中西医结合治疗非酒精性脂肪肝的临床观察  

CLINICAL OBSERVETION ON NONALCOHOLIC FATTY LIVER TREATED BY COMBINED TRADITIONAL CHINESE MEDICINE AND WESTERN MEDICINE

作　　者：白洁[1] 邓彩云[1] 史美媛[1] 闫素珍[1] 孟素荣[1] 白云驰[1] 

机构地区：[1]华北煤炭医学院开滦医院,河北省唐山市063000

出　　处：《中国煤炭工业医学杂志》2005年第8期910-912,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的采用中西医结合方法治疗非酒精性脂肪肝,观察临床疗效。方法选择90例非酒精性脂肪肝患者,随机分为中药汤剂组(Ⅰ组)、中药汤剂加熊去氧胆酸组(Ⅱ组)和护肝片组(Ⅲ组)。Ⅰ组予自拟中药方剂“保肝降脂汤”口服,Ⅱ组予同样方剂加熊去氧胆酸口服,Ⅲ组予护肝片口服,疗程均为3个月。于治疗前后检测患者的肝功能、血脂,并行肝脏B超、CT影像学检查。结果治疗后,Ⅱ组肝功能血清酶水平明显低于另二组,差异有统计学意义(P<0.01),Ⅰ组与Ⅲ组比较,各血清酶水平相近,差异无统计学意义(P>0.05);Ⅱ组、Ⅰ组的总胆固醇(TC)、甘油三酯(TG)较治疗前均明显下降,差异有统计学意义(P<0.01),Ⅱ组下降较Ⅰ组更为显著,二组比较差异有统计学意义(P<0.01);影像学的改善为Ⅱ组优于Ⅰ组,Ⅰ组优于Ⅲ组,组间比较差异有统计学意义(P<0.05);三组治疗方法的综合疗效显示,Ⅱ组的治愈率和总有效率最高,Ⅰ组次之,Ⅲ组最低,组间比较差异有统计学意义(P<0.05或P<0.01)。结论“保肝降脂汤”治疗非酒精性脂肪肝,能有效地消除或减轻脂肪肝;如与熊去氧胆酸合用,则更能显著地降低肝功能血清酶和血脂水平,肝脏的影像学改变也更加明显减轻,从而能进一步提高综合疗效。Objective To investigate the clinical effect of TCM and western medicine combined treatment on nonalcoholic fatty liver (NAFL). Methods 90 patients with NAFL were randomly divided into three groups: traditional Chinese medicine group (C group ), traditional Chinese medicine and ursodeoxycholic acid group (C+U group) and Hugan tablets group (H group). The C group received “Protect liver and reduce fat scope”. The C+U group received ursodeoxycholic acid (UDCA) besides Protect liver and reduced fat scope, while the H group received Hugan tablet. The therapeutic course was 3 months. The changes of liver function, blood lipid, ultrasonic wave (UW) and computer tomography (CT) of liver were observed. Results Serum enzyme level of C+U group was significantly lower than those groups after treatment (P<0.01) and that of C group was similar to that of H group (P>0.05). Serum total cholesterol (TC) and triglyceride (TG) levels of C+U group and C group decreased significantly after treatment (P<0.01) and those of C+U group decreased more significantly (P<0.01). The improvement of image appearance in C+U group was better than those in C group and H group (P<0.05). The cure rate and total effective rate in C+U group were highest and those in H group were lowest (P<0.05 or P<0.01). Conclusion “Protect live and reduce fat soup” may cure or ameliorate fatty liver. The combinative therapy of UDCA and the recipe may decrease the levels of serum enzyme and lipid more effectively while the changes of image appearance are also relieved significantly. The results suggest that the combinative therapy may improve total effect greatly on NAFL patients.

关 键 词：脂肪肝 中西医结合治疗 熊去氧胆酸 

分 类 号：R575.5[医药卫生—消化系统]