中医药治疗非酒精性脂肪肝病临床研究进展
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摘要
非酒精性脂肪性肝病(NAFLD)是一种与胰岛素抵抗和遗传易感性密切相关的代谢应激性肝损伤。现代医学对NAFLD缺乏有效的治疗方法,实验药理研究及临床疗效观察均已证实,中医药在防治NAFLD方面有一定的优势。文章就近年来NAFLD病因病机的研究,单味药、复方以及中成药实验和临床研究成果进行了归纳和总结,以期深化对NAFLD的认识以及提升该病的防治策略。
Non-alcoholic fatty liver disease(NAFLD) is a type of hepatic injury caused by metabolic stress,and the disease is closely related to insulin resistance and genetic susceptibility. Numerous pharmacological studies have demonstrated that many single or compound preparations of Chinese medicine can achieve satisfactory curative effect and possess unique advantages in prevention and treatment of NAFLD. This paper summarizes the study on pathology of NAFLD,and the experiment and clinical research with single herb,compounds and patent formula,and thus to help in better understanding of NAFLD and contributing the prevention and treatment of the disease.
Non-alcoholic fatty liver disease(NAFLD) is a type of hepatic injury caused by metabolic stress,and the disease is closely related to insulin resistance and genetic susceptibility. Numerous pharmacological studies have demonstrated that many single or compound preparations of Chinese medicine can achieve satisfactory curative effect and possess unique advantages in prevention and treatment of NAFLD. This paper summarizes the study on pathology of NAFLD,and the experiment and clinical research with single herb,compounds and patent formula,and thus to help in better understanding of NAFLD and contributing the prevention and treatment of the disease.
引文
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[2]Diehl A M,Day C.Cause,Pathogenesis,and Treatment of Nonalcoholic Steatohepatitis[J].N Engl J Med,2017,377(21):2063-2072.
[3]Tziomalos K,Athyros VG,Paschos P,et al.Nonalcoholic fatty liver disease and statins[J].Metabolism:clinical and experimental,2015,64(10):1215-1223.
[4]Charlton MR,Burns JM,Pedersen RA,et al.Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States[J].Gastroenterology,2011,141(4):1249-1253.
[5]Takahashi Y,Sugimoto K,Inui H,et al.Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis[J].World Journal of Gastroenterology,2015,21(13):3777-3785.
[6]赵文霞,张丽慧.非酒精性脂肪性肝病应归属“肝癖”论[J].河南中医,2015,35(8):1820-1822.
[7]崔健娇,赵文霞.赵文霞教授治疗非酒精性脂肪性肝病经验总结[J].中国中医药现代远程教育,2014(22):26-27.
[8]任鹏,卢秉久.卢秉久气血兼顾-阴阳同调辨治脂肪肝[J].实用中医内科杂志,2016,30(7):3-4.
[9]谷诺诺,王凯星,杨倩,等.杨倩治疗非酒精性脂肪肝经验[J].中华中医药杂志,2017(10):4509-4511.
[10]薛建华,张银华,杜秀萍,等.陈建杰教授从脾论治非酒精性脂肪肝经验[J].河北中医,2017(12):1765-1767.
[11]季光,郑培永.中医药治疗脂肪肝的研究述评[J].中华中医药学刊,2004,22(1):87-88.
[12]车军勇,方南元,何晶,等.邵铭论治非酒精性脂肪肝经验撷粹[J].中医药临床杂志,2017(11):1811-1813.
[13]俞芹,谢兆丰,薛博瑜.谢兆丰教授治疗非酒精性脂肪肝经验[J].四川中医,2016(7):23-24.
[14]罗伟,马建伟,董静,等.非酒精性脂肪肝218例中医体质类型与证型分布研究[J].环球中医药,2014(6):453-455.
[15]刘乐鑫,池晓玲,林姗姗,等.非酒精性脂肪性肝病中医证型与临床指标的相关性[J].河南中医,2017,37(5):820-823.
[16]周爱华.中医辨证治疗酒精性脂肪肝145例临床观察[J].中国民族民间医药,2014(19):70-71.
[17]王唯坚,胡峻.155例非酒精性脂肪肝患者的中医证候学研究[J].首都医科大学学报,2014,35(1):129-131.
