小陷胸汤加味治疗湿热蕴结型非酒精性脂肪性肝病45例  

Forty-Five Cases of Nonalcoholic Fatty Liver Disease with Syndrome of Dampness-Heat Accumulation Treated with Supplemented Minor Chest-Draining Decoction

作　　者：夏凯 谢晓彤 王笑梅[1] 肖家军 XIA Kai;XIE Xiao-tong;WANG Xiao-mei;XIAO Jia-jun(Bengbu Hospital of TCM,Bengbu,Anhui,China,233080)

机构地区：[1]蚌埠市中医医院,安徽蚌埠233080

出　　处：《河南中医》2020年第9期1332-1335,共4页Henan Traditional Chinese Medicine

基　　金：蚌埠市中医医院科学研究项目(BBTCM2018013)。

摘　　要：目的:观察小陷胸汤加味治疗湿热蕴结型非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的临床疗效。方法:将确诊的90例湿热蕴结型NAFLD患者按照随机数字表法分为治疗组和对照组,每组各45例。对照组口服多烯磷脂酰胆碱胶囊治疗,治疗组在对照组的基础上加服小陷胸汤加味治疗。比较两组患者的临床疗效,检测两组患者治疗前后肝功能[丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、谷氨酰转肽酶(glutamyl transpeptidase,GGT)]、血脂[总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL-C)、高密度脂蛋白(high density lipoprotein,HDL-C)、三酰甘油(triglyceride,TG)]、空腹血糖(fasting blood glucose,FBG)及钙卫蛋白(fecal calprotectin,FC)含量。结果:两组患者治疗后病情严重程度低于本组治疗前,且治疗组治疗后无症状及轻度患者多于对照组治疗后,差异具有统计学意义(P<0.05)。对照组有效率为42.2%,治疗组有效率为64.4%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后AST、ALT、GGT及FC低于本组治疗前,治疗后ALT、FC低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后TG、TC低于本组治疗前,且治疗组治疗后低于对照组治疗后,两组患者治疗后HDL-L高于本组治疗前,且治疗组治疗后高于对照组治疗后,差异均有统计学意义(P<0.05)。结论:小陷胸汤加味治疗NAFLD,可减轻患者脂肪肝严重程度,降低胆固醇水平,其作用机制可能与减轻肠道炎症水平有关。Objective:To observe the clinical curative effect of Supplemented Minor Chest-Draining Decoction on nonalcoholic fatty liver disease(NAFLD)with syndrome of dampness-heat accumulation.Methods:A total of 90 cases of NAFLD with syndrome of dampness-heat accumulation were divided into the treatment group and the control group according to random number table method,with 45 cases in each group.The control group was treated with polyene phosphatidylcholine capsules,and the treatment group was treated with Supplemented Minor Chest-Draining Decoction on the basis of the control group.The clinical efficacies were compared between the two groups.The levels of liver functions including alanine aminotransferase(ALT),aspartate aminotransferase(AST),and Glutamyl transpeptidase(GGT),blood fat including total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),and triglyceride(TG),and fasting blood sugar(FPG)and the contents of calcium calprotectin(FC)before and after the treatment were measured.Results:After the treatment,the severity of the disease in the two groups was lower than that of the same group before the treatment,and the number of asymptomatic and mild patients in the treatment group was more than that in the control group after the treatment,and the difference was statistically significant(P<0.05).The effective rate of the control group was 42.2%,and that of the treatment group was 64.4%.The difference was statistically significant(P<0.05).After the treatment,AST,ALT,GGT and FC of the two groups were lower than those of the same group before the treatment,and ALT and FC of the treatment group after the treatment were lower than those of the control group after treatment,and all the differences were statistically significant(P<0.05).After the treatment,TG and TC in the two groups were lower than those of the same group before the treatment,and the above two indexes in the treatment group were lower than those in the control group after the treatment.After treatment,HDL-L of the two groups

关 键 词：非酒精性脂肪性肝病 小陷胸汤加味 湿热蕴结证 《伤寒论》 张仲景 

分 类 号：R259.755[医药卫生—中西医结合]