清化方治疗湿热蕴结型非酒精性脂肪性肝病临床研究  

Clinical Study on Qinghua Formula(清化方)in Treatment of Non-Alcoholic Fatty Liver Disease with Dampness-Heat Accumulation Syndrome

作　　者：李运东[1] 王怡群 王德鹤 吴眉[1] 李莹[2] LI Yundong;WANG Yiqun;WANG Dehe;WU Mei;LI Ying(Department of Hepatology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Infectious Disease,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属曙光医院肝病科,上海201203 [2]上海中医药大学附属龙华医院感染科,上海200032

出　　处：《山东中医杂志》2024年第6期578-584,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：上海市中医药高层次人才引领计划项目(批文号:沪卫中发〔2021〕2号);上海中医药大学附属龙华医院“龙医科技创新培育计划”项目(编号:YD202209)。

摘　　要：目的:观察清化方治疗非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:将66例NAFLD患者按随机数字表法分为对照组和观察组各33例,因研究过程中有脱落,对照组、观察组最终完成研究的患者例数分别为30例、32例。两组均给予生活方式干预,观察组在此基础上给予清化方干预。两组均以12周为1个疗程,共治疗2个疗程。观察两组患者干预前、干预12周、干预24周的受控衰减参数(CAP)、血脂代谢指标、肝功能指标、血糖代谢指标及体质量指数(BMI),并评价干预24周的腹部B超疗效和中医证候疗效。结果:①干预12周、24周后,两组CAP较干预前均降低(P<0.05);干预24周后,两组CAP较干预12周均降低(P<0.05)。干预12周、24周后,观察组CAP均低于对照组(P<0.05)。②干预24周后,观察组血清TG水平较干预前及干预12周降低(P<0.05),且低于同时点对照组(P<0.05)。③干预24周后,观察组空腹胰岛素(FINS)水平和HOMA胰岛素抵抗(HOMA-IR)指数较干预前降低(P<0.05),且低于同时点对照组(P<0.05)。④干预12周、24周后,两组BMI较干预前均降低(P<0.05)。干预24周后,观察组BMI较干预12周降低(P<0.05),且低于同时点对照组(P<0.05)。⑤干预24周后,观察组腹部B超疗效和中医证候疗效均优于对照组(P<0.05)。结论:清化方联合生活方式干预有助于改善NAFLD患者肝脏脂肪沉积,并可改善患者中医证候,疗效确切。Objective:To observe the clinical efficacy of Qinghua Formula(清化方)in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods:A total of 66 patients with NAFLD were divided into a control group and an observation group by the random number table method,with 33 cases in each group.Due to dropouts during the study,there were ultimately 30 cases in the control group and 32 cases in the observation group.Both groups received lifestyle interventions,while the observation group also received intervention with Qinghua Formula.In both groups,each course of treatment lasted for 12 weeks,and a total of two courses were administered.Controlled attenuation parameter(CAP),blood lipid metabolism indicators,liver function indicators,blood glucose metabolism indicators,and body mass index(BMI)were observed before intervention,after 12 weeks of intervention,and after 24 weeks of intervention in both groups.The clinical curative efficacy on abdominal B-ultrasound and traditional Chinese medicine(TCM)syndrome after 24 weeks of intervention were evaluated.Results:①After 12 weeks and 24 weeks of intervention,the level of CAP was decreased compared to that before intervention in both groups(P<0.05).After 24 weeks of intervention,the level of CAP was lower than that after 12 weeks of intervention in both groups(P<0.05).After 12 weeks and 24 weeks of intervention,the level of CAP in the observation group was lower than that in the control group(P<0.05).②After 24 weeks of intervention,the level of TG in the observation group was lower than that before intervention and that after 12 weeks of intervention(P<0.05),and it was also lower than that in the control group at the same time point(P<0.05).③After 24 weeks of intervention,the level of fasting insulin(FINS)and the result of homeostasis model assessment of insulin resistance(HOMA-IR)in the observation group were lower than those before intervention,and they were also lower than those in the control group at the same time point(P<0.05).④After 12 weeks and 24 weeks

关 键 词：非酒精性脂肪性肝病 清化方 湿热 糖脂代谢 受控衰减参数 中医证候 

分 类 号：R256.43[医药卫生—中医内科学]