[18]尹述平.非酒精性脂肪性肝病的中医证候及用药分析[J].中国处方药,2016,14(3):87-88.
[19]魏华凤,柳涛,邢练军,等.793例脂肪肝患者证候分布规律[J].中西医结合学报,2009,7(5):411-417.
[20]曹福岭.柴胡疏肝散治疗非酒精性脂肪肝的疗效观察[J].光明中医,2015,30(4):746-749.
[21]万斌,商洪涛.健脾疏肝活血方治疗非酒精性脂肪肝的临床疗效观察[J].陕西中医,2016,37(2):135-138.
[22]宋清武,李慧臻.加味苓桂术甘汤治疗非酒精性脂肪性肝病的临床研究[J].四川中医,2013,31(8):60-62.
[23]鲁恒心.消脂清肝汤治疗非酒精性脂肪肝痰湿内阻证临床研究[J].中医学报,2017(12):2477-2480.
[24]刘秀林,付京云,刘丽花,等.柴荷化痰活血方治疗非酒精性脂肪肝50例临床疗效观察[J].北京中医药,2015(7):560-562.
[25]李进,李月翠,胡伟跃,等.自拟降脂护肝方联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的临床研究[J].中华中医药学刊,2015(1):236-239.
[26]王淼,柳涛,魏华凤,等.降脂颗粒联合行为干预治疗痰瘀互结型非酒精性脂肪性肝病的临床研究[J].上海中医药杂志,2010,44(4):11-13,17.
[27]季光,范建高,陈建杰,等.胆宁片治疗非酒精性脂肪性肝病的多中心随机对照临床研究[J].中西医结合学报,2008,6(2):128-133.
[28]杨跃武,肖阁敏,招柏明,等.壳脂胶囊治疗非酒精性脂肪肝的随机对照研究[J].实用医学杂志,2014(4):638-640.
[29]付喜花,袁冬生,黄明寿.壳脂胶囊治疗非酒精性脂肪性肝病临床疗效及疲劳特征观察[J].新中医,2014(7):69-71.
[30]常彬霞,邹正升,李保森,等.2015年日本胃肠病学会非酒精性脂肪性肝病/非酒精性脂肪性肝炎的循证医学临床治疗指南[J].临床肝胆病杂志,2015,31(7):1027-1030.
[31]张清,杨永和,罗和平.针灸结合运动康复训练对非酒精性脂肪肝疗效的临床研究[J].中华肿瘤防治杂志,2016(s2):178-179.
[32]卢利仁,黄振.超声评价穴位埋线配合药物治疗非酒精性脂肪性肝病的疗效[J].上海针灸杂志,2014,33(11):1016-1017.
[33]林坤,杨建全.快走结合太极拳锻炼对老年非酒精性脂肪性肝病合并高血压患者的影响[J].中国老年学杂志,2016,36(11):2700-2702.
[2]Diehl A M,Day C.Cause,Pathogenesis,and Treatment of Nonalcoholic Steatohepatitis[J].N Engl J Med,2017,377(21):2063-2072.
[3]Tziomalos K,Athyros VG,Paschos P,et al.Nonalcoholic fatty liver disease and statins[J].Metabolism:clinical and experimental,2015,64(10):1215-1223.
[4]Charlton MR,Burns JM,Pedersen RA,et al.Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States[J].Gastroenterology,2011,141(4):1249-1253.
[5]Takahashi Y,Sugimoto K,Inui H,et al.Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis[J].World Journal of Gastroenterology,2015,21(13):3777-3785.
[6]赵文霞,张丽慧.非酒精性脂肪性肝病应归属“肝癖”论[J].河南中医,2015,35(8):1820-1822.
[7]崔健娇,赵文霞.赵文霞教授治疗非酒精性脂肪性肝病经验总结[J].中国中医药现代远程教育,2014(22):26-27.
[8]任鹏,卢秉久.卢秉久气血兼顾-阴阳同调辨治脂肪肝[J].实用中医内科杂志,2016,30(7):3-4.
[9]谷诺诺,王凯星,杨倩,等.杨倩治疗非酒精性脂肪肝经验[J].中华中医药杂志,2017(10):4509-4511.
