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目的:探讨双歧杆菌三联活菌肠溶胶囊与疏肝降脂汤联合治疗对非酒精性脂肪性肝炎(NASH)患者肝功能及炎症因子的影响。方法:选取78例NASH患者,随机分为中西医组和西医组各39例。2组均予以多烯磷脂酰胆碱胶囊,每次2片,每天3次,口服。西医组予以双歧杆菌三联活菌肠溶胶囊,每次420 mg,每天3次。中西医组在西医组治疗方案的基础上加用疏肝降脂汤治疗,每天1剂,加水煎汁300 mL,分早、晚2次口服。2组均连用8周。观察并比较2组治疗前后肝功能[丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)以及谷氨酰转肽酶(GGT)]、血清超敏C-反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)指标的变化。结果:治疗8周后,2组ALT、AST和GGT水平分别与治疗前比较均有下降,差异均有统计学意义(P<0.05,P<0.01),且中西医组较西医组下降更明显,差异均有统计学意义(P<0.05);同时2组血清hs-CRP和TNF-α指标与治疗前比较均有下降,差异均有统计学意义(P<0.05,P<0.01),且中西医组较西医组下降更明显,差异有统计学意义(P<0.05)。结论:双歧杆菌三联活菌肠溶胶囊与疏肝降脂汤联合中西医结合治疗NASH的疗效较单纯使用双歧杆菌三联活菌肠溶胶囊西医治疗效果更佳,能降低血清hs-CRP和TNF-α的指标,抑制肝炎症损伤,加快肝功能的好转。
Objective: To investigate the effect of triple bifidobacterium enteric-coated enteric-coated capsules and Shugan Jiangzhi decoction on liver function and inflammatory factors in patients with non-alcoholic steatohepatitis (NASH). Methods: Seventy-eight NASH patients were randomly divided into two groups: 39 cases in each group. 2 groups were given polyene phosphatidylcholine capsules, each 2 tablets 3 times a day orally. Western medicine group to Bifidobacterium triple live bacteria enteric-coated capsules, each 420 mg, 3 times a day. Western medicine group in the Western medicine group based on the treatment program plus Shugan Jiang Zhi Tang treatment, 1 day, add water decoction 300 mL, points early and late 2 times orally. 2 groups were used in conjunction for 8 weeks. The changes of liver function (ALT, AST and GGT), serum hs-CRP, And tumor necrosis factor-α (TNF-α) index changes. Results: After 8 weeks of treatment, the levels of ALT, AST and GGT decreased in both groups compared with before treatment, the differences were statistically significant (P <0.05, P <0.01), and the Western medicine group decreased more significantly than Western medicine group (P <0.05). At the same time, the indexes of hs-CRP and TNF-α in serum of two groups decreased compared with those before treatment, the differences were statistically significant (P <0.05, P <0.01), and the differences were statistically significant Western medicine group decreased more significantly than Western medicine group, the difference was statistically significant (P <0.05). Conclusion: Bifidobacterium triple live bacteria enteric-coated capsules and Shugan Jiangzhi Decoction combined with traditional Chinese and Western medicine treatment of NASH than Bifidobacterium triple viable enteric capsule Western medicine treatment is better, can reduce serum hs-CRP and TNF-α index, inhibition of hepatic inflammation damage, improve liver function improvement.