目的 觀察水飛薊賓葡甲胺聯合多烯磷脂酰膽堿治療脂肪肝的臨床療效和安全性。方法 選取蘇州市立醫(yī)院2013年6月-2014年6月收治的脂肪肝患者150例,隨機分為對照組(74例)和治療組(76例)。對照組患者口服還原型谷胱甘肽片,4片/次,3次/d,同時口服多烯磷脂酰膽堿膠囊,2粒/次,3次/d。治療組口服水飛薊賓葡甲胺片,2片/次,3次/d,多烯磷脂酰膽堿膠囊的用法用量同對照組。兩組均連續(xù)治療8周。比較兩組的臨床療效,同時比較兩組治療前后血清谷丙轉氨酶(ALT)、谷草轉氨酶(AST)、三酰甘油(TG)、總膽固醇(TC)、CT影像學變化、聲觸診組織定量(VTQ)值的變化。結果 對照組和治療組總有效率分別為82.43%、93.42%,兩組比較差異有統計學意義(P<0.05)。治療后,兩組患者血清ALT、AST、TC、TG、VTQ值均較治療前顯著降低,同組治療前后差異有統計學意義(P<0.05);且治療組的改善程度優(yōu)于對照組,兩組比較差異有統計學意義(P<0.05)。治療后,兩組患者CT影像顯示脂肪肝情況均得到較好的治療。治療組輕度及以下脂肪肝比例顯著高于對照組,兩組比較差異有統計學意義(P<0.05)結論 水飛薊賓葡甲胺結合多烯磷脂酰膽堿治療脂肪肝患者具有較好的臨床療效,可有效改善患者肝功能與肝內脂肪沉積,值得在臨床推廣應用。

Objective To investigate the clinical efficacy and safety of silibin meglumine combined with polyene phosphatidylcholine in treatment of fatty liver. Methods The patients with fatty liver (150 cases) of Suzhou Municipal Hospital from June 2013 to June 2014 were randomly divided into control (n=74) and treatment (n=76) groups. The patients in the control group were po administered with Reduced Glutathione Tablets (4 tablets/time, three times daily) and Polyene Phosphatidylcholine Capsules (2 grains/time, three times daily). The patients in the treatment group were po administered with Silibin Meglumine Tablets, (2 tablets/time, three times daily) and Polyene phosphatidylcholine Capsule (the usage and dosage was the same with the control group). After the treatment, the efficacy was evaluated, and the changes of ALT, AST, TG, TC, CT imaging, and VTQ value were compared in two groups. Results The efficacies in the control and treatment groups were 82.43% and 93.42%, respectively, and there were differences between two groups (P< 0.05). After treatment, ALT, AST, TG, TC, CT imaging changes and VTQ value in two groups were significantly reduced, and the difference was statistically significant in the same group (P< 0.05). The improvement degree in the treatment group was better than that in the control group with significant difference between two groups (P< 0.05). After treatment, CT images showed that patients in the two groups got better than before treatment. The proportion of patients with fatty liver under mild degree in the treatment was significantly higher than that in the control group with significant difference between two groups (P< 0.05). Conclusion Silibin meglumine combined with polyene phosphatidylcholine has the good clinical effect in treatment of fatty liver, and can effectively improve liver function and deposition of fat in liver, which is worth clinical promotion.