逍遥散联合水飞蓟素胶囊治疗肝郁脾虚证非酒精性脂肪性肝病临床研究  

Clinical Study on Xiaoyao San Prescription Combined with Silymarin Capsules for Non-Alcoholic Fatty Liver Disease with Syndrome of Liver Depression and Spleen Deficiency

作　　者：苏林红[1] 林军[1] 柳侠平 叶小丹[1] 陈剑 SU Linhong;LIN Jun;LIU Xiaping;YE Xiaodan;CHEN Jian(Department of Infectious Hepatology,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou Zhejiang 325000,China)

机构地区：[1]温州市中医院感染肝病科,浙江温州325000

出　　处：《新中医》2024年第7期42-46,共5页New Chinese Medicine

摘　　要：目的:逍遥散联合水飞蓟素胶囊治疗肝郁脾虚证非酒精性脂肪性肝病(NAFLD)的疗效。方法:选取90例肝郁脾虚证NAFLD患者,按随机数字表法分为对照组及治疗组各45例。2组行非药物措施,对照组予以水飞蓟素胶囊口服,治疗组在对照组基础上加逍遥散治疗。2组均连续治疗12周。比较2组临床疗效,比较2组治疗前后肝功能指标[谷草转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转肽酶(GGT)]值、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]值、血清TLR4/NF-κB信号通路相关蛋白水平[血清TOLL样受体4(TLR4)、髓样分化因子88(MyD88)、核转录因子-κB(NF-κB)]、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化。结果:治疗12周后,治疗组临床疗效总有效率为91.11%,对照组为73.33%,2组比较,差异有统计学意义(P<0.05)。治疗12周后,2组AST、ALT、GGT指标值均较治疗前下降(P<0.05),治疗组上述3项指标值均低于对照组(P<0.05)。治疗12周后,2组TC、TG、LDL-C水平均较治疗前下降(P<0.05),HDL-C水平均较治疗前上升(P<0.05);治疗组TC、TG、LDL-C水平均低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。治疗12周后,2组血清TLR4、MyD88、NF-κB、IL-6、TNF-α水平均较治疗前下降(P<0.05),治疗组上述5项水平均低于对照组(P<0.05)。结论:逍遥散联合水飞蓟素胶囊对肝郁脾虚证NAFLD的疗效确切,可有效改善肝功能及血脂状况,调节血清TLR4-NF-κB信号通路,抑制炎症反应。Objective:To observe the curative effect of the therapy of Xiaoyao San Prescription combined with Silymarin Capsules on non-alcoholic fatty liver disease(NAFLD)with syndrome of liver depression and spleen deficiency.Methods:A total of 90 NAFLD patients with syndrome of liver depression and spleen deficiency were selected and divided into the control group and the treatment group according to random number table method,with 45 cases in each group.The two groups were given non-drug measures.The control group was given Silymarin Capsules orally,and the treatment group was additionally given Xiaoyao San Prescription based on the treatment of the control group.Both groups were treated for 12 weeks.The clinical effects in the two groups were compared.The changes of liver function indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT)],blood lipid indexes[total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C),lowdensity lipoprotein(LDL-C)]and relative protein levels of TLR4/NF-κB signaling pathway in serum[serum TOLL-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),nuclear transcription factorκB(NF-κB)],interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)were compared between the two groups before and after treatment.Results:After 12 weeks of treatment,the total effective rate was 91.11%in the treatment group and 73.33%in the control group,the difference being significant(P<0.05).After 12 weeks of treatment,the levels of AST,ALT and GGT in the two groups were decreased when compared with those before treatment(P<0.05),and the above three levels in the treatment group were lower than those in the control group(P<0.05).After 12 weeks of treatment,the levels of TC,TG and LDL-C in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of HDL-C were increased when compared with those before treatment(P<0.05);the levels of TC,TG and LDL-C in the treatment group were lower than those in the control group(P<0.

关 键 词：非酒精性脂肪性肝病 肝郁脾虚证 逍遥散 水飞蓟素胶囊 血清TOLL样受体4 髓样分化因子88 

分 类 号：R575.5[医药卫生—消化系统]