二甲双胍联合多烯磷脂酰胆碱治疗非酒精性脂肪性肝病的分析

目的分析二甲双胍联合多烯磷脂酰胆碱对非酒精性脂肪肝患者的治疗作用。方法符合诊断标准的肥胖型非酒精性脂肪肝患者80例分为两组,试验组40例联合多烯磷脂酰胆碱及二甲双胍,对照组40例服用多烯磷脂酰胆碱及维生素C片,疗程均为4～6个月。治疗前后测定各组患者血清转氨酶水平（ALT、AST）、血脂水平（TG、TC、LDL-C及HDL-C）、胰岛素抵抗指数（IRI）及肝/脾cT比值并作统计学处理,同时观察实验过程中出现的不良反应。结果治疗后两组患者血清ALT均明显降低,尤以试验组降低明显（P〈0.01）;试验组患者治疗后各项血脂水平均显著改善;试验组胰岛素抵抗指数于治疗后明显下降（P〈0.05）,而对照组无明显改变（P〉0.05）;同时试验组治疗后肝/脾CT比值显著升高（P〈0.01）。结论二甲双胍联合多烯磷脂酰胆碱对非酒精性脂肪肝有显著疗效且用药安全。

Clinical Effect of Metformin Combined with Polyene Phosphatidyl Choline on Patients with Non-alcoholic Fatty Liver Disease

Objective To assess the therapeutic effect of metformin combined with polyene phosphatidyl choline on patients with non-alcoholic fatty liver disease.Methods Eighty obesity patients with non-alcoholic fatty liver disease were randomly divided into experiment group treated with metformin combined with polyene phosphatidyl choline（n=40）and control group treated with Vitamin C combined with polyene phosphatidyl choline （n=40）respectively for consecutive 4～6 months,and serum transaminase 1evel（ALT,AST）, triglyceride （ TG）, cholesterol（ TC, LDL - C and HDL - C ）, insulin resistance index（ IRI） and liver/spleen CT index were detected pre -treatment and post -treatment respectively. Side - effect was also observed during the experiment. Results The levels of serum ALT in experiment group and control group were all obviously reduced at the end point compared with the baseline,especially the former （P 〈 0. 01 ） ; the abnormity of TG,TC,LDL - C and HDL - C were all markedly ameliorated in experiment group compared with that of control group after treatment, and the level of IRI in experiment group was significantly decreased at the end point compared with the baseline （ P 〈 0.05 ） , while the change was not obvious in control group （P 〉 0. 05 ） ; meanwhile, liver/spleen CT index in experiment group were obviously increased after treatment （P 〈 0.01 ）, and no severe side -effects occurred during the experiment. Conclusion Metformin combined with polyene phosphatidyl choline is an effective and safe remedy for patients with non - alcoholic fatty liver disease.