤维化,降低血脂。
Objective To study the clinical effect of polyene phosphatidylcholine combined with compound Danshen dripping pills on non-alcoholic fatty liver disease. Methods A total of 116 non-alcoholic fatty liver disease patients who were diagnosed and treated in Baoji Hospital affiliated to Xi’an Medical College from January 2012 to December 2015 were randomly divided into observation group and control group with 58 cases in each group. The control group treated with compound Danshen dripping pills, the observation group with polyene phosphatidylcholine combined with compound Danshen dripping pills were treated for 3 months. The clinical efficacies of the two groups were compared. Before and after treatment, the indexes of liver function were detected: AST, ALT, γ-GT, , Total bile acid (TBIL); blood lipid indicators: total cholesterol (TC), triglyceride (TG); liver fibrosis indicators: laminin (LN), hyaluronic acid (HA) , Type IV collagen (IV-C); and CT scan of the upper abdomen to calculate the ratio of liver / spleen CT. Results The effective rate of the observation group was 91.4% (53/58), which was significantly higher than that of the control group (72.4%, 42/58) (P <0.05) The levels of γ-GT, TBIL, TC and TG were significantly decreased and the ratio of liver to spleen was significantly increased (P <0.05), and the improvement in the observation group was significantly better than that in the control group (P <0.05) The levels of LN, PCIII, IV-C and HA after treatment in both groups were significantly decreased (P <0.05), and the reduction in the observation group was significantly better than that in the control group (P <0.05). Conclusion Polyene phosphatidylcholine combined with compound Danshen dripping pills can significantly improve liver function and liver fibrosis in patients with non-alcoholic fatty liver and lower blood lipid.