• Florica NAFTANAILA-MALI National Institute of Aeronautical and Space Medicine “Gen. Dr. Aviator Victor Anastasiu”, Bucharest, Romania
  • Ioana Alexandra NEGOITA Central University Emergency Military Hospital “Dr. Carol Davila”, Bucharest, Romania
  • Diana Elena SOLOMAN Central University Emergency Military Hospital “Dr. Carol Davila”, Bucharest, Romania
  • Georgiana ROBU Central University Emergency Military Hospital “Dr. Carol Davila”, Bucharest, Romania


The high incidence of liver diseases due to the use of xenobiotics and unhealthy lifestyle is associated with increased need for hepatoprotective product administration. Aim: The hepatoprotective effect of the combination silymarin / Phyllanthus niruri extract / choline was investigated in comparison with silymarin alone in patients with hepatic steatosis, in an open clinical study. Material and methods: 101 patients with non-alcoholic hepatic steatosis confirmed by high values of serum transaminases and ultrasonography were included in the study. The patients were divided into two groups, group A received 150 mg silymarin three times daily, and group B a hepatoprotective complex (120 mg silymarin / 225 mg Phyllanthus niruri extract / 60 mg choline) three times daily, for 6 months. The hepatoprotective effects were assessed through the evolution of the following laboratory parameters: aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase, serum bilirubin and serum cholesterol at 3 and 6 months after the initiation of the hepatoprotective treatment. Results: Both products were effective in the normalization of liver function, but the combination silymarin / Phyllanthus niruri extract / choline showed significantly better results than silymarin alone, considering the normalization of the hepatic parameter values after 3 and 6 months. The risk for hepatoprotective failure was significantly lower with the combination silymarin / Phyllanthus niruri extract / choline versus silymarin alone, the number needed to treat (NNT) being 3.7 after 3 months and 2.5 after 6 months. Conclusions: The combination silymarin / Phyllanthus niruri extract / choline induced a better liver protection than silymarin alone.


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