益生菌辅助复方甘草酸苷治疗肥胖儿童非酒精性脂肪性肝病对肝功能、肠道菌群的影响

摘要/Abstract

摘要： 目的探讨益生菌辅助复方甘草酸苷治疗肥胖儿童非酒精性脂肪性肝病(NAFLD)对肝功能、肠道菌群的影响。方法纳入肥胖NAFLD患儿120例,入选时间为2019年5月至2024年5月,随机分为对照、观察组。对照组使用复方甘草酸苷,观察组使用益生菌辅助复方甘草酸苷。比较两组肝功能指标,包括天冬氨酸氨基转移酶(AST)、丙氨酶氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、肠道菌群、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6),评估两组疗效并比较两组不良反应发生率。结果治疗后,观察组AST、ALT、γ-GT、TNF-α、IL-6[(38.72±9.15)U/L、(42.44±8.17)U/L、(95.48±28.19)U/L、(24.73±5.28)μg/L、(16.71±3.14)μg/L]低于对照组[(56.16±10.31)U/L、(57.48±9.35)U/L、(129.21±33.75)U/L、(37.15±6.52)μg/L、(20.45±3.56)μg/L](P<0.05)。治疗后,观察组双歧杆菌、乳酸杆菌数量[(8.63±0.44)lg/g、(8.87±0.54)lg/g]高于对照组[(8.11±0.52)lg/g、(8.41±0.73)lg/g],大肠杆菌数量[(6.55±0.47)lg/g]低于对照组[(6.88±0.59)lg/g](P<0.05)。治疗后,观察组总有效率高于对照组,为91.67 %比76.67 %,P<0.05。两组不良反应相当(P>0.05)。结论益生菌辅助复方甘草酸苷能够显著改善肥胖NAFLD患儿肝功能,减轻肠道菌群紊乱及炎症,疗效较佳,且安全性良好。

关键词: 非酒精性脂肪性肝病, 复方甘草酸苷, 益生菌, 肝功能, 炎症

Abstract: Objective To investigate the effects of probiotics and compound glycyrrhizin on liver function and intestinal flora in the treatment of obese children with non-alcoholic fatty liver disease (NAFLD). Methods A total of 120 obese children with NAFLD were enrolled from May 2019 to May 2024, and were divided into control group and observation group. The control group was treated with compound glycyrrhizin, and the observation group was treated with compound glycyrrhizin and probiotics. Serum aspartate aminotransferase (AST), alanase aminotransferase (ALT), γ-glutamyltranspeptidase (γ-GT), intestinal flora, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were compared, and the efficacy and adverse reactions were evaluated between the two groups. Results After treatment, AST, ALT, γ-GT, TNF-α, and IL-6 in observation group [(38.72±9.15) U/L, (42.44±8.17) U/L, (95.48±28.19) U/L, (24.73±5.28) μg/L, (16.71±3.14) μg/L] were lower than those in control group [(56.16±10.31) U/L, (57.48±9.35) U/L, (129.21±33.75) U/L, (37.15±6.52) μg/L, (20.45±3.56) μg/L] (P<0.05). After treatment, the number of bifidobacterium and lactobacillus in observation group [(8.63±0.44) lg/g, (8.87±0.54) lg/g] was higher than those in control group [(8.11±0.52) lg/g, (8.41±0.73) lg/g], and the number of E. coli [(6.55±0.47) lg/g] was lower than that in control group [(6.88±0.59) lg/g] (P<0.05). After treatment, the total effective rate of observation group was higher than that in control group (91.67% vs. 76.67%, P<0.05). The two groups had comparable adverse reactions (P>0.05). Conclusion Probiotic-assisted compound glycyrrhizin can significantly improve liver function, alleviate intestinal flora disorder and inflammation in obese-NAFLD children, with good efficacy and safety.

Key words: Non-alcoholic fatty liver disease, Compound glycyrrhizin, Probiotics, Liver function, Inflammation

孙志伟, 朱炜杰, 张海英, 梅祯茹, 李晓云. 益生菌辅助复方甘草酸苷治疗肥胖儿童非酒精性脂肪性肝病对肝功能、肠道菌群的影响[J]. 肝脏, 2025, 30(6): 825-828.

