胆宁片治疗非酒精性脂肪肝临床效果及对血脂、肝功能和肝纤维化的影响
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摘要
目的探讨胆宁片联合非诺贝特治疗非酒精性脂肪肝(NAFLD)临床疗效及对患者血脂、肝功能和肝纤维化的影响。方法选取2016年11月—2017年11月收治的NAFLD 104例,按治疗方法分为观察组和对照组,每组52例。对照组采用非诺贝特片治疗;观察组在对照组基础上给予胆宁片治疗。比较2组临床疗效及治疗前后血脂、肝功能和肝纤维化情况,记录2组不良反应发生情况。结果观察组总有效率高于对照组(P <0. 01)。2组治疗后甘油三酯、总胆固醇水平和肝功能、肝纤维化指标水平均低于治疗前,且观察组低于对照组(P <0. 05,P <0. 01)。2组均未发生明显不良反应。结论胆宁片联合非诺贝特片治疗NAFLD临床效果较好,可改善血脂、肝功能及肝纤维化,且安全性较高。
Objective To investigate clinical efficacy of Danning Tablets combined with Fenofibrate in treatment of patients with nonalcoholic fatty liver(NAFLD) and its effects on blood lipids,liver function and liver fibrosis. Methods A total of 104 patients with NAFLD admitted during November 2016 and November 2017 were randomly divided into observation group and control group(n = 52 for each group). Control group was treated with Fenofibrate Tablets,while observation group was added with Danning Tablets on the basis of treatment for control group. Clinical efficacy and changes of blood lipid,liver function and liver fibrosis conditions before and after treatment were compared,and incidence rates of adverse reactions were recorded in two groups. Results The total effective rate in observation group was significantly higher than that in control group(P < 0. 01). After treatment,levels of triglyceride(TG),total cholesterol(TC),liver function and liver fibrosis were significantly lower than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group(P < 0. 05,P < 0. 01). No obvious adverse reactions were found in two groups. Conclusion Danning Tablets combined with Fenofibrate in treatment of patients with nonalcoholic fatty liver may achieve good clinical efficacy and improve blood lipids,liver function and liver fibrosis with safe.
Objective To investigate clinical efficacy of Danning Tablets combined with Fenofibrate in treatment of patients with nonalcoholic fatty liver(NAFLD) and its effects on blood lipids,liver function and liver fibrosis. Methods A total of 104 patients with NAFLD admitted during November 2016 and November 2017 were randomly divided into observation group and control group(n = 52 for each group). Control group was treated with Fenofibrate Tablets,while observation group was added with Danning Tablets on the basis of treatment for control group. Clinical efficacy and changes of blood lipid,liver function and liver fibrosis conditions before and after treatment were compared,and incidence rates of adverse reactions were recorded in two groups. Results The total effective rate in observation group was significantly higher than that in control group(P < 0. 01). After treatment,levels of triglyceride(TG),total cholesterol(TC),liver function and liver fibrosis were significantly lower than those before treatment in two groups,and the levels in observation group were significantly lower than those in control group(P < 0. 05,P < 0. 01). No obvious adverse reactions were found in two groups. Conclusion Danning Tablets combined with Fenofibrate in treatment of patients with nonalcoholic fatty liver may achieve good clinical efficacy and improve blood lipids,liver function and liver fibrosis with safe.
引文
[1]郭伟,高明松,李伟,等.二甲双胍联合双歧杆菌三联活菌胶囊对非酒精性脂肪肝病的治疗作用[J].中国新药杂志,2016,25(4):439-442,446.
[2] Chalasani N,Younossi Z,Lavine J E,et al. The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology,2018,67(1):328-357.
[3]黄维国,黄修献,杨恒,等.六味能消胶囊联合非诺贝特和辛伐他汀治疗混合性高脂血症的疗效观察[J].现代药物与临床,2017,32(4):625-627.
[4]侯艺鑫,王宪波,杨玉英,等.中医药防治非酒精性脂肪性肝病的作用机制[J].临床肝胆病杂志,2016,32(4):785-789.
[5]杜卫星,叶青,李金科,等.胆宁片联合瑞舒伐他汀治疗非酒精性脂肪性肝病患者HOMA-IR和血清TNF-α水平变化[J].实用肝脏病杂志,2017,20(4):490-491.
[6]中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊断标准[J].中华肝脏病杂志,2003,7(2):364.
