降脂方加减联合消胀包治疗痰热型非酒精性脂肪性肝炎的临床效果观察及对肝脂代谢的影响  

Clinical efficacy observation on the treatment of phlegm-heat non-alcoholic fatty liver disease with modified Jiangzhi decoction combined with Xiaozhang bag and its influence on liver lipid metabolism

作　　者：曾滨 王龙宗 周婉迎 林珊瑜 ZENG Bin;WANG Longzong;ZHOU Wanying;LIN Shanyu(Department of Spleen and Stomach Diseases,Jinjiang Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine,Fujian,Jinjiang 362200,China)

机构地区：[1]福建中医药大学附属晋江中医院脾胃病科,福建晋江362200

出　　处：《中国医药科学》2024年第11期97-101,共5页China Medicine And Pharmacy

基　　金：福建中医药大学校管科研课题(XB2022057)。

摘　　要：目的探讨采取降脂方加减联合消胀包治疗痰热型非酒精性脂肪性肝炎(NAFLD)的效果。方法选取2022年8月至2023年8月福建中医药大学附属晋江中医院脾胃病科收治的80例痰热型NAFLD患者,采用随机数表法分成观察组与对照组,每组各40例。对照组给予西医水飞蓟素胶囊、阿托伐他汀钙片治疗12周;观察组患者在对照组基础上加用降脂方加减口服及消胀包外敷治疗12周。比较两组患者治疗前后中医症候积分、肝脏酶学指标、脂质代谢指标、身体状况、胰岛素抵抗与安全性。结果治疗12周后,观察组患者各中医症候积分均低于对照组,差异有统计学意义(P<0.05);两组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰胺转移酶(GGT)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、体重、腰臀比、体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)均低于治疗前,且观察组指标水平低于对照组,差异有统计学意义(P<0.05);两组高密度脂蛋白胆固醇(HDL-C)高于治疗前,且观察组指标水平高于对照组,差异有统计学意义(P<0.05)。观察组在安全性Ⅰ级占比为87.50%,高于对照组的62.50%,差异有统计学意义(P<0.05)。结论应用降脂方加减联合消胀包治疗痰热型NAFLD可改善症候积分、肝脏酶学指标、脂质代谢指标,降低体重与腰臀比,改善身体状况,且安全性较高。Objective To explore the effect of modified Jiangzhi decoction combined with Xiaozhang bag on phlegm-heat non-alcoholic fatty liver disease(NAFLD).Methods A total of 80 patients with phlegm-heat NAFLD who were admitted to the Department of Spleen and Stomach Diseases,Jinjiang Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine,from August 2022 to August 2023 were divided into the observation group and the control group by random number table method,with 40 patients in each group.The control group was treated with western medicine silymarin capsules and atorvastatin calcium tablets for 12 weeks,while the patients in the observation group were treated with modified oral Jiangzhi decoction and external application of Xiaozhang bag for 12 weeks based on the treatment for the control group.The traditional Chinese medicine syndrome score,liver enzyme index,lipid metabolism index,physical condition,insulin resistance and safety of the two groups were compared before and after treatment.Results After 12 weeks of treatment,the traditional Chinese medicine syndrome score in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).Alanine amino transferase(ALT),aspartate aminotransferase(AST),gamma-glutamyltransferase(GGT),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),body weight,waist-to-hip ratio,body mass index(BMI)and HOMA insulin resistance index(HOMA-IR)in the two groups after treatment were lower than those before treatment,and after treatment,the levels of those indexes in the observation group was lower than those in the control group,with statistically significant differences(P<0.05).The high-density lipoprotein cholesterol(HDL-C)in the two groups after treatment was higher than that before treatment,and after treatment,the HDL-C level in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).The proportion of sa

关 键 词：非酒精性脂肪性肝炎 痰热型 降脂方加减 消胀包 肝脏酶学 脂质代谢 

分 类 号：R259[医药卫生—中西医结合]