自拟中药治疗非酒精性脂肪性肝病患者血清炎症反应指标水平的变化  

Short-term efficacy of herbal medicine in treatm ent of patients with nonalcoholic fatty liver disease

作　　者：张胥磊 杨庆余 韩秋玉 缪鋆鋆[4] 蔡仁诚 马亦旻 Zhang Xu Lei;Yang Qingyu;Han Qiuyu(Department of Infectious disease,People's Hospital,Gaochun 211300,Jiangsu Province,China)

机构地区：[1]南京市高淳人民医院感染病科,211300 [2]南京市高淳人民医院内分泌科,211300 [3]南京市高淳人民医院消化科,211300 [4]南京中医药大学附属江苏省中医院内分泌科

出　　处：《实用肝脏病杂志》2019年第5期660-663,共4页Journal of Practical Hepatology

基　　金：江苏省自然科学基金资助项目(编号：2882781)

摘　　要：目的探讨应用自拟中药辅助治疗非酒精性脂肪性肝病(NAFLD)患者对血清肝损伤、炎症反应和糖脂代谢指标的影响。方法2015年1月~2017年1月诊治的NAFLD患者100例,采用office软件提供的数字表随机将患者分为观察组50例和对照组50例,给予对照组饮食和运动指导,观察组在常规指导的基础上加上自拟中药辅助治疗8 w。常规检测血生化指标,包括空腹血糖(FBG)和空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR),采用ELISA法检测血清总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、丙二醛(MDA)和一氧化氮(NO)水平。结果在治疗结束时,观察组血清ALT、AST和GGT水平分别为(65.1±7.8)U/L、(69.4±8.5)U/L和(95.4±12.3)U/L,显著低于对照组[分别为(94.1±12.3)U/L、(99.3±8.6)U/L和(141.9±15.7)U/L,P<0.05];观察组血清T-AOC、SOD、NO和MDA水平分别为(38.1±5.1)U/ml、(89.1±12.1)μg/ml、(20.1±1.8)mg/L和(8.4±1.1)ng/ml,与对照组的(25.1±3.2)U/ml、(62.1±6.9)μg/ml、(13.1±1.2)mg/L和(12.0±1.2)ng/ml比,差异显著(P<0.05);观察组FBG、HOMA-IR、TC和TG分别为(6.1±1.2)mmol/L、(5.8±0.9)、(2.2±0.1)mmol/L和(0.4±0.1)mmol/L,均显著低于对照组【分别为(6.8±2.3)mmol/L、(6.4±1.9)、(2.7±0.3)mmol/L和(0.7±0.3)mmol/L,P<0.05]。结论应用自拟中药治疗非酒精性脂肪性肝病患者,短期内能降低血清肝酶活性,调节糖脂代谢,其远期作用还有待观察。Objective To observe the short-term efficacy of herbal medicine in treatment of patients with nonalcoholic fatty liver disease(NAFLD).Methods 100 patients with NAFLD were recruited in our hospital between January 2015 and January 2017,and were randomly divided into the observation(n=50)and the control group(n=50)by office-software-generated randomized number.The patients in control were guided for food and exercise modulation,and the patients in observation were given herbal medicine for 8 weeks.Serum total antioxidant capacity(T-AOC),superoxide dismutase(SOD),malondialdehyde(MDA),and nitric oxide(NO)level were detected by ELISA,and serum fasting blood glucose(FBG)as well as fasting insulin(FINS)were assayed to calculate the insulin resistance index(HOMA IR).Results At the end of 8-week treatment,serum ALT,AST and GGT levels in the observation were(65.1±7.8)U/L,(69.4±8.5)U/L and(95.4±12.3)U/L,significantly lower than(94.1±12.3)U/L,(99.3±8.6)U/L and(141.9±15.7)U/L,respectively,in the control(P<0.05);serum T-AOC,SOD,NO and MDA levels were(38.1±5.1)U/ml,(89.1±12.1)μg/ml,(20.1±1.8)mg/L and(8.4±1.1)ng/ml,significantly different as compared to(25.1±3.2)U/ml,(62.1±6.9)μg/ml,(13.1±1.2)mg/L and(12.0±1.2)ng/ml in the control(P<0.05);serum FBG,HOMA-IR,TC and TG levels were(6.1±1.2)mmol/L,(5.8±0.9),(2.2±0.1)mmol/L and(0.4±0.1)mmol/L,significantly lower than(6.8±2.3)mmol/L,(6.4±1.9),(2.7±0.3)mmol/L and(0.7±0.3)mmol/L,respectively,in the control(P<0.05).Conclusion The application of herbal medicine in the treatment of patients with NAFLD might have a short-term efficacy,which could decrease serum liver enzymes and regulate the glycolipid metabolism.

关 键 词：非酒精性脂肪性肝病 中药 氧化应激 治疗 

分 类 号：R57[医药卫生—消化系统]