[7]刘晏,朱凌云,王跃荣,等.荷泽降脂口服液治疗肝郁脾虚型非酒精性脂肪肝的临床研究[J].中成药,2014,36(8):1607-1612.
[8]张四青,习燕华,钟树妹,等.格列美脲联合二甲双胍对新诊断2型糖尿病伴非酒精性脂肪肝病患者胰岛素抵抗和胰岛β细胞功能的影响[J].中国全科医学,2016,19(5):525-528.
[9] Yaghoubi M,Jafari S,Sajedi B,et al. Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease[J]. Eur J Gastroenterol Hepatol,2017,29(12):1385-1388.
[10]陈立震,姜曼,辛永宁,等.甘油三酯在成纤维细胞生长因子-21减轻非酒精性脂肪性肝病中的作用及其机制[J].中华肝脏病杂志,2016,24(2):102-107.
[11]殷海锟,张奡,韩焱.阿托伐他汀联合非诺贝特治疗混合型高脂血症的疗效和安全性分析[J].中国循证心血管医学杂志,2015,7(3):378-380.
[12]李建军,李文杰.依折麦布联合非诺贝特治疗混合型高脂血症对血脂水平的影响及其临床疗效[J].重庆医学,2017,46(35):5004-5006.
[13]沈馨茹,鲁云霞,章秋.非诺贝特保护非酒精性脂肪性肝病小鼠胰岛素抵抗作用机制的探讨[J].安徽医科大学学报,2014,49(6):721-725.
[14]柯文炳,袁征,刘文涛.化痰活血汤联合非诺贝特对非酒精性脂肪肝患者血脂、胰岛素抵抗和肝纤维化指标的影响[J].中国中西医结合消化杂志,2016,24(11):851-854.
[15]叶长江,叶志伟.中药联合硫普罗宁与多烯磷脂酰胆碱治疗非酒精性脂肪肝40例[J].中西医结合肝病杂志,2016,26(5):302-304.
[16]王唯坚,胡峻. 155例非酒精性脂肪肝患者的中医证候学研究[J].首都医科大学学报,2014,35(1):129-131.
[17]高鹰,周颖.胆宁片联合多烯磷脂酰胆碱胶囊治疗非酒精性脂肪肝的疗效观察[J].现代药物与临床,2017,32(3):464-467.
[18]刘皓,王平,冷秀梅,等.中药胆宁片治疗胆囊胆固醇结石作用机制的实验研究[J].中国中西医结合消化杂志,2014,22(11):658-661.
[19]陶英杰.胆宁片对非酒精性脂肪肝患者血生化指标影响及临床疗效分析[J].肝脏,2018,23(1):65-68.
[20]罗成福,刘姝,冯燕,等.替米沙坦对非酒精性脂肪性肝病患者肝纤维化和血管内皮功能及炎症因子的影响[J].中国中西医结合消化杂志,2018,26(3):248-251.
[21]张闻平,吴静,任美杰,等.非酒精性脂肪肝病与血清铁及铁蛋白的相关性研究[J].首都医科大学学报,2015,36(5):778-781.
[22]黄志鹏,苏智军,蒋建家,等.非酒精性脂肪肝严重程度与代谢综合征组分的相关性分析[J].中国综合临床,2013,29(11):1158-1161.
[23]张艺露,杨晶,敖娜,等. 2型糖尿病合并或未合并非酒精性脂肪性肝病与糖尿病视网膜病变的相关性[J].中国综合临床,2016,32(8):687-690.
[24]欧强,徐燕华,曲立娟,等.强肝胶囊对非酒精性脂肪性肝病患者胰岛素抵抗指数和肝纤维化评分的影响[J].临床肝胆病杂志,2016,32(10):1951-1954.
[25]柯文炳,李亚,刘文涛.复方丹参滴丸辅助治疗非酒精性脂肪肝合并肝纤维化的临床研究[J].临床内科杂志,2017,34(8):566-567.
[2] Chalasani N,Younossi Z,Lavine J E,et al. The diagnosis and management of nonalcoholic fatty liver disease:Practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology,2018,67(1):328-357.
[3]黄维国,黄修献,杨恒,等.六味能消胶囊联合非诺贝特和辛伐他汀治疗混合性高脂血症的疗效观察[J].现代药物与临床,2017,32(4):625-627.
