消脂清肝方辨证加减治疗代谢相关脂肪性肝病的临床观察  

Clinical Observation on the Treatment of Metabolic-associated Fatty Liver Disease with Modified Xiaozhi Qinggan Formula Based on Syndrome Differentiation

作　　者：李偲 卢秉久[2] 于澜 郑佳连[2] 齐兆东 LI Cai;LU Bingjiu;YU Lan;ZHENG Jialian;QI Zhaodong(Department of Traditional Chinese Medicine,Liaoning University of Traditional Chinese Medicine,Shenyang 110031,China;Department of Hepatology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;Department of Pediatrics,Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,China)

机构地区：[1]辽宁中医药大学中医系,沈阳110031 [2]辽宁中医药大学附属医院肝病科,沈阳110032 [3]辽宁中医药大学附属第二医院儿科,沈阳110034

出　　处：《世界中医药》2023年第20期2933-2936,共4页World Chinese Medicine

基　　金：辽宁省教育厅科学技术研究项目(L202015)。

摘　　要：目的:探究消脂清肝方辨证加减对代谢相关脂肪性肝病(MAFLD)患者脂代谢、抗氧化能力及肝纤维化的影响。方法:选取2020年6月至2023年2月辽宁中医药大学附属医院收治的MAFLD患者85例作为研究对象,按照随机数字表法随机为对照组(n=42)和观察组(n=43)。对照组饮食控制和运动指导治疗,观察组在对照组基础给予消脂清肝方辨证加减治疗,2组均连续治疗1个月。比较2组患者临床疗效、中医证候积分、脂代谢、抗氧化能力和肝纤维化指标。结果:观察组临床总有效率为90.70%,较对照组的71.43%显著提高(P>0.05);与治疗前比较,2组患者治疗后各项中医证候积分均显著下降,观察组较对照组更明显(P<0.05);三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、肝脏硬度值和脂肪衰减值均下降,高密度脂蛋白胆固醇(HDL-C)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均明显升高,且观察组优于对照组(P<0.05)。结论:MAFLD患者应用消脂清肝方辨证加减治疗,疗效显著,可有效改善脂代谢指标,提高抗氧化能力,减轻肝纤维化程度。Objective:To investigate the effect of modified Xiaozhi Qinggan Formula based on syndrome differentiation on lipid metabolism,antioxidant capacity and hepatic fibrosis in patients with metabolic-associated fatty liver disease(MAFLD).Methods:A total of 85 patients with MAFLD admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from June 2020 to February 2023 were assigned to the control group(n=42) and the observation group(n=43) by random number table method.The control group was given dietary control and exercise guidance,while the observation group was treated with modified Xiaozhi Qinggan Formula based on syndrome differentiation in addition to the basic treatment of the control group.Both groups underwent continuous treatment for one month.Clinical efficacy,traditional Chinese medicine(TCM) syndrome scores,lipid metabolism,antioxidant capacity and hepatic fibrosis indicators were compared between the two groups.Results:The total clinical effective rate in the observation group(90.70%) was significantly higher than that in the control group(71.43%)(P<0.05).Compared with before treatment,TCM syndrome scores in both groups significantly decreased,with a more significant decrease in the observation group compared to the control group(P<0.05).After treatment,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),liver hardness value and fat attenuation value all decreased,while high-density lipoprotein cholesterol(HDL-C),superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) levels significantly increased in both groups,with the observation group showing better results than the control group(P<0.05).Conclusion:Modified Xiaozhi Qinggan Formula based on syndrome differentiation is therapeutically effective in treating MAFLD,which can effectively improve lipid metabolism indicators and antioxidant capacity,and alleviate hepatic fibrosis.

关 键 词：代谢相关脂肪性肝病 消脂清肝方 辨证加减 脂代谢 抗氧化能力 肝纤维化 中医证候积分 临床疗效 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R285.6[医药卫生—基础医学]