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 P P P 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 P P 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.
LI Yu-Wen,HU Yu-Hua,ZHU Tian-Tian et al. Clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease[J]. CJCP, 2017, 19(5): 505-509.
Moran JR, Gishan FK, Halter SA, et al. Steatohepatitis in obese children:a cause of chronic liver dysfunction[J]. Am J Gastroenterol, 1983, 78(6):374-377.
Noureddin M, Anstee QM, Loomba R. Review article:emerging anti-fibrotic therapies in the treatment of non-alcoholic steatohepatitis[J]. Aliment Pharmacol Ther, 2016, 43(11):1109-1123.
Feldstein AE, Charatcharoenwitthaya P, Treeprasertsuk S, et al. The natural history of non-alcoholic fatty liver disease in children:a follow-up study for up to 20 years[J]. Gut, 2009, 58(11):1538-1544.
[10]
Kobyliak N, Abenavoli L. The role of liver biopsy to assess non-alcoholic fatty liver disease[J]. Rev Recent Clin Trials, 2014, 9(3):159-169.
[11]
Ciocca M, Ramonet M, Álvarez F. Non-alcoholic fatty liver disease:a new epidemic in children[J]. Arch Argent Pediatr, 2016, 114(6):563-569.
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease:practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association[J]. Hepatology, 2012, 55(6):2005-2023.
[14]
Nguyen V, George J. Nonalcoholic fatty liver disease management:dietary and lifestyle modifications[J]. Semin Liver Dis, 2015, 35(3):318-337.
[15]
Day CP, James OF. Steatohepatitis:a tale of two "hits"[J]. Gastroenterology, 1998, 114(4):842-845.
[16]
Stojsavljević S, Gomerčić Palčić M, Virović Jukić L, et al. Adipokines and proinflammatory cytokines, the key mediators in the pathogenesis of nonalcoholic fatty liver disease[J]. World J Gastroenterol, 2014, 20(48):18070-18091.
Wang C, Duan X, Sun X, et al. Protective effects of glycyrrhizic acid from edible botanical glycyrrhiza glabra against non-alcoholic steatohepatitis in mice[J]. Food Funct, 2016, 7(9):3716-3723.
