甘草酸二铵肠溶胶囊联合双歧杆菌四联活菌对NAFLD患者炎性指标和肝损伤的影响

Effects of Diammonium Glycyrrhizinate Enteric Capsule Combined with Bifidobacterium Tetralogy on Inflammatory Indexes and Liver Injury in NAFLD Patients

关键词:  甘草酸二铵肠溶胶囊  双歧杆菌四联活菌  非酒精性脂肪肝  肝损伤  胰岛素抵抗

Key words:  diammonium glycyrrhizinate enteric capsule  bifidobacterium tetralogy  non-alcoholic fatty liver (NAFLD)  liver injury  insulin resistance

摘要:

目的 探讨甘草酸二铵肠溶胶囊联合双歧杆菌四联活菌对非酒精性脂肪肝（non-alcoholic fatty liver disease，NAFLD）患者炎性指标和肝损伤的影响。方法 取2015年4月— 2017年6月厦门大学附属第一医院门诊收治的102例NAFLD患者，随机分为观察组和对照组，每组51例。观察组采用甘草酸二铵肠溶胶囊联合双歧杆菌四联活菌片治疗，对照组采用甘草酸二铵肠溶胶囊治疗。比较2组患者治疗效果、血脂水平、肝损伤指标、脂质过氧化指标、炎性指标、胰岛素抵抗指标、影响因素的pearson相关性分析、不良反应发生情况。结果 观察组的总有效率（94.1%）显著高于对照组（80.4%）（P<0.05）。治疗后，观察组血脂（TG、TC、LDL-C、HDL-C）、肝损伤指标（ALT、AST、GGT）及脂质过氧化指标（SOD、T-GSH、MDA）与对照组相比，差异具有统计学意义（P<0.05）。观察组炎性指标（TNF-α、IL-6、NK-κB、LPS）和胰岛素抵抗指标（FPG、FINS、HOMA-IR）均显著优于对照组（P<0.05）。经过pearson相关性分析，SOD、T-GSH活性与肝损伤指标呈负相关（P<0.05），MDA、TNF-α、IL-6、NK-κB、LPS、FINS、HOMA-IR与肝损伤指标呈正相关（P<0.05）。2组不良反应发生率无统计学差异。结论 甘草酸二铵肠溶胶囊联合双歧杆菌四联活菌可有效改善NAFLD患者的肝损伤，可能与改善肝脏的脂质过氧化、炎性反应及胰岛素抵抗有关。

Abstract:

OBJECTIVE To investigate the effects of diammonium glycyrrhizinate enteric capsule combined with bifidobacterium tetralogy on inflammatory indexes and liver injury in patients with nonalcoholic fatty liver (NAFLD). METHODS From April 2015 to June 2017, 102 NAFLD patients were randomly divided into 2 groups:the observation group and the control group (n=51). The observation group was treated with diammonium glycyrrhizinate enteric capsule combined with bifidobacterium tetralogy, while the control group was treated with diammonium glycyrrhizinate enteric capsule. The therapeutic effect, blood lipid level, liver injury index, lipid peroxidation index, inflammatory index, insulin resistance index, pearson correlation analysis and adverse reaction were compared between the 2 groups. RESULTS The total effective rate of observation group (94.1%) was significantly higher than that of control group (80.4%) (P<0.05). After treatment, blood lipid (TG, TC, LDL-C, HDL-C), liver injury index (ALT, AST, GGT), lipid peroxidation index (SOD, T-GSH, MDA) in observation group were significantly different from that in the control group (P<0.05). Compared with control group, inflammatory index (TNF-α, IL-6, NK-κB, LPS), insulin resistance index (FPG, FINS, HOMA-IR) of observation group were significantly better (P<0.05). After pearson correlation analysis, there was a negative correlation between the activity of SOD, T-GSH and liver injury index (P<0.05). MDA, TNF-α, IL-6, NK-κB, LPS, FINS, HOMA-IR were positively correlated with the liver injury index (P<0.05). There was no significant difference in the incidence of adverse reactions between the 2 groups. CONCLUSION Diammonium glycyrrhizinate enteric capsule combined with bifidobacterium quadruple viable can effectively improve the liver injury in NAFLD patients, which may be related to improving lipid peroxidation, inflammatory reaction and insulin resistance.