目的 觀察楓蓼腸胃康聯(lián)合腸內(nèi)營(yíng)養(yǎng)混懸液治療老年非酒精性脂肪肝合并代謝綜合征的臨床療效.方法 選取2014年1 月-2015 年2 月眉山市人民醫(yī)院收治的老年非酒精性脂肪肝合并代謝綜合征患者共116 例,隨機(jī)分為治療組和對(duì)照組,每組各58 例.兩組均給予一般治療,在此基礎(chǔ)上對(duì)照組給予腸內(nèi)營(yíng)養(yǎng)混懸液,84～126 kJ/(kg·d),經(jīng)鼻胃管滴注.治療組在對(duì)照組治療的基礎(chǔ)上,加用楓蓼腸胃康顆粒,1 袋/次,3 次/d,于腸內(nèi)營(yíng)養(yǎng)治療前15 min 適量溫開(kāi)水溶解經(jīng)鼻胃管注入.兩組療程均為8 周.觀察兩組的臨床療效,同時(shí)比較兩組肝臟超聲檢查、營(yíng)養(yǎng)指標(biāo)及生化指標(biāo)改善情況和不良反應(yīng)發(fā)生情況.結(jié)果 治療后,對(duì)照組和治療組總有效率分別為67.24%、86.21%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05).治療后,兩組輕度脂肪肝例數(shù)增加,中度脂肪肝例數(shù)減少,治療組的改善情況優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).治療后,兩組體質(zhì)量指數(shù)(BMI)、三酰甘油(TG)、總膽固醇(TC)、低密度脂白膽固醇(LDL-C)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、谷氨酸氨基轉(zhuǎn)移酶(AST)、總膽紅素(TBIL)、直接膽紅素(DBIL)、空腹血糖(FPG)、糖化血紅蛋白(HbAlc)、餐后2 h血糖(2h FBG)均較治療前顯著降低,高密度脂蛋白膽固醇(HDL-C)顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05),治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P< 0.05).對(duì)照組和治療組不良反應(yīng)發(fā)生率分別為25.86%、5.17%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05).結(jié)論 楓蓼腸胃康聯(lián)合腸內(nèi)營(yíng)養(yǎng)混懸液治療老年非酒精性脂肪肝合并代謝綜合征臨床療效確切,多項(xiàng)生化指標(biāo)改善明顯,不良反應(yīng)更少發(fā)生,值得臨床應(yīng)用.

Objective To investigate the efficacy of Fengliao Changweikang combined with enteral nutrition suspension in treatment of elderly non-alcoholic fatty liver complicated with metabolic syndrome. Methods Patients (116 cases) with non-alcoholic fatty liver complicated with metabolic syndrome in Meishan City People's Hospital from January 2014 to February 2015 were randomly divided into control and treatment groups. Each group had 58 cases. Patients in two groups were given conventional treatment. Patients in control group were ig administered with Enteral Nutritional Suspension, 84-126 kJ/(kg·d). Patients in treatment group were ig administered with Fengliao Changweikang dissolving with a moderate amount of warm water 15 min before enteral nutrition therapy, 1 bag/time, three times daily. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and liver ultrasound, nutrition indexes, biochemical indexes and adverse reactions in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 67.24% and 86.21%, respectively, and there were differences between two groups (P < 0.05). After treatment, the number of mild fatty liver in two groups were increased, while moderate fatty liver cases were decreased, and the improvement of treatment group was superior to the control group (P < 0.05). After treatment, BMI, TG, TC, LDL-C, ALT, AST, TBIL, DBIL, FPG, HbAlc, and 2h FBG in two groups were significantly reduced, while HDL-C were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). The incidences of adverse reactions in the control and treatment groups were 25.86% and 5.17%, respectively, and there were differences between two groups (P < 0.05). Conclusion Fengliao Changweikang combined with Enteral Nutrition Suspension has clinical curative effect in treatment of elderly non-alcoholic fatty liver complicated with metabolic syndrome, and biochemical indexes improved significantly with less adverse reactions, which is worthy of clinical application.