目的:观察理中汤加减治疗非酒精性脂肪性肝病的临床疗效.方法:将110 例非酒精性脂肪性肝病患者按照随机数字表法分为观察组和对照组,每组各55 例.对照组给予多烯磷脂酰胆碱治疗,观察组在对照组治疗的基础上给予理中汤加减.比较两组患者治疗前后肝功能指标[丙氨酸氨基转移酶(alamine aminotransferase,ALT)、门冬氨酸氨基转移酶(aspartate amin-otransferase,AST)、谷氨酰胺转肽酶(glutamine transpeptidase,GGT)]、血脂指标[总胆固醇(total cholesterol,CHOL)、三酰甘油(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL-C)]、血糖指标[空腹血糖(fasting blood-glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、糖化血红蛋白A1c(hemoglobin A1c,HbA1c)、胰岛素抵抗指数(homa-insulin resistance index,HO-MA-IR)]、肝脏硬度值(liver stiffness measurement,LSM)、受控衰减参数值(controlled attenuation parameter,CAP)及中医证候积分变化情况.结果:观察组有效率为85.45%,高于对照组的54.55%(P<0.05).两组患者治疗后ALT、AST、GGT水平低于本组治疗前,治疗后观察组低于对照组(P<0.05).两组患者治疗后FBG、HOMA-IR、FINS、HbA1c低于本组治疗前,且治疗后观察组FBG、HOMA-IR低于对照组(P<0.05),治疗后观察组FINS、HbA1c水平与对照组比较,差异无统计学意义(P>0.05).两组患者治疗后CHOL、TG、LDL-C水平低于本组治疗前,治疗后观察组低于对照组(P<0.05).两组患者治疗后LSM、CAP水平低于本组治疗前,且治疗后观察组CAP水平低于对照组(P<0.05),治疗后观察组LSM水平与对照组比较,差异无统计学意义(P>0.05).两组患者治疗后中医证候积分低于本组治疗前,治疗后观察组低于对照组(P<0.05).结论:理中汤加减治疗非酒精性脂肪性肝病,可有效改善患者肝功能指标、血脂水平及胰岛素抵抗情况,缓解临床症状,提高生活质量.
Objective:To observe the clinical efficacy of Modified Middle-Regulating Decoction on non-alcoholic fatty liver disease(NAFLD).Methods:A total of 110 patients with NAFLD were randomly divided into the observation group and the control group,with 55 cases in each group.The control group was given polyene phosphatidylcholine for treatment,while the observation group was given Modified Middle-Regulating Decoction on the basis of the control group.The liver function indexes[including alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamine transpeptidase(GGT)],blood lipid indexes[including total cholesterol(CHOL),triglyceride(TG),low density lipoprotein(LDL-C)],blood glucose indexes[including fasting blood glucose(FBG),fasting insulin(FINS),hemoglobin A1c(HbA1c),insulin resistance index(HOMA-IR)],liver stiffness measurement(LSM),controlled at-tenuation parameter(CAP)and TCM syndrome scores were compared between the two groups before and after treatment.Results:The effective rate of the observation group was 85.45%,higher than that of the control group(54.55%)(P<0.05).After treatment,the levels of ALT,AST and GGT in the two groups were lower than those before treatment,and the above indexes in the observation group were lower than those in the control group(P<0.05);the levels of FBG,HOMA-IR,FINS and HbA1c in the two groups were lower than those before treatment,and the levels of FBG and HOMA-IR in the observation group were lower than those in the control group(P<0.05),and there were no statistically significant differences in the levels of FINS and HbA1c in the observation group compared with the control group(P>0.05);the levels of CHOL,TG and LDL-C in the two groups were lower than those before treatment,and the above indexes in the observation group were lower than those in the control group(P<0.05);the levels of LSM and CAP in the two groups were lower than those before treatment,and the level of CAP in the observation group was lower than that in the control group(P<0.05),and there was no statistically significant difference in the level of LSM in the observation group compared with the control group(P>0.05);the syndrome scores of TCM in the two groups were lower than those before treatment,and the syndrome scores of TCM in the observation group were lower than those in the control group(P<0.05).Conclusion:Middle-Regulating Decoction for NAFLD can effectively improve the patients'liver function indexes,blood lipid levels and insulin resistance,relieve clinical symptoms and improve quality of life.
王月明;李泽鹏;周晓玲;沈新辉
柳州市中医医院,柳州市壮医医院,广西 柳州 545001广西中医药大学,广西 南宁 530200
中医学
非酒精性脂肪性肝病;理中汤;多烯磷脂酰胆碱;中西医结合疗法;《伤寒论》;张仲景
non-alcoholic fatty liver disease(NAFLD);Middle-Regulating Decoction;polyene phosphatidylcholine;integrated traditional Chinese and western medicine therapy;Treatise on Gold Damage;Zhang Zhongjing
《河南中医》 2024 (004)
503-508 / 6
广西壮族自治区自然科学基金青年基金项目(2020GXNSFBA297133);广西壮族自治区中医药管理局自筹课题项目(GZZC2020417);柳州市应用技术研究与开发计划项目(2018AF10503)
10.16367/j.issn.1003-5028.2024.04.0094
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