关键词: 非酒精性脂肪性肝炎, 水飞蓟宾, 烯磷脂酰胆碱, 细胞因子, 治疗

Abstract: Objective The aim of this study was to observe silybin and polyene phosphatidyl choline combination in treatment of patients with alcoholic steatohepatitis (NASH). Methods A total of 178 consecutive patients with NASH were recruited in our hospital between May 2023 and May 2025, and were randomly assigned to receive oral polyene phosphatidyl choline therapy in 82 cases in group A, or receive oral polyene phosphatidyl choline and silybin capsule combination therapy in 96 cases in group B for six months. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were determined by Fibrotouch, and serum hyaluronic acid (HA), laminin (LN), IV collagen (IV-C), III procollagen (PCIII) and interleukin-10 (IL-10), IL-6 and tumor necrosis factor-α (TNF-α) levels were detected by ELISA. Results By end of six month treatment, serum ALT and AST, and CAP in group B were (50.3±4.2)U/L and (42.8±3.4)U/L, and (274.6±10.8)dB/m, all much lower than [(58.7±6.6)U/L, (48.9±5.1)U/L and (286.2±13.2)dB/m, respectively, P＜0.05] in group A; LSM, serum HA, Ⅳ-C and PCⅢ levels were (7.1±1.1)kPa, (60.9±5.2)μg/L, (58.6±6.7)μg/L and (92.5±10.1)μg/L, all significantly lower than [(8.6±1.9)kPa, (74.7±7.8)μg/L, (82.9±8.2)μg/L and (149.8±11.9)μg/L, respectively, P＜0.05] in group A; serum IL-6 and TNF-α levels were (13.6±4.2)ng/L and (14.4±3.6)mg/L, both much lower than [(20.2±5.1)ng/L and (25.1±3.3)mg/L, respectively, P＜0.05], while serum IL-10 level was (30.1±7.1)mg/L, much higher than [(24.9±6.4)mg/L, P＜0.05] in group A. Conclusion Effectiveness of silybin capsule and polyene phosphatidyl choline combination in treatment of patients with NASH is short-termly satisfactory, which could improve normalization of liver function tests, and might be due to inhibition of cytokine reactions.

Key words: Non-alcoholic steatohepatitis, Silybin, Polyene phosphatidyl choline, Cytokines, Therapy