茵芩清肝降脂汤治疗非酒精性脂肪肝临床研究

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英文篇名：Clinical Study of Yinqin Clearing Liver and Lowering Lipid Decoction in Treatment of Nonalcoholic Fatty Liver Disease 作者：翁育才 ; 王高岸 ; 王炜 英文作者：WENG Yucai;WANG Gao'an;WANG Wei;Pharmacy Department,The Second Affiliated Hospital of Hainan Medical University;Traditional Chinese Medicine Department,The Second Affiliated Hospital of Hainan Medical University; 关键词：中医 ; 非酒精性脂肪肝 ; 茵芩清肝降脂汤 英文关键词：Chinese medicine;;nonalcoholic fatty liver;;Yinqin Clearing Liver and Lowering Lipid Decoction 中文刊名：ZYHS 英文刊名：Chinese Archives of Traditional Chinese Medicine 机构：海南医学院第二附属医院药学部;海南医学院第二附属医院中医科; 出版日期：2019-03-10 出版单位：中华中医药学刊 年：2019 期：v.37 基金：海南省卫生厅项目(琼卫2013-01) 语种：中文; 页：ZYHS201903060 页数：4 CN：03 ISSN：21-1546/R 分类号：240-243

摘要

目的:探讨茵芩清肝降脂汤治疗非酒精性脂肪肝的临床效果。方法:选取非酒精性脂肪肝患者88例,按数字表法随机分为对照组43例与观察组45例。予以对照组血脂康口服治疗;观察组则服用茵芩清肝汤进行治疗。对比两组治疗前后血脂、肝功能、炎症因子水平、超声影像学评分变化情况及不良反应。结果:治疗3月后,观察组ALT(67.28±23.01)U/L、AST(63.11±17.05)U/L、GGT(65.13±29.02)U/L、ALP(131.17±26.08)U/L、TBIL(21.11±4.62)mmol/L、DBIL(6.79±2.47)mmol/L、TC(6.42±2.85)mmol/L、TG(2.63±0.87)mmol/L、TNF-α(53.45±23.47)μg/L、IL-6(105.79±28.97)μg/L等指标水平均明显低于对照组ALT(85.13±24.18)U/L、AST(75.16±14.38)U/L、GGT(112.13±23.06)U/L、ALP(155.08±34.09)U/L、TBIL(32.17±4.56)mmol/L、DBIL(9.24±2.85)mmol/L、TC(7.20±2.51)mmol/L、TG(3.08±0.55)mmol/L、TNF-α(78.68±26.97)μg/L、IL-6(154.28±33.96)μg/L等指标水平,且均处于正常范围内,差异有统计学意义(P<0.05);两种治疗方法对轻度、中度脂肪肝改善效果显著,且观察组改善程度明显优于对照组(P<0.05);观察组不良反应发生率(4.44%)明显低于对照组的(18.60%)(P<0.05)。结论:茵芩清肝汤治疗非酒精性脂肪肝临床效果显著,可有效改善患者血脂及肝功能指标,减轻其临床不适症状,安全性更高。
        Objective: To investigate the clinical effect of Yinqin Clearing Liver and Lowering Lipid Decoction on non-alcoholic fatty liver disease. Methods: Eighty-eight cases of nonalcoholic fatty liver disease were randomly divided into 43 cases in the control group and 45 cases in the observation group according to the digital table method. The control group was treated with Xuezhikang orally, while the observation group was treated with Yinqin Clearing Liver and Lowering Lipid Decoction. The changes of blood lipid, liver function, inflammatory factors, ultrasonic imaging scores and adverse reactions were compared between two groups before and after treatment. Results: After 3 months treatment, the observation group's ALT(67.28±23.01) U/L, AST(63.11±17.05) U/L, GGT(65.13±29.02) U/L, ALP(131.17±26.08) U/L, TBIL(21.11±4.62) mmol/L, DBIL(6.79±2.47) mmol/L, TC(6.42±2.85) mmol/L, TG(2.63±0.87) mmol/L, TNF-α(53.45±23.47)μg/L and IL-6(105.79±28.97) μg/L were significantly lower than the control group's ALT(85.13±24.18) U/L, AST(75.16±14.38) U/L, GGT(112.13±23.06) U/L, ALP(155.08±34.09) U/L, TBIL(32.17±4.56) mmol/L, DBIL(9.24±2.85) μg/L, TC(7.20±2.51) mmol/L, TG(3.08±0.55) mmol/L, TNF-α(78.68±26.97) μg/L, IL-6(154.28±33.96) μg/L, and all were in the normal range, and the difference was statistically significant(P<0.05). The effect of two treatments on mild and moderate fatty liver was significant, and the improvement of the observation group was obviously better than that of the control group(P<0.05). The incidence of adverse reactions in the observation group(4.44%) was significantly lower than that in the control group(18.60%)(P<0.05). Conclusion: Yinqin Clearing Liver and Lowering Lipid Decoction is effective in the treatment of nonalcoholic fatty liver. It can effectively improve the blood lipid and liver function of the patients, reduce the clinical discomfort symptoms and have higher safety.

