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目的探讨双歧三联活菌胶囊联合多烯磷脂酰胆碱胶囊对非酒精性脂肪性肝炎(NASH)患者脂质过氧化损伤的保护作用。方法选取80例NASH患者随机分为观察组和对照组各40例。两组患者予以调整饮食和适当体育锻炼。对照组予以多烯磷脂酰胆碱胶囊456mg/次,3次/d,口服。观察组在对照组基础上加用双歧三联活菌胶囊630mg/次,2次/d,温水口服治疗,连用8周。检测并比较两组患者治疗前后肝功能指标[丙氨酸转氨酶(ALT)和γ-谷氨酰转肽酶(γ-GT)]、肝/脾CT比值及血清氧化应激参数[丙二醛(MDA)和超氧化物歧化酶(SOD)]水平的变化。结果对照组与观察组患者治疗期间分别失访3例与5例,两组失访率比较差异无统计学意义(χ2=0.14,P>0.05)。治疗8周后,两组患者ALT和γ-GT水平较前明显下降,肝/脾CT比值较前明显上升(t=2.39、2.24、2.19、3.37、3.15、2.92,P<0.05或P<0.01),且观察组下降或上升值比对照组更明显(t=2.27、2.26、2.13,P<0.05);两组血清MDA水平较前明显下降,SOD水平较前明显上升(t=2.14、2.29、2.94、2.97,P<0.05或P<0.01),且观察组下降或上升值比对照组更明显(t=2.28、2.15,P<0.05)。结论双歧三联活菌胶囊联合多烯磷脂酰胆碱胶囊治疗NASH的疗效显著,对脂质过氧化损伤具有保护作用,减少肝脏脂肪过度沉积和改善肝功能指标。
Objective To investigate the protective effect of bifid triple viable capsule combined with polyene phosphatidyl choline on lipid peroxidation in patients with non-alcoholic steatohepatitis (NASH). Methods 80 patients with NASH were randomly divided into observation group and control group, 40 cases each. Two groups of patients to be adjusted diet and appropriate physical activity. The control group were given polyene phosphatidylcholine capsules 456mg / time, 3 times / d, orally. Observation group in the control group based on the use of bifidobacterium triple live capsule 630mg / times, 2 times / d, warm water oral treatment, once every 8 weeks. The liver function indexes (ALT and γ-GT), ratio of hepatic / splenic CT and the parameters of serum oxidative stress [MDA (MDA) and superoxide dismutase (SOD)] levels. Results The patients in the control group and the observation group were lost in 3 and 5 cases, respectively. There was no significant difference in the follow-up rate between the two groups (χ2 = 0.14, P> 0.05). After 8 weeks of treatment, ALT and γ-GT levels in both groups were significantly lower than those in the previous two groups (t = 2.39,2.24,2.19,3.37,3.15,2.92, P <0.05 or P <0.01) ), And the decrease or increase of the observation group was more obvious than that of the control group (t = 2.27,2.26,2.13, P <0.05); the level of serum MDA decreased obviously and the level of SOD increased obviously (t = 2.14,2.29 , 2.94,2.97, P <0.05 or P <0.01), and the decrease or increase value of the observation group was more obvious than that of the control group (t = 2.28,2.15, P <0.05). Conclusion Bifid triple viable capsule combined with polyene phosphatidylcholine capsule treatment of NASH significant effect on lipid peroxidation injury has a protective effect, reduce liver fat deposition and improve liver function indicators.