SUN Zhi-wei, ZHU Wei-jie, ZHANG Hai-ying, MEI Zhen-ru, LI Xiao-yun. Effect of probiotics assisted compound glycyrrhizin on liver function and intestinal flora in obese children with non-alcoholic fatty liver disease[J]. Chinese Hepatolgy, 2025, 30(6): 825-828.

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参考文献

[1] Pouwels S, Sakran N, Graham Y, et al. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss[J]. BMC Endocr Disord,2022,22(1):63.
[2] Bonsembiante L, Targher G, Maffeis C. Non-alcoholic fatty liver disease in obese children and adolescents: a role for nutrition?[J]. Eur J Clin Nutr,2022,76(1):28-39.
[3] Shaunak M, Byrne C D, Davis N, et al. Non-alcoholic fatty liver disease and childhood obesity[J]. Arch Dis Child,2021,106(1):3-8.
[4] 周雪莲, 傅君芬. 儿童非酒精性脂肪肝病的诊断及治疗策略[J]. 中华儿科杂志,2024,62(6):590-592.
[5] 王浩楠, 梁士兵, 姚晓玲, 等. 复方甘草酸苷注射液改善慢性乙型肝炎肝损伤疗效和安全性的系统评价与Meta分析[J]. 中国中药杂志,2021,46(3):694-702.
[6] 蔡宇, 王孟春, 邱新平, 等. 复方甘草酸苷联合丁二磺酸腺苷蛋氨酸治疗酒精性肝炎伴胆汁淤积患者疗效研究[J]. 实用肝脏病杂志,2021,24(1):71-74.
[7] Vallianou N, Christodoulatos G S, Karampela I, et al. Understanding the role of the gut microbiome and microbial metabolites in non-alcoholic fatty liver disease: current evidence and perspectives[J]. Biomolecules,2021,12(1):56.
[8] Avelar-Rodríguez D, Peña-Vélez R, Popov J, et al. Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review[J]. Rev Esp Enferm Dig,2023,115(8):418-427.
[9] 中华医学会儿科学分会内分泌遗传代谢学组, 中华医学会儿科学分会消化学组, 中华医学会儿科学分会青春期医学专业委员会, 等. 儿童非酒精性脂肪肝病诊断与治疗专家共识[J].中国实用儿科杂志,2018,33(7):487-492.
[10] 中华医学会肝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疗指南(2010年修订版)[J]. 中华肝脏病杂志,2010,18(3):163-166.
[11] Li H B, Hu Y, Tang H L, et al. The potential of glycyrrhizinate in the management of covid-19: a systematic review of the efficacy and safety of glycyrrhizin preparations in the treatment of SARS and MERS[J]. Am J Chin Med,2020,48(7):1539-1552.
[12] Mou Y, Liao W H, Li Y C, et al. Glycyrrhizin and the related preparations: an inspiring resource for the treatment of liver diseases[J]. Am J Chin Med,2024,52(2):315-354.
[13] Mazziotta C, Tognon M, Martini F, et al. Probiotics mechanism of action on immune cells and beneficial effects on human health[J]. Cells,2023,12(1):184.
[14] Hu H M, Lin A Z, Kong M W, et al. Intestinal microbiome and NAFLD: molecular insights and therapeutic perspectives[J]. J Gastroenterol,2020,55(2):142-158.
[15] Ebrahimzadeh Leylabadlo H, Ghotaslou R, Samadi Kafil H, et al. Non-alcoholic fatty liver diseases: from role of gut microbiota to microbial-based therapies[J]. Eur J Clin Microbiol Infect Dis,2020,39(4):613-627.
[16] 王芳, 高晓霞, 汪庆强. 黄连解毒汤联合益生菌制剂对非酒精性脂肪性肝炎患者中医症候积分和肠道菌群平衡的影响[J]. 实用肝脏病杂志,2022,25(2):235-238.
[17] 卫栋萍, 韩黎黎, 凌佳慧, 等. 甘草酸二胺与复方甘草酸苷治疗环磷酰胺所致的药物性肝损伤患者疗效研究[J]. 实用肝脏病杂志,2023,26(3):388-391.
[18] 蒋宇桐, 曾瑞, 冯洁, 等. 益生菌辅助更昔洛韦治疗新生儿人巨细胞病毒肝炎后的疾病转归观察[J]. 肝脏,2024,29(8):990-993,1014.