| 吴天军,王光,朱理珂,等.小檗碱调节肠道菌群佐治代谢相关脂肪性肝病 32例分析[J].安徽医药,2020,24(7):1457-1460. |
| 小檗碱调节肠道菌群佐治代谢相关脂肪性肝病 32例分析 |
| Effect of berberine on regulating intestinal flora of patients with metabolic associated fatty liver disease |
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| DOI：10.3969/j.issn.1009?6469.2020.07.047 |
| 中文关键词: 脂肪肝 小檗碱 肠道菌群 代谢相关脂肪性肝病 水飞蓟宾胶囊 双歧杆菌 大肠埃希菌 |
| 英文关键词: Fatty liver Berberine Intestinal flora Metabolic associated fatty liver disease Silybin capsules Bifidobacte? rium Escherichia coli |
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| 中文摘要: |
| 目的观察小檗碱调节肠道菌群作用辅助治疗代谢相关脂肪性肝病( MAFLD)的临床疗效。方法选择河南神火集团职工总医院 2016年 5月至 2017年 3月间就诊的 64例 MAFLD病人采用随机数字表法分为治疗组和对照组。对照组予水飞蓟宾胶囊等常规药物治疗；治疗组在对照组治疗的基础上给予盐酸小檗碱片口服治疗；两组疗程均为 8周。留取粪便标本，对肠道中常见的双歧杆菌及大肠埃希菌进行培养和计数，计算双歧杆菌与大肠埃希菌数值之比以反映肠道菌群变化状态，并比较两组病人肝功能［丙氨酸氨基转移酶( ALT)、天门冬氨酸氨基转氨酶( AST)、 γ?谷氨酰转移酶( GGT)、碱性磷酸酶( ALP)］、血脂及糖代谢指标的变化。结果治疗后治疗组及对照组大肠埃希菌数量均较本组治疗前下降( P＜0.01)，治疗组改善更明显［(8.14±0.98)比( 8.97±0.13)lg cfu/g，P＜0.01］；两组治疗后双歧杆菌数量、双歧杆菌与大肠埃希菌数值之比均较本组治疗前升高( P＜0.01)，治疗组改善更明显［(9.97±0.13)比( 9.44±0.97)lg cfu/g，P＜0.05；(1.23±0.13)比( 1.05±0.09)P＜0.01］。治疗后治疗组 ALT、AST、ALP及 GGT均较治疗前下降( P＜0.01或 P＜0.05)；对照组较治疗前下降差异有统计学意义，的为 ALT及 AST(均 P＜0.01)；疗程结束后治疗组 ALT及 AST改善水平更明显［(36.75±9.07)比( 46.88±8.24)U/L；(42.25±9.42)比( 51.63±4.78)U/ L；均 P＜0.05］。治疗后治疗组及对照组 TC、TG、FPG及胰岛素抵抗指数均较本组治疗前下降( P＜0.01或 P＜0.05)；治疗后治疗组的血脂、糖代谢指标改善更明显［TC:(3.79±0.59)比( 4.49±0.60)mmol/L；TG:(1.64±0.35)比( 2.01±0.30)mmol/L；FPG:(5.41±0.39)比( 5.99±0.61)mmol/L；胰岛素抵抗指数:(4.61±0.40)比( 5.19±0.60)；均 P＜0.05］。结论小檗碱可改善肠道菌群失调，辅助治疗 MAFLD，促进肝功能恢复及代谢组分的改善。 |
| 英文摘要: |
| Objective To observe the effect of berberine on regulating intestinal flora of patients with in metabolic associated fatty liver disease.Methods From May 2016 to March 2017，64 patients with metabolic associated fatty liver disease from Gener Hospi?tal of Henan Shenhuo Group were randomly divided into 2 groups.All patients were given outpatient medication on the basis ofweight control and improved lifestyle.The control group(32 patients)was given silybin capsules daily for 8 weeks.The treatment group(32 patients)was given berberine hydrochloride tablets daily for 8 weeks on the basis of control group.Two kinds of commonintestinal bacteria were cultured and counted，then the ratio of bifidobacteria and escherichia coli which reflected changes of intesti? nal flora was calculated，.In addition，clinical indexes were evaluated，which included Liver function［( alanine aminotransferase， ALT)；(aspartate aminotransferase，AST)；(γ?glutamyl transferase，GGT)；(alkaline phosphatase，ALP)］，serum lipid［(triglyceride， TG)；(total cholesterol，TC)］fasting plasm glucose(FPG)，insulin，insulin resistance index.Results After treatment，the quantity ofescherichiacoliinboththet，reatment group and the control group decreased compared with pretherapy(P＜0.01)，and the de? crease was more obviously in the treatment group［(8.14±0.98)vs.(8.97±0.13)lg cfu/g，P＜0.01］.Not only the quantity of bifido?bacteria but also the ratio of bifidobacteria and escherichia coli in both the treatment group and the control group were higher thanthat of pretherapy(P＜0.01)and the increase was pronounced in the treatment group［( 9.97±0.13)vs.(9.44±0.97)lg cfu/g，P＜ 0.05；(1.23±0.13)vs.(1.05±0.0，9)P＜0.01］.Levels of ALT，AST，ALP and GGT in the treatment group after treatment were better than that of pretherapy(P＜0.01或，P＜0.05).The levels of ALT and AST in the control group after treatment were obviously de? creased compared with pretherapy(P＜0.01)，and the levels of ALT and AST in the treatment group were superior to control group after treatment［ALT:(36.75±9.07)vs.(46.88±8.24)U/L；AST:(42.25±9.42)vs.(51.63±4.78)U/L；P＜0.05］.Levels of TC，TG， FPG and insulin resistance index in the two group after treatment were better than that of pretherapy respectiely(P＜0.01或 P＜0.05).Compared with control group，the levels of serum lipid，metabolic parametre about glucose in the treatment group after treat?ment were obviously better with significant defference respectiely［TC:(3.79±0.59)vs.(4.49±0.60)mmol/L；TG:(1.64±0.35)vs.(2.01±0.30)mmol/L；FPG:(5.41±0.39)vs.(5.99±0.61)mmol/L；insulin resistance index:(4.61±0.40)vs.(5.19±0.60)； P＜0.05］. Conclusion Treatment with berberine which may improve intestinal flora can effectively optimize liver function and metaboliccomponents with metabolic associated fatty liver disease. |
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