水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎患者疗效研究OA
Application of silybin and polyene phosphatidyl choline combination in treatment of patients with alcoholic steatohepatitis
目的 观察水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝炎(NASH)患者的效果.方法 2023年5月~2025年5月我院收治的NASH患者178例,被随机分为两组,给予A组多烯磷脂酰胆碱治疗(n=82),给予B组水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗(n=96),两组均治疗6个月.使用Fibrotouch行受控衰减参数(CAP)和肝脏硬度检测(LSM),采用ELISA法检测血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)、白细胞介素-10(IL-10)、IL-6和肿瘤坏死因子-α(TNF-α)水平.结果 在治疗6个月末,B组血清ALT、AST和CAP分别为(50.3±4.2)U/L、(42.8±3.4)U/L 和(274.6±10.8)dB/m,均显著低于 A 组[分别为(58.7±6.6)U/L、(48.9±5.1)U/L 和(286.2±13.2)dB/m,P<0.05];B 组 LSM、血清 HA、Ⅳ-C 和 PC Ⅲ水平分别为(7.1±1.1)kPa、(60.9±5.2)μg/L、(58.6±6.7)μg/L 和(92.5±10.1)μg/L,均显著低于 A 组[分别为(8.6±1.9)kPa、(74.7±7.8)μg/L、(82.9±8.2)μg/L 和(149.8±11.9)μg/L,P<0.05];B组血清IL-6和TNF-α水平分别为(13.6±4.2)ng/L和(14.4±3.6)mg/L,均显著低于A组[分别为(20.2±5.1)ng/L 和(25.1±3.3)mg/L,P<0.05],而血清 IL-10 水平为(30.1±7.1)mg/L,显著高于 A 组[(24.9±6.4)mg/L,P<0.05].结论 应用水飞蓟宾胶囊联合多烯磷脂酰胆碱治疗NASH患者可获得近期肝功能指标恢复的效果,可能与改善了肝纤维化状态,抑制细胞因子反应有关.
Objective The aim of this study was to observe silybin and polyene phosphatidyl choline combination in treatment of patients with alcoholic steatohepatitis(NASH).Methods A total of 178 consecutive patients with NASH were recruited in our hospital between May 2023 and May 2025,and were randomly assigned to receive oral polyene phosphatidyl choline therapy in 82 cases in group A,or receive oral polyene phosphatidyl choline and silybin capsule combination therapy in 96 cases in group B for six months.Liver stiffness measurement(LSM)and controlled attenuation parameter(CAP)were determined by Fibrotouch,and serum hyaluronic acid(HA),laminin(LN),Ⅳ collagen(Ⅳ-C),Ⅲ procollagen(PCⅢ)and interleukin-10(IL-10),IL-6 and tumor necrosis factor-α(TNF-α)levels were detected by ELISA.Results By end of six month treatment,serum ALT and AST,and CAP in group B were(50.3±4.2)U/L and(42.8±3.4)U/L,and(274.6±10.8)dB/m,all much lower than[(58.7±6.6)U/L,(48.9±5.1)U/L and(286.2±13.2)dB/m,respectively,P<0.05]in group A;LSM,serum HA,Ⅳ-C and PC Ⅲ levels were(7.1±1.1)kPa,(60.9±5.2)μg/L,(58.6±6.7)μg/L and(92.5±10.1)μg/L,all significantly lower than[(8.6±1.9)kPa,(74.7±7.8)μg/L,(82.9±8.2)μg/L and(149.8±11.9)μg/L,respectively,P<0.05]in group A;serum IL-6 and TNF-α levels were(13.6±4.2)ng/L and(14.4±3.6)mg/L,both much lower than[(20.2±5.1)ng/L and(25.1±3.3)mg/L,respectively,P<0.05],while serum IL-10 level was(30.1±7.1)mg/L,much higher than[(24.9±6.4)mg/L,P<0.05]in group A.Conclusion Effectiveness of silybin capsule and polyene phosphatidyl choline combination in treatment of patients with NASH is short-termly satisfactory,which could improve normalization of liver function tests,and might be due to inhibition of cytokine reactions.
王富军;张婷;崔翔;张甜甜
725000 陕西省安康市中医医院药剂科西安医学院第一附属医院消化内科725000 陕西省安康市中医医院肝病科725000 陕西省安康市中医医院药学部
非酒精性脂肪性肝炎水飞蓟宾烯磷脂酰胆碱细胞因子治疗
Non-alcoholic steatohepatitisSilybinPolyene phosphatidyl cholineCytokinesTherapy
《实用肝脏病杂志》 2026 (3)
341-344,4
陕西省科技厅科研项目(编号:2022JM-454)
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