健脾化湿方治疗非酒精性脂肪肝合并慢性腹泻  

Treatment of Non-Alcoholic Fatty Liver Disease with Chronic Diarrhea with Jianpi Huashi Prescription

作　　者：刘晓彦[1] 马素平[1] 聂山文[2] 马庆亮 尚东方[1] 赵文霞[1] LIU Xiaoyan;MA Suping;NIE Shanwen;MA Qingliang;SHANG Dongfang;ZHAO Wenxia(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The Second Affiliated Hospital of Henan University of Chinese Medicine/Henan Provincial Hospital of Chinese Medicine,Zhengzhou Henan China 450002)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2022年第10期2225-2229,共5页Acta Chinese Medicine

基　　金：国家中医临床基地专项课题基金资助项目(2019JDZX2012);河南省中医药科学研究专项课题基金资助项目(2017ZY2098,2019ZY2109);河南省中医药传承与创新人才工程第二批拔尖人才资助项目。

摘　　要：目的:观察健脾化湿方治疗非酒精性脂肪肝合并慢性腹泻患者的临床疗效。方法:90例非酒精性脂肪肝合并慢性腹泻患者按照随机数字表法分为试验组46例和对照组44例。试验组给予健脾化湿方颗粒,对照组给予双歧杆菌四联活菌片,两组疗程均为4周。治疗后,比较两组患者临床疗效,肠道菌群杆/球比,谷丙转氨酶(alanine transaminase, ALT)、三酰甘油(triglyceride, TG)、游离脂肪酸(free fatty acid, FFA)、肝脏瞬时弹性受控衰减参数(controlled attenuation parameter, CAP)、体质量指数(body mass index, BMI)、腰围等。结果:治疗后,试验组有效率为91.3%(42/46),对照组有效率为86.4%(38/44),两组有效率比较,差异有统计学意义(P<0.05)。治疗后,两组患者粪便杆/球比显著升高,每日大便次数显著降低(P<0.05);且试验组每日大便次数显著少于对照组(P<0.05)。治疗后,两组患者ALT、TG、FFA水平均显著降低(P<0.05),且试验组低于同期对照组(P<0.05)。治疗后,两组患者CAP、腰围、BMI均显著下降(P<0.05),且试验组CAP、腰围显著低于同期对照组(P<0.05)。结论:健脾化湿方治疗非酒精性脂肪肝合并慢性腹泻疗效显著,可改善患者临床症状、肝脂肪变程度,调节肠道菌群杆/球比水平。Objective: To observe the clinical efficacy of Jianpi Huashi Prescription in the treatment of patients with non-alcoholic fatty liver disease(NAFLD) complicated with chronic diarrhea.Methods: 90 patients with NAFLD complicated with chronic diarrhea were randomly divided into the experimental group of 46 cases and the control group of 44 cases according to the random number table method.The experimental group was given Jianpi Huashi Granules, and the control group was given Bifidobacterium quadruple viable tablets.The treatment course of both groups was 4 weeks.After treatment, the clinical efficacy, bacillus/coccus ratio of intestinal flora, alanine transaminase(ALT),triglyceride(TG),free fatty acid(FFA),liver transient Elasticity controlled attenuation parameter(CAP),body mass index(BMI),waist circumference, etc.were compared between the two groups.Results: After treatment, the effective rate was 91.3%(42/46) in the experimental group and 86.4%(38/44) in the control group, and the difference was statistically significant(P<0.05).After treatment, the ratio of fecal rods/balls in the two groups was significantly increased, and the daily stool frequency was significantly decreased(P<0.05).And the daily stool frequency in the experimental group was significantly less than that in the control group(P<0.05).After treatment, the levels of ALT,TG,and FFA in the two groups were significantly decreased(P<0.05),and the experimental group was lower than the control group during the same period(P<0.05).After treatment, the CAP,waist circumference, and BMI of the two groups were significantly decreased(P<0.05),and the CAP and waist circumference of the experimental group were significantly lower than those of the control group(P<0.05).Conclusion: Jianpi Huashi Prescription has a significant curative effect in the treatment of NAFLD complicated with chronic diarrhea, can improve the clinical symptoms, the degree of hepatic steatosis, and adjust the bacillus/coccus ratio of intestinal flora.

关 键 词：非酒精性脂肪肝 慢性腹泻 健脾化湿方 肠道菌群杆/球比 

分 类 号：R259.752[医药卫生—中西医结合]