双环醇联合益生菌治疗非酒精性脂肪肝的效果及对脂代谢、肝功能的影响

摘要/Abstract

摘要： 目的观察双环醇联合益生菌治疗非酒精性脂肪肝(NAFLD)的效果及其对脂代谢、肝功能的影响。方法 2019年6月至2022年6月我院收治NAFLD患者102例,随机分为观察组和对照组,各51例,对照组给予双环醇片,观察组给予双环醇片和双歧杆菌三联活菌胶囊。检测治疗前后肝功能和脂代谢指标;比较两组临床疗效和安全性。结果观察组和对照组治疗总有效率分别为90.2%(46/51)、74.5%(38/51)(P<0.05);治疗后,两组血清AST分别为(49.2±11.5)U/L、(65.3±11.8)U/L,ALT分别为(50.8±13.2)U/L、(68.2±12.7)U/L,谷氨酰转肽酶(GGT)分别为(48.5±9.8)U/L、(61.2±10.3)U/L,差异有统计学意义(P<0.05);治疗后,两组血清甘油三酯(TG)分别为(1.8±0.4)mmol/L、(2.3±0.5)mmol/L,总胆固醇(TC)分别为(4.3±0.6)mmol/L、(5.1±0.8)mmol/L,低密度脂蛋白胆固醇(LDL-C)分别为(2.6±0.5)mmol/L、(3.5±0.7)mmol/L,差异有统计学意义(P<0.05)。两组高密度脂蛋白胆固醇(HDL-C)分别为(1.6±0.4)mmol/L、(1.3±0.4)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组肠球菌、大肠杆菌水平分别为(4.9±1.2)lgCFU/g、(6.2±0.9)lgCFU/g,明显低于对照组的(6.6±1.0)lgCFU/g、(6.9±1.2)lgCFU/g(P<0.05),观察组双歧杆菌、乳酸菌水平分别为(7.5±1.1)lgCFU/g、(6.8±1.3)lgCFU/g,明显高于对照组的(6.7±1.1)lgCFU/g、(5.9±0.9)lgCFU/g(P<0.05)。治疗后观察组出现不良反应9例(17.6%),包括乏力3例(5.9%)、食欲不振4例(7.8%)、失眠2例(3.9%),对照组不良反应5例(9.80%),包括乏力1例(2.0%)、食欲不振2例(3.9%)、失眠2例(3.9%),两组比较无明显差异(P>0.05)。结论采用双环醇联合益生菌治疗NAFLD患者有利于缓解肠道菌群紊乱,调控血脂水平,改善患者的肝功能,安全性较好。

关键词: 非酒精性脂肪肝, 双环醇, 益生菌, 脂代谢, 肝功能

Abstract: Objective To investigate the effects of bicyclol in combination with probiotics on non-alcoholic fatty liver disease (NAFLD) and to evaluate its influence on lipid metabolism and liver function. Methods Between June 2019 and June 2022, a total of 102 patients diagnosed with NAFLD were enrolled at our hospital. These patients were randomly divided into two groups, with each group comprising 51 individuals: an observation group and a control group. Bicyclol were administered to the control group, while the observation group received a combination treatment consisting of bicyclol and bifidobacterium-triplex viable capsules. Liver function and lipid metabolism indicators were evaluated before and after treatment.The clinical efficacy and safety profiles of the two therapeutic strategies were compared. Results The study revealed that the total effective rates for the obersvation and control groups were 90.2% and 74.5%, respectively, with the observation group showing a significantly higher rate (P<0.05). Post-treatment, serum aspartate aminotransferase (AST) levels were measured at (49.2±11.5) U/L for the observation group and (65.3±11.8) U/L for the control group. Similarly, alanine aminotransferase (ALT) levels were(50.8±13.2) U/L and (68.2±12.7) U/L, repectively. Glutamyl transpeptidase (GGT) levels also followed this trend, being(48.5±9.8) U/L in the observation group and (61.2±10.3) U/L in the control group(P<0.05). Furthermore, triglyceride (TG) levels were (1.8±0.4) mmol/L, and total cholesterol (TC) levels were (4.3±0.6) mmol/Lin the observation group, compared to (5.1±0.8) mmol/L in the control group. Low-density lipoprotein cholesterol (LDL-C) levels were also lower in the observation group at (2.6±0.5) mmol/L, compared to (3.5±0.7) mmol/L in the control group, with a significant difference(P<0.05). High-density lipoprotein cholesterol (HDL-C) levels were (1.6±0.4) mmol/L in the observation group and (1.3±0.4) mmol/L in the contrl group, with the observation group showing higher levels(P<0.05). Following treatment, the observation group exhibited a higher serum HDL-C level(P<0.05). Additionally, post-treatment assessments revealed that the counts of enterococcus and Escherichia coli in the observation group, recorded at (4.9±1.2) lgCFU/g and (6.2±0.9) lgCFU/g respectively, were significantly lower compared to the control group, which showed counts of [(6.6±1.0) lgCFU/g and (6.9±1.2) lgCFU/g, respectively(P<0.05). Conversely, the abundance of Bifidobacterium and Lactobacillus in the observation group, measured at (7.5±1.1) lgCFU/g and (6.8±1.3) lgCFU/g respectively, was significantly higher than in the control group. Which had counts of (6.7±1.1) lgCFU/g and (5.9±0.9) lgCFU/g(P<0.05). Post-treatment adverse reactions were observed in 9 cases (17.6%) within the observation group, including fatigure(3 cases, 5.9%), loss of appetite(4 cases, 7.8%), and insomnia(2 cases, 3.9%). In the control group 5 cases (9.80%) experienced adverse reactions, including fatigue(1 case, 2.0%), loss of appetite(2 cases, 3.9%), and insomnia(2 cases, 3.9%). The difference in adverse reactions between the two groups was not statistically significant(P>0.05). Conclusion The application of bicyclol in combination with probiotics for treating patients with NAFLD appears beneficial in mitigating intestinal flora imbalances, regulating lipid levels, and improving liver function. This treatment approach also demonstrates good safety profiles, suggesting its potential value for wider clinical adoption.

Key words: Nonalcoholic fatty liver, bicyclol, Probiotics, Lipid metabolism, Liver function

许映红, 凌大军, 吴元祥, 刘建. 双环醇联合益生菌治疗非酒精性脂肪肝的效果及对脂代谢、肝功能的影响[J]. 肝脏, 2024, 29(2): 223-226.

XU Ying-hong, LING Da-jun, WU Yuan-xiang, LIU Jian. Combined impact of bicyclol and probiotics on non-alcoholic fatty liver disease (NAFLD): assessing changes in lipid metabolism and liver function[J]. Chinese Hepatolgy, 2024, 29(2): 223-226.

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