复方甘草酸苷片治疗儿童非酒精性脂肪性肝病疗效观察

Clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease

摘要:

目的 探讨复方甘草酸苷片治疗儿童非酒精性脂肪性肝病的临床疗效。方法 将2014年6月至2016年5月就诊的65例非酒精性脂肪性肝病患儿随机分为复方甘草酸苷片治疗组（n=33）和护肝片对照治疗组（n=32），分别予以口服复方甘草酸苷片和护肝片治疗24周。两组患儿均于治疗前后检测血清丙氨酶氨基转移酶（ALT）、γ-谷氨酰转肽酶（γ-GT）、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CⅣ）和层黏连蛋白（LN）水平。结果 复方甘草酸苷片组和护肝片组治疗总有效率分别为85%和50%，两组比较差异有统计学意义（P < 0.05）；两组患儿血清ALT水平治疗后较治疗前均显著下降（P < 0.05），但复方甘草酸苷片组较护肝片组下降更明显（P < 0.01）；复方甘草酸苷片组治疗后血清γ-GT水平以及肝纤维化四项指标（HA、PCⅢ、CⅣ、LN）水平较治疗前均得到明显改善（P < 0.05），而护肝片组上述各指标水平较治疗前均无显著变化（P > 0.05）。结论 复方甘草酸苷片可有效改善非酒精性脂肪性肝病患儿的肝功能，并能降低肝纤维化血清学指标水平；其疗效优于护肝片治疗。

Abstract:

Objective To investigate the clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease. Methods A total of 65 children with nonalcoholic fatty liver disease between June 2014 and May 2016 were randomly divided into two groups:compound glycyrrhizin tablets treatment (n=33) and liver-protecting tablets treatment (n=32). The course of treatment was 24 weeks for both groups. The serum levels of alanine aminotransferase, gamma-glutamyl transpeptidase, hyaluronic acid, procollagen type III, type IV collagen, and laminin were measured before and after treatment for both groups. Results There was a significant difference in the overall response rate between the compound glycyrrhizin tablets treatment and liver-protecting tablets treatment groups (85% vs 50%; P < 0.05). Both groups had a significant reduction in the serum level of alanine aminotransferase after treatment, but the compound glycyrrhizin tablets treatment group had a significantly greater reduction (P < 0.01). The compound glycyrrhizin tablets treatment group showed significant improvements in the serum levels of gamma-glutamyl transpeptidase and the four markers of liver fibrosis (hyaluronic acid, procollagen type III, type IV collagen, and laminin) after treatment (P < 0.05), while the liver-protecting tablets treatment group had no significant improvements in these markers. Conclusions Compound glycyrrhizin tablets can effectively improve hepatic function and reduce serum levels of liver fibrosis markers in children with nonalcoholic fatty liver disease and have a better clinical efficacy than liver-protecting tablets.