疏肝健脾、化痰散瘀法治疗他莫昔芬所致脂肪性肝病30例  

Thirty Cases of Fatty Liver Disease due to Tamoxifen Treated with Method of Dispersing Liver and Strengthening Spleen and Dissipating Phlegm and Removing Blood Stasis

作　　者：马大宝 唐武军[2] MA Da-bao;TANG Wu-jun(Yanqing Hospital of Beijing TCM Hospital,Beijing,China,102100;Beijing TCM Hospital Affiliated to Capital Medical University,Beijing,China,100010)

机构地区：[1]北京中医医院延庆医院,北京102100 [2]首都医科大学附属北京中医医院,北京100010

出　　处：《河南中医》2018年第12期1852-1855,共4页Henan Traditional Chinese Medicine

基　　金：北京市科委首都市民健康培育项目(编号:Z151100003915128)

摘　　要：目的:观察疏肝健脾、化痰散瘀法治疗他莫昔芬所致脂肪性肝病的临床疗效。方法:将60例患者随机分为对照组和治疗组,每组各30例。对照组给予多烯磷脂酰胆碱胶囊,治疗组以疏肝健脾、化痰散瘀为治疗大法,给予自拟方剂治疗。观察两组患者的临床疗效,比较两组患者治疗前后中医症状积分,检测两组患者治疗前后肝功能[丙氨酸氨基转移酶(glutamic pyruvic transaminase,ALT)、天门冬氨酸氨基转移酶(aspertate aminotransferase,AST)、谷氨酰胺转肽酶(gammaglutamyl transpeptidase,GGT)、总胆红素(total bilirubin,TBIL)]及血脂水平[胆固醇(Total cholesterol,TC)、三酰甘油(three acyl glycerin,TG)、低密度脂蛋白(low density lipoprotein cholesterol,LDL-C)和高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)]。结果:两组患者治疗4周、治疗8周中医症状评分均低于治疗前,且治疗组低于同期对照组,差异具有统计学意义(P <0. 05)。对照组有效率为53. 3%,治疗组有效率为73. 3%,两组患者临床疗效比较,差异具有统计学意义(P <0. 05)。两组患者治疗前后AST、ALT、GGT、STB无明显改变,差异无统计学意义(P> 0. 05)。两组患者治疗8周TG低于治疗前,且治疗组低于对照组,差异具有统计学意义(P <0. 05)。结论:疏肝健脾、化痰散瘀法能够一定程度上缓解患者临床症状,降低患者TG水平,改善脂肪性肝病严重程度。Objective: To observe the clinical curative effect of method of dispersing liver and strengthening spleen and dissipating phlegm and removing blood stasis on fatty liver disease due to tamoxifen. Methods: Sixty patients were randomly divided into the control group and the treatment group,with 30 cases in each group. The ones in the control group were given Polyene Phosphatidylcholine Capsules,while the ones in the treatment group were given self-made prescription to for dispersing liver and strengthening spleen and dissipating phlegm and removing blood stasis. The clinical efficacies of the two groups were observed,and the scores of TCM symptoms before and after the treatment were compared. The liver functions [glutamic pyruvic transaminase( ALT),aspertate aminotransferase( AST),gamma-glutamyl transpeptidase( GGT),total bilirubin( TBIL) ],and blood lipid levels [total cholesterol( TC),triglycerin( TG),low density lipoprotein cholesterol( LDL-C) and high density lipoprotein cholesterol( HDL-C)( HDLC) ]were measured before and after treatment. Results: The scores of TCM symptoms in the two groups after 4 weeks and 8 weeks of treatment were lower than those before the treatment,and the scores in the treatment group were lower than those in the control group at the same time,the difference was statistically significant( P < 0. 05). The effective rate was 53. 3% in the control group and73. 3% in the treatment group. There was a significant difference between the two groups( P < 0. 05). There were no significant differences in AST,ALT,GGT and STB between the two groups before and after the treatment( P > 0. 05). The TG in the treatment group was lower than that in the control group after 8 weeks of treatment,and the difference was statistically significant( P < 0. 05).Conclusion: Method of dispersing liver and strengthening spleen and dissipating phlegm and removing blood stasis can relieve the clinical symptoms,reduce the level of TG and improve the severity of fatty liver disease to a certain extent.

关 键 词：脂肪性肝病 他莫昔芬 疏肝健脾 化痰散瘀法 多烯磷脂酰胆碱胶囊 

分 类 号：R259.751[医药卫生—中西医结合]