引文

[1] 洪慧闻,赵晓威,张思淼,等.当飞利肝宁胶囊加中药茶饮治疗非酒精性脂肪肝肝郁脾虚、湿热蕴结证37例临床观察[J].中医杂志,2018,59(3):227-230.
    [2] 周烨威,王继海,郑井平,等.活血降脂方治疗非酒精性脂肪肝的CT定量疗效评价[J].现代中西医结合杂志,2018,27(9):975-977.
    [3] Vecchione G,Grasselli E,Voci A,et al. Silybin counteracts lipid excess and oxidative stress in cultured steatotic hepatic cells[J].World J Gastroenterol,2016,22(26):6016-6026.
    [4] 潘雨亭,许方圆,于希忠,等.中药活性成分治疗非酒精性脂肪肝作用靶点的研究进展[J].中国中药杂志,2017,42(6):1109-1112.
    [5] 中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗和指南[S].中华肝病杂志,2006,14(3):161-163.
    [6] Buzzetti E,Pinzani M,Tsochatzis EA,et al. The multiple-hit pathogenesis of non-alcoholic fatty liver disease(NAFLD)[J]. Metabolism,2016,65(8):1038-1048.
    [7] 董艳敏,陈亚楠,李美锋,等.五味子乙素对非酒精性脂肪肝病的治疗效果[J].广东医学,2016,37(3):349-351.
    [8] 牛海艳,李海,丁玉平.非酒精性脂肪性肝病的治疗进展[J].临床肝胆病杂志,2018,34(2):433-437.
    [9] Abenavoli L,Milic N,Di Renzo L,et al. Metabolic aspects of adult patients with nonalcoholic fatty liver disease[J].World J Gastroenterol,2016,22(31):7006-7016.
    [10] 董艳敏,李美锋,陈亚楠,等.中药治疗非酒精性脂肪肝病研究进展[J].现代生物医学进展,2016,16(15):2976-2979.
    [11] 徐中菊,王慧,顾婷婷,等.丹芍疏肝颗粒对不同中医证型非酒精性脂肪肝临床疗效研究[J].辽宁中医杂志,2016,43(4):771-773.
    [12] 黄欣,王海洋,孙玉英,等.杨震教授应用清肝化郁法治疗非酒精性脂肪肝2则[J].陕西中医,2016,37(1):119.
    [13] 王珏云,杨高松,张显燕.化浊解毒中药联合利拉鲁肽治疗2型糖尿病合并非酒精性脂肪肝疗效及对血脂、肝功能的影响[J].现代中西医结合杂志,2017,26(22):2425-2428.
    [14] 朱明清,江云,孙学华,等.中药治疗非酒精性脂肪性肝病研究进展[J].辽宁中医药大学学报,2017,19(8):93-96.
    [15] Lonardo A,Byrne CD,Caldwell SH,et al. Global epidemiology of nonalcoholic fatty liver disease:meta-analytic assessment of prevalence incidence and outcomes[J].Hepatology,2016,64(4):1388-1389.
    [16] 郭一,李军祥,韩海啸.近五年中医药治疗非酒精性脂肪性肝病研究进展[J].中医药导报,2017,23(22):100-102.
    [17] 戴冰清,张明香.中西医结合治疗非酒精性脂肪肝病研究概况[J].辽宁中医药大学学报,2017,19(11):139-142.
    [18] 陶杨,左玉江,王东宁,等.速效降脂舒肝汤治疗非酒精性脂肪肝临床研究[J].中医学报,2017,32(3):444-448.
    [19] Byrne CD.NAFLD A multisystem disease[J].Journal ofhepatology,2015,62(1):47-64.
    [20] 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,2017,32(12):2477-2480.
    [21] 贺晓芳,邓力军,季菲.疏肝清热祛湿法治疗非酒精性脂肪性肝病的临床观察[J].中国中西医结合消化杂志,2017,25(2):85-88.
    [22] 周雨,张智伟,王京奇.从“二次打击”学说探讨中药防治非酒精性脂肪肝的研究进展[J].中医药导报,2017,23(18):109-111.