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Chronic liver diseases of the adult represent one of the most important part of the daily medical practice due to a high prevalence and incidence. A number of synthetic as well as plant-based drugs, are used for various liver diseases. Synthetic drugs, although highly effective, come with adverse effects whereas plant-based drugs have a clearly better safety profile. The most studied and used plant-based remedy for hepatic disorders is Silybum marianum seeds extract standardized in silymarin. However, plant-based products are often described as having a lower efficacy which entails the need of higher and multiple doses in a long-time treatment. That is why the idea of a combination between several hepatoprotectives for a synergistic effect rises as logical and necessary. The present research aimed to evaluate the hepatoprotective effect of the combination silymarin + Phyllanthus niruri extract + choline versus the effect of silymarin alone in higher dose in patients with various hepatic disorders. The patients included in the study were adults diagnosed with different hepatic disorders (viral hepatitis B or C, compensated cirrhosis, steatohepatitis) and then randomized between the two hepatoprotective treatment groups. Hepatoprotective treatments were administered daily for 180 days and the patients were investigated initially and then 3 and 6 months later for specific biomarkers and Fatty liver index (FLI) as a parameter for the degree of hepatic steatosis. The results demonstrated the superior efficacy of silymarin + Phyllanthus niruri extract + choline hepatoprotective combination versus silymarin alone, even if the dose of silymarin in combination was smaller than the dose of silymarin alone. The superior efficacy of the combination in terms of individual parameters was more evident in the group with a more severe pathology, where the degree of inflammation and destruction is higher.

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COMPARATIVE HEPATOPROTECTIVE EFFICACY OF SILYMARIN-PHYLLANTHUS-CHOLINE COMBINATION VERSUS SILYMARIN ALONE IN LIVER DISEASES WITH DIFFERENT DESTRUCTION AND INFLAMMATION STAGES