调肝理脾法治疗非酒精性脂肪肝的临床队列研究  

Clinical cohort study on non-alcoholic fatty liver disease by regulating liver and spleen

作　　者：周滔[1] 张声生[1] 郁强[1] 

机构地区：[1]首都医科大学附属北京中医医院消化中心,北京100010

出　　处：《北京中医药》2013年第6期403-405,共3页Beijing Journal of Traditional Chinese Medicine

基　　金：首都医学发展科研基金(SF-2009-Ⅱ-09);北京市中医药科技发展资金科技提升专项(KJTS2011_01)

摘　　要：目的观察调肝理脾法治疗非酒精性脂肪肝(NAFLD)的临床疗效。方法采用队列研究方法,将轻、中、重度NAFLD患者分别分为治疗组与对照组,治疗组采用中医调肝理脾法组方治疗,对照组采用水飞蓟宾治疗,2组均以12周为1个疗程。比较治疗前后肝脏脂肪变性程度,血清肝功能指标及中医证候积分。结果按照NAFLD患者肝脏脂肪变性程度分层,治疗后治疗组无脂肪肝42例,轻度85例,中度42例,重度9例;对照组无脂肪肝18例,轻度59例,中度52例,重度28例,2组比较差异有统计学意义(P﹤0.01)。治疗后2组轻、中度NAFLD患者血清肝功能指标ALT、AST、GGT比较,差异均无统计学意义(P>0.05),但2组与治疗前比较差异均有统计学意义(P﹤0.05);治疗组重度NAFLD患者数量与对照组比较,差异有统计学意义(P﹤0.05);治疗组轻度NAFLD患者中医证候积分与对照组比较,差异无统计学意义(P>0.05),但治疗组中、重度NAFLD患者中医证候积分与对照组比较,差异有统计学意义(P﹤0.05)。结论调肝理脾法能有效减轻肝脏脂肪变性,且对重度NAFLD患者肝功能,以及中、重度NAFLD患者中医证候的改善,优于西药治疗。Objective To observe the clinical efficacy on non-alcoholic fatty liver disease（NAFLD） by regulating liver and spleen.Methods A cohort study was conducted with patients of mild,moderate and severe NAFLD,who were divided into a treatment group and a control group respectively.The TCM prescriptions by the method of regulating liver and spleen were applied in the treatment group while silibinin was used in the control group,and 12 weeks were required for one course.The degree of hepatocyte steatosis,serum liver function index and TCM score before and after the treatment were compared.Results According to the degree of hepatocyte steatosis of the NAFLD patients,there were 42 cases of no fatty liver disease,85 cases of mild,42 cases of moderate and 9 cases of severe in the treatment group,while there were 18 cases of no fatty liver disease,59 cases of mild,52 cases of moderate and 28 cases of severe in the control group,with significant difference（P 0.01）.There was insignificant difference in the serum liver function index including ALT,AST and GGT of the mild and the moderate NAFLD patients after the treatment in two groups（P 0.05）,but there was significant difference when compared before the treatment（P 0.05）.There was significant difference in the number of patients with sever NAFLD when comparing the treatment group with the control group（P 0.05）.The TCM score of mild NAFLD in the treatment group showed no difference with that in the control group（P 0.05）,while of moderate and severe NAFLD showed significant difference（P 0.05）.Conclusion The method of regulating liver and spleen could alleviate the hepatocyte steatosis effectively,and it is superior to the Western medicine in improving liver function for patients with severe NAFLD and TCM syndrome for patients with moderate and severe NAFLD.

关 键 词：非酒精性脂肪肝 调肝理脾法 中医治疗 临床疗效 

分 类 号：R259[医药卫生—中西医结合]