疏肝降脂汤联合门冬氨酸-鸟氨酸治疗病毒性肝炎后脂肪肝的临床效果  

Effects of Shugan Jiangzhi decoction combined with L-ornithine-L-aspartate in fatty liver after viral hepatitis

作　　者：张笑丹[1] 苏江卫[2] 梁倞[3] 梁平[4] Xiao-Dan ZHANG;Jiang-Wei SU;Jing LIANG;Ping LIANG(Department of Pharmacy,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Clinical Pharmacological Experiment,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Medical Equipment,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Pharmacy,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北省胸科医院药学部,石家庄050041 [2]河北省胸科医院临床药理试验部,石家庄050041 [3]河北省胸科医院医学装备处,石家庄050041 [4]河北医科大学第四医院药学部,石家庄050011

出　　处：《中国药师》2023年第12期472-479,共8页China Pharmacist

基　　金：河北省中医药管理局科研计划项目(2023310);河北省医学科学研究课题计划(20230877)。

摘　　要：目的探讨中药疏肝降脂汤联合门冬氨酸-鸟氨酸(LOLA)治疗病毒性肝炎后脂肪肝的临床疗效及应用价值。方法纳入2018年10月至2020年10月在河北省胸科医院诊治的病毒性肝炎后脂肪肝患者为研究对象,随机分为对照组和试验组。对照组给予LOLA治疗,试验组在对照组治疗的基础上给予疏肝降脂汤治疗,观察比较两组治疗前后肝功能、血脂及免疫功能变化情况。结果研究共纳入患者144例,对照组和试验组各72例。治疗后试验组总有效率为93.06%,显著高于对照组的79.17%(P<0.05)。治疗后,两组血清中丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素、直接胆红素、谷氨酰转肽酶、总胆固醇、低密度脂蛋白胆固醇、甘油三酯显著降低(P<0.05),且试验组低于对照组(P<0.05)。两组高密度脂蛋白胆固醇值与CD4+T淋巴细胞比例高于治疗前(P<0.05),试验组高于对照组(P<0.05),但CD8+T淋巴细胞比例变化差异无统计学意义(P>0.05)。试验组脂肪肝超声分级优于对照组(P<0.05)。结论疏肝降脂汤联合门冬氨酸-鸟氨酸可改善病毒性肝炎后脂肪肝患者的免疫功能,提高患者肝功能,平衡血脂水平,持续改善患者的预后。Objective To investigate the clinical efficacy and application value of traditional Chinese medicine Shugan Jiangzhi decoction combined with L-ornithine-L-aspartate(LOLA)in the treatment of fatty liver after viral hepatitis.Methods Patients with fatty liver after viral hepatitis who were diagnosed and treated in Hebei Chest Hospital from October 2018 to October 2020 were enrolled and randomly divided into control group and test group.The control group was treated with LOLA,and the test group was treated with Shugan Jiangzhi decoction on the basis of the treatment of the control group,and the changes of liver function,blood lipids and immune function before and after treatment in the two groups were observed and compared.Results A total of 144 patients were included in the study,including 72 patients in the control group and 72 cases in the test group.After treatment,the total effective rate of the test group was 93.06%,which was higher than that of the control group(79.17%)(P<0.05).After treatment,the serum levels of ALT,AST,TBIL,DBIL,GGT,TC,LDL-C and TG in the two groups were significantly decreased(P<0.05),and the test group was lower than that in the control group(P<0.05).The ratio of HDL-C value to CD4+T lymphocytes in the two groups was higher than that before treatment(P<0.05),and the test group was higher than that in the control group(P<0.05),but there was no significant change in the proportion of CD8+T lymphocytes(P>0.05).The ultrasound grade of fatty liver in the test group was better than that in the control group(P<0.05).Conclusion Shugan Jiangzhi decoction combined with LOLA can improve the immune function and the liver function,balance the blood lipid level,and continuously improve the prognosis of patients with fatty liver after viral hepatitis.

关 键 词：脂肪肝 疏肝降脂汤 门冬氨酸-鸟氨酸 病毒性肝炎 

分 类 号：R575.5[医药卫生—消化系统]