目的 观察水飞蓟宾葡甲胺联合多烯磷脂酰胆碱治疗脂肪肝的临床疗效和安全性。方法 选取苏州市立医院2013年6月-2014年6月收治的脂肪肝患者150例,随机分为对照组(74例)和治疗组(76例)。对照组患者口服还原型谷胱甘肽片,4片/次,3次/d,同时口服多烯磷脂酰胆碱胶囊,2粒/次,3次/d。治疗组口服水飞蓟宾葡甲胺片,2片/次,3次/d,多烯磷脂酰胆碱胶囊的用法用量同对照组。两组均连续治疗8周。比较两组的临床疗效,同时比较两组治疗前后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、三酰甘油(TG)、总胆固醇(TC)、CT影像学变化、声触诊组织定量(VTQ)值的变化。结果 对照组和治疗组总有效率分别为82.43%、93.42%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者血清ALT、AST、TC、TG、VTQ值均较治疗前显著降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者CT影像显示脂肪肝情况均得到较好的治疗。治疗组轻度及以下脂肪肝比例显著高于对照组,两组比较差异有统计学意义(P<0.05)结论 水飞蓟宾葡甲胺结合多烯磷脂酰胆碱治疗脂肪肝患者具有较好的临床疗效,可有效改善患者肝功能与肝内脂肪沉积,值得在临床推广应用。

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.