[10]薛建华,张银华,杜秀萍,等.陈建杰教授从脾论治非酒精性脂肪肝经验[J].河北中医,2017(12):1765-1767.
[11]季光,郑培永.中医药治疗脂肪肝的研究述评[J].中华中医药学刊,2004,22(1):87-88.
[12]车军勇,方南元,何晶,等.邵铭论治非酒精性脂肪肝经验撷粹[J].中医药临床杂志,2017(11):1811-1813.
[13]俞芹,谢兆丰,薛博瑜.谢兆丰教授治疗非酒精性脂肪肝经验[J].四川中医,2016(7):23-24.
[14]罗伟,马建伟,董静,等.非酒精性脂肪肝218例中医体质类型与证型分布研究[J].环球中医药,2014(6):453-455.
[15]刘乐鑫,池晓玲,林姗姗,等.非酒精性脂肪性肝病中医证型与临床指标的相关性[J].河南中医,2017,37(5):820-823.
[16]周爱华.中医辨证治疗酒精性脂肪肝145例临床观察[J].中国民族民间医药,2014(19):70-71.
[17]王唯坚,胡峻.155例非酒精性脂肪肝患者的中医证候学研究[J].首都医科大学学报,2014,35(1):129-131.
[18]尹述平.非酒精性脂肪性肝病的中医证候及用药分析[J].中国处方药,2016,14(3):87-88.
[19]魏华凤,柳涛,邢练军,等.793例脂肪肝患者证候分布规律[J].中西医结合学报,2009,7(5):411-417.
[20]曹福岭.柴胡疏肝散治疗非酒精性脂肪肝的疗效观察[J].光明中医,2015,30(4):746-749.
[21]万斌,商洪涛.健脾疏肝活血方治疗非酒精性脂肪肝的临床疗效观察[J].陕西中医,2016,37(2):135-138.
[22]宋清武,李慧臻.加味苓桂术甘汤治疗非酒精性脂肪性肝病的临床研究[J].四川中医,2013,31(8):60-62.
[23]鲁恒心.消脂清肝汤治疗非酒精性脂肪肝痰湿内阻证临床研究[J].中医学报,2017(12):2477-2480.
[24]刘秀林,付京云,刘丽花,等.柴荷化痰活血方治疗非酒精性脂肪肝50例临床疗效观察[J].北京中医药,2015(7):560-562.
[25]李进,李月翠,胡伟跃,等.自拟降脂护肝方联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的临床研究[J].中华中医药学刊,2015(1):236-239.
[26]王淼,柳涛,魏华凤,等.降脂颗粒联合行为干预治疗痰瘀互结型非酒精性脂肪性肝病的临床研究[J].上海中医药杂志,2010,44(4):11-13,17.
[27]季光,范建高,陈建杰,等.胆宁片治疗非酒精性脂肪性肝病的多中心随机对照临床研究[J].中西医结合学报,2008,6(2):128-133.
[28]杨跃武,肖阁敏,招柏明,等.壳脂胶囊治疗非酒精性脂肪肝的随机对照研究[J].实用医学杂志,2014(4):638-640.
[29]付喜花,袁冬生,黄明寿.壳脂胶囊治疗非酒精性脂肪性肝病临床疗效及疲劳特征观察[J].新中医,2014(7):69-71.
[30]常彬霞,邹正升,李保森,等.2015年日本胃肠病学会非酒精性脂肪性肝病/非酒精性脂肪性肝炎的循证医学临床治疗指南[J].临床肝胆病杂志,2015,31(7):1027-1030.
[31]张清,杨永和,罗和平.针灸结合运动康复训练对非酒精性脂肪肝疗效的临床研究[J].中华肿瘤防治杂志,2016(s2):178-179.
[32]卢利仁,黄振.超声评价穴位埋线配合药物治疗非酒精性脂肪性肝病的疗效[J].上海针灸杂志,2014,33(11):1016-1017.
[33]林坤,杨建全.快走结合太极拳锻炼对老年非酒精性脂肪性肝病合并高血压患者的影响[J].中国老年学杂志,2016,36(11):2700-2702.