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目的:探讨二甲双胍联合双歧杆菌三联活菌胶囊对非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)患者血清TNF-α及肝脂肪变的影响。方法:选取NAFLD患者84例。其中,对照组42例,予以二甲双胍治疗;治疗组42例,在二甲双胍基础上加用双歧杆菌三联活菌胶囊。疗程均为8周。治疗前及治疗8周后,所有患者进行肝脏CT检查,比较2组生化指标及肿瘤坏死因子(tumor necrosis factor-α,TNF-α)变化。结果:治疗8周后,与治疗前及对照组治疗后比较,治疗组体重指数(body mass index,BMI)、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,Hb A1C)、甘油三脂(triglyceride,TG)、胆固醇(cholesterol,TC)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)、TNF-α减低,治疗组总有效率显著高于对照组(P<0.05)。治疗组肝脂肪变的程度与BMI,HOMA-IR,TG,TC和TNF-α呈正相关(P<0.05)。结论:二甲双胍联合双歧杆菌三联活菌胶囊治疗NAFLD疗效明确,TNF-α水平降低,肝脏脂肪变程度减轻,疗效优于单用二甲双胍。
Objective: To investigate the effects of metformin combined with Bifidobacterium triple viable capsule on serum TNF-α and hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods: 84 patients with NAFLD were selected. Among them, 42 cases in the control group were treated with metformin; 42 cases in the treatment group were treated with Bifidobacterium triple viable capsule on the basis of metformin. The course of treatment is 8 weeks. Before treatment and after 8 weeks of treatment, all the patients underwent liver CT examination. The biochemical indexes and the changes of tumor necrosis factor-α (TNF-α) in the two groups were compared. Results: After 8 weeks of treatment, the body mass index (BMI), fasting blood glucose (FBG), glycosylated hemoglobin (Hb A1C), glycerol The triglyceride (TG), cholesterol (TC), insulin resistance index (HOMA-IR) and TNF-α decreased. The total effective rate in the treatment group was significantly higher than that in the control group (P <0.05). The degree of hepatic steatosis in the treatment group was positively correlated with BMI, HOMA-IR, TG, TC and TNF-α (P <0.05). CONCLUSION: Metformin combined with Bifidobacterium triple viable capsule can effectively treat NAFLD, reduce the level of TNF-α and alleviate the degree of fatty degeneration in liver, which is superior to metformin alone.