微生态制剂改善非酒精性脂肪性肝病患者胰岛素抵抗的临床研究

目的:观察美常安对非酒精性脂肪性肝病(NAFLD)患者临床症状及胰岛素抵抗(IR)的作用。方法:选取2009年4月至2013年3月我院收治的88例NAFLD患者,随机分为治疗组和对照组。对照组给予基础治疗,治疗组在对照组的基础上,加用美常安胶囊进行治疗。比较两组疗效及治疗前后两组血清谷丙转氨酶(ALT)、甘油三酯(TG)及稳态胰岛素抵抗指数(HOMA-IR)水平,并分析血浆D乳酸、TNF-α、内毒素与HOMA-IR的相关性,观察两组不良反应情况。结果:治疗组治疗有效率为52.3%,明显高于对照组的29.5%(P0.05)。治疗后治疗组ALT、TG、HOMA-IR下降幅度,均明显优于对照组(P0.05)。治疗后治疗组患者血浆D乳酸、TNF-α、内毒素水平明显低于对照组(P0.05),且治疗组患者HOMA-IR与患者血浆D乳酸、血清TNF-α、内毒素水平呈正相关(r=0.352,0.44,0.48;均P0.05)。不良反应发生率低,且两组不良反应发生率无显著差异(P0.05)。结论:美常安治疗NAFLD疗效显著,可降低ALT、TG水平,降低肠道通透性,改善肠源性内毒素血症,改善IR,且安全性较高。

Clinical Study of Microecologics in Improving Insulin Resistance of Patients with Non-Alcoholic Fatty Liver Disease

Objective:To explore the effect of microecologics (Mei Chang An capsules) in improving the clinlcal symptom and insulin resistance(IR) of patients with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 88 patients with NAFLD, who were treated in Zhongshan Affiliated Hospital of Dalian University from April 2009 to March 2013, were randomly divided into treatment group and control group. The control group was treated with basic therapy, while the treatment group was added Mei Chang An capsules on the basis of control group''s therapy. The curative effect and alanine aminotransferase(ALT), triglyceride(TG), and homeostasis model assessment for insulin resistance (HOMA-IR) before and after treatment were compared; the correlation between plasma D-lactic acid, TNF-alpha, endotoxin and HOMA-IR was analyzed; the incidence of adverse reaction in the two groups was observed.Results:The effective rate (52.3%) of treatment group was significantly higher than that (29.5%) of control group (P<0.05). The levels of ALT, TG and HOMA-IR in the treatment group after treatment were significantly lower than those in the control group (P<0.05). The levels of Plasma D-lactic acid, TNF-alpha and endotoxin in the treatment group after treatment were significantly lower than those in the control group(P<0. 05), and the level of HOMA-IR in the treatment group was positively correlated with plasma D-lactic acid, TNF-alpha, endotoxin (r=0.352, 0.44, 0.48; P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion:Mei Chang An capsules has an exact effect in the treatment of patients with NAFLD, which can cut down the levels of ALT and TG, reduce the intestinal permeability, improve the intestines-derived endotoxemia and IR, with high safety.