[4]侯艺鑫,王宪波,杨玉英,等.中医药防治非酒精性脂肪性肝病的作用机制[J].临床肝胆病杂志,2016,32(4):785-789.
[5]杜卫星,叶青,李金科,等.胆宁片联合瑞舒伐他汀治疗非酒精性脂肪性肝病患者HOMA-IR和血清TNF-α水平变化[J].实用肝脏病杂志,2017,20(4):490-491.
[6]中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊断标准[J].中华肝脏病杂志,2003,7(2):364.
[7]刘晏,朱凌云,王跃荣,等.荷泽降脂口服液治疗肝郁脾虚型非酒精性脂肪肝的临床研究[J].中成药,2014,36(8):1607-1612.
[8]张四青,习燕华,钟树妹,等.格列美脲联合二甲双胍对新诊断2型糖尿病伴非酒精性脂肪肝病患者胰岛素抵抗和胰岛β细胞功能的影响[J].中国全科医学,2016,19(5):525-528.
[9] Yaghoubi M,Jafari S,Sajedi B,et al. Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease[J]. Eur J Gastroenterol Hepatol,2017,29(12):1385-1388.
[10]陈立震,姜曼,辛永宁,等.甘油三酯在成纤维细胞生长因子-21减轻非酒精性脂肪性肝病中的作用及其机制[J].中华肝脏病杂志,2016,24(2):102-107.
[11]殷海锟,张奡,韩焱.阿托伐他汀联合非诺贝特治疗混合型高脂血症的疗效和安全性分析[J].中国循证心血管医学杂志,2015,7(3):378-380.
[12]李建军,李文杰.依折麦布联合非诺贝特治疗混合型高脂血症对血脂水平的影响及其临床疗效[J].重庆医学,2017,46(35):5004-5006.
[13]沈馨茹,鲁云霞,章秋.非诺贝特保护非酒精性脂肪性肝病小鼠胰岛素抵抗作用机制的探讨[J].安徽医科大学学报,2014,49(6):721-725.
[14]柯文炳,袁征,刘文涛.化痰活血汤联合非诺贝特对非酒精性脂肪肝患者血脂、胰岛素抵抗和肝纤维化指标的影响[J].中国中西医结合消化杂志,2016,24(11):851-854.
[15]叶长江,叶志伟.中药联合硫普罗宁与多烯磷脂酰胆碱治疗非酒精性脂肪肝40例[J].中西医结合肝病杂志,2016,26(5):302-304.
[16]王唯坚,胡峻. 155例非酒精性脂肪肝患者的中医证候学研究[J].首都医科大学学报,2014,35(1):129-131.
[17]高鹰,周颖.胆宁片联合多烯磷脂酰胆碱胶囊治疗非酒精性脂肪肝的疗效观察[J].现代药物与临床,2017,32(3):464-467.
[18]刘皓,王平,冷秀梅,等.中药胆宁片治疗胆囊胆固醇结石作用机制的实验研究[J].中国中西医结合消化杂志,2014,22(11):658-661.
[19]陶英杰.胆宁片对非酒精性脂肪肝患者血生化指标影响及临床疗效分析[J].肝脏,2018,23(1):65-68.
[20]罗成福,刘姝,冯燕,等.替米沙坦对非酒精性脂肪性肝病患者肝纤维化和血管内皮功能及炎症因子的影响[J].中国中西医结合消化杂志,2018,26(3):248-251.
[21]张闻平,吴静,任美杰,等.非酒精性脂肪肝病与血清铁及铁蛋白的相关性研究[J].首都医科大学学报,2015,36(5):778-781.
[22]黄志鹏,苏智军,蒋建家,等.非酒精性脂肪肝严重程度与代谢综合征组分的相关性分析[J].中国综合临床,2013,29(11):1158-1161.
[23]张艺露,杨晶,敖娜,等. 2型糖尿病合并或未合并非酒精性脂肪性肝病与糖尿病视网膜病变的相关性[J].中国综合临床,2016,32(8):687-690.
[24]欧强,徐燕华,曲立娟,等.强肝胶囊对非酒精性脂肪性肝病患者胰岛素抵抗指数和肝纤维化评分的影响[J].临床肝胆病杂志,2016,32(10):1951-1954.
[25]柯文炳,李亚,刘文涛.复方丹参滴丸辅助治疗非酒精性脂肪肝合并肝纤维化的临床研究[J].临床内科杂志,2017,34(8):566-567.