目的 观察枫蓼肠胃康联合肠内营养混悬液治疗老年非酒精性脂肪肝合并代谢综合征的临床疗效.方法 选取2014年1 月-2015 年2 月眉山市人民医院收治的老年非酒精性脂肪肝合并代谢综合征患者共116 例,随机分为治疗组和对照组,每组各58 例.两组均给予一般治疗,在此基础上对照组给予肠内营养混悬液,84～126 kJ/(kg·d),经鼻胃管滴注.治疗组在对照组治疗的基础上,加用枫蓼肠胃康颗粒,1 袋/次,3 次/d,于肠内营养治疗前15 min 适量温开水溶解经鼻胃管注入.两组疗程均为8 周.观察两组的临床疗效,同时比较两组肝脏超声检查、营养指标及生化指标改善情况和不良反应发生情况.结果 治疗后,对照组和治疗组总有效率分别为67.24%、86.21%,两组比较差异具有统计学意义(P< 0.05).治疗后,两组轻度脂肪肝例数增加,中度脂肪肝例数减少,治疗组的改善情况优于对照组,两组比较差异有统计学意义(P< 0.05).治疗后,两组体质量指数(BMI)、三酰甘油(TG)、总胆固醇(TC)、低密度脂白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、谷氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、空腹血糖(FPG)、糖化血红蛋白(HbAlc)、餐后2 h血糖(2h FBG)均较治疗前显著降低,高密度脂蛋白胆固醇(HDL-C)显著升高,同组治疗前后差异有统计学意义(P< 0.05),治疗组这些观察指标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).对照组和治疗组不良反应发生率分别为25.86%、5.17%,两组比较差异具有统计学意义(P< 0.05).结论 枫蓼肠胃康联合肠内营养混悬液治疗老年非酒精性脂肪肝合并代谢综合征临床疗效确切,多项生化指标改善明显,不良反应更少发生,值得临床应用.

Objective To investigate the efficacy of Fengliao Changweikang combined with enteral nutrition suspension in treatment of elderly non-alcoholic fatty liver complicated with metabolic syndrome. Methods Patients (116 cases) with non-alcoholic fatty liver complicated with metabolic syndrome in Meishan City People's Hospital from January 2014 to February 2015 were randomly divided into control and treatment groups. Each group had 58 cases. Patients in two groups were given conventional treatment. Patients in control group were ig administered with Enteral Nutritional Suspension, 84-126 kJ/(kg·d). Patients in treatment group were ig administered with Fengliao Changweikang dissolving with a moderate amount of warm water 15 min before enteral nutrition therapy, 1 bag/time, three times daily. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and liver ultrasound, nutrition indexes, biochemical indexes and adverse reactions in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 67.24% and 86.21%, respectively, and there were differences between two groups (P < 0.05). After treatment, the number of mild fatty liver in two groups were increased, while moderate fatty liver cases were decreased, and the improvement of treatment group was superior to the control group (P < 0.05). After treatment, BMI, TG, TC, LDL-C, ALT, AST, TBIL, DBIL, FPG, HbAlc, and 2h FBG in two groups were significantly reduced, while HDL-C were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The incidences of adverse reactions in the control and treatment groups were 25.86% and 5.17%, respectively, and there were differences between two groups (P < 0.05). Conclusion Fengliao Changweikang combined with Enteral Nutrition Suspension has clinical curative effect in treatment of elderly non-alcoholic fatty liver complicated with metabolic syndrome, and biochemical indexes improved significantly with less adverse reactions, which is worthy of clinical application.