还原型谷胱甘肽联合护肝清脂片治疗非酒精性脂肪性肝病患者疗效研究  

Combination therapy of reduced glutathione and herbal medicine compound,Hugan Qingzhi tablet in treatment of patients with non-alcoholic fatty liver diseases

作　　者：王卓雅[1] 吴洋鹏[2] 黄益桃 Wang Zhuoya;Wu Yangpeng;Huang Yitao(Medical Education Office for Post-graduates,First Affiliated Hospital,Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan Province,China)

机构地区：[1]湖南中医药大学第一附属医院毕业后医学教育办公室,长沙市410007 [2]湖南中医药大学第一附属医院内镜中心,长沙市410007

出　　处：《实用肝脏病杂志》2023年第6期823-826,共4页Journal of Practical Hepatology

基　　金：湖南省卫生健康委科研课题项目(编号:20191225)。

摘　　要：目的探讨应用还原型谷胱甘肽联合护肝清脂片治疗非酒精性脂肪性肝病(NAFLD)患者的疗效。方法2020年2月~2022年2月我院诊治的61例NAFLD患者,被随机分为对照组30例和观察组31例,分别给予还原型谷胱甘肽治疗或在此基础上联合护肝清脂片治疗6个月。依据文献评估中医症状评分,采用ELISA法检测肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、IL-8、超敏C反应蛋白(hs-CRP)、丝氨酸蛋白酶抑制剂(vaspin)、可溶性白细胞分化抗原163(sCD163)、成纤维细胞生长因子-21(FGF21)、纤溶酶原激活物抑制剂-1(PAI-1)和脂联素(APN)水平。结果在治疗6个月末,观察组神疲乏力、腹胀满、肝区不适、粪便不畅、尿黄、形体偏胖、面色萎黄和口苦口淡评分分别为(0.6±0.1)、(0.9±0.1)、(0.8±0.1)、(0.6±0.1)、(0.8±0.1)、(0.8±0.1)、(0.7±0.1)和(1.2±0.2),均显著低于对照组【分别为(1.2±0.1)、(1.4±0.2)、(1.6±0.2)、(1.1±0.1)、(1.4±0.2)、(1.6±0.2)、(1.1±0.2)和(1.9±0.3),P<0.05】;观察组血清TNF-α、IL-6、IL-8和hs-CRP水平分别为(20.3±4.1)ng/L、(22.9±3.4)mg/L、(132.9±16.6)ng/L和(12.5±2.1)mg/L,均显著低于对照组【分别为(27.9±3.6)ng/L、(27.5±3.1)mg/L、(167.5±18.2)ng/L和(16.5±2.7)mg/L,P<0.05】;观察组血清TC、TG和LDL-C水平分别为(4.2±0.4)mmol/L、(1.5±0.2)mmol/L和(2.3±0.4)mmol/L,均显著低于对照组【分别为(6.3±0.5)mmol/L、(2.9±0.3)mmol/L和(3.1±0.4)mmol/L,P<0.05】;观察组血清vaspin、PAI-1、FGF21水平分别为(1.1±0.2)μg/L、(8.2±1.6)ng/mL和(143.5±16.8)pg/mL,均显著低于对照组【分别为(1.5±0.2)μg/L、(10.4±2.3)ng/mL和(181.6±19.7)pg/mL,P<0.05】,而血清APN和sCD163水平分别为(15.7±2.4)μg/mL和(76.8±9.1)ng/mL,显著高于对照组【分别为(12.1±3.5)μg/mL和(62.3±7.4)ng/mL,P<0.05】。结论应用还原型谷胱甘肽联合护肝清脂片治疗NAFLF患者可显著改善中医症状,降低血脂和炎症因子水平,需要进一步临床验证。Objective The aim of this study was to investigate the combination therapy of reduced glutathione and herbal medicine compound,Hugan Qingzhi tablet in treatment of patients with non-alcoholic fatty liver diseases(NAFLD).Methods 61 patients with NAFLD were admitted to our hospital between February 2020 and February 2022,and were randomly divided into control(n=30)and observation group(n=31),receiving reduced glutathione or reduced glutathione and herbal medicine compound,Hugan Qingzhi tablets therapy for six months.The TCM symptoms were evaluated based on Chinese literature,and serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8,high sensitivity C-reactive protein(hs-CRP),serine protease inhibitor(vaspin),soluble leukocyte differentiation antigen 163(sCD163),fibroblast growth factor-21(FGF21),plasminogen activator inhibitor-1(PAI-1)and adiponectin(APN)levels were detected by ELISA.Results At the end of six month treatment,the mental fatigue,abdominal distension,right epigastric region discomfort,unsmooth defecation,dark urine,overweight,yallow complexion and tastelessness scores in observation group were(0.6±0.1),(0.9±0.1),(0.8±0.1),(0.6±0.1),(0.8±0.1),(0.8±0.1),(0.7±0.1)and(1.2±0.2),significantly lower than[(1.2±0.1),(1.4±0.2),(1.6±0.2),(1.1±0.1),(1.4±0.2),(1.6±0.2),(1.1±0.2)and(1.9±0.3),P<0.05]in the control;serum TNF-α,IL-6,IL-8 and hs-CRP levels(20.3±4.1)ng/L,(22.9±3.4)mg/L,(132.9±16.6)ng/L and(12.5±2.1)mg/L,all much lower than[(27.9±3.6)ng/L,(27.5±3.1)mg/L,(167.5±18.2)ng/L and(16.5±2.7)mg/L,P<0.05]in the control;plasma total cholesterol,triglyceride and low-density lipoprotein cholesterol levels were(4.2±0.4)mmol/L,(1.5±0.2)mmol/L and(2.3±0.4)mmol/L,much lower than[(6.3±0.5)mmol/L,(2.9±0.3)mmol/L and(3.1±0.4)mmol/L,P<0.05]in the control;serum vaspin,PAI-1 and FGF21 levels sere(1.1±0.2)μg/L,(8.2±1.6)ng/mL and(143.5±16.8)pg/mL,much lower than[(1.5±0.2)μg/L,(10.4±2.3)ng/mL and(181.6±19.7)pg/mL,P<0.05],while serum APN and sCD163 levels were(15.7±2.4)μg/mL and(7

关 键 词：非酒精性脂肪性肝病 还原型谷胱甘肽 护肝清脂片 成纤维细胞生长因子-21 脂联素 治疗 

分 类 号：R575.5[医药卫生—消化系统]