参葛方联合生活饮食运动干预治疗肝功能异常代谢相关脂肪性肝病的临床观察  

Clinical observation of Shenge Decoction combined with lifestyle,diet,and exercise interventions in treating abnormal liver function in metabolic associated fatty liver disease

作　　者：方淼 张荣杰 房华 孙学华[3] 高月求[1] 吕佳[3] FANG Miao;ZHANG Rongjie;FANG Hua;SUN Xuehua;GAO Yueqiu;LYU Jia(Laboratory of Cell Immunity,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Clinical College of Anhui Medical University,Hefei,Anhui 230000,China;Department of Hepatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院细胞免疫实验室,上海201203 [2]安徽医科大学临床医学院,安徽合肥230000 [3]上海中医药大学附属曙光医院肝病科,上海201203

出　　处：《上海中医药杂志》2024年第8期41-44,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82004160);上海市卫健委科研课题(202040237);国家中医药管理局高水平中医药重点学科建设项目(ZYYZDXK-2023060)。

摘　　要：目的观察参葛方联合生活饮食运动干预治疗肝功能异常代谢相关脂肪性肝病(MAFLD)的临床疗效及对患者血清CD44水平的影响。方法将70例脾虚痰湿兼有血瘀型肝功能异常MAFLD患者随机分为对照组和治疗组,每组35例,两组均给予生活饮食运动干预,治疗组加用参葛方,对照组加用参葛方安慰剂,疗程均为12周。观察临床疗效,比较磁共振成像质子密度脂肪含量(MRI-PDFF)及血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、CD44水平的变化情况。结果(1)最终完成试验者64例,其中治疗组32例、对照组32例。(2)治疗组、对照组总有效率分别为75.0%、46.9%,治疗组临床疗效优于对照组(P<0.05)。(3)治疗前后组内比较,两组MRI-PDFF值降低(P<0.05),治疗组血清CD44水平降低(P<0.05);组间治疗后比较,治疗组MRI-PDFF值、血清CD44水平低于对照组(P<0.05)。(4)治疗前后组内比较,治疗组血清ALT、AST、GGT水平降低(P<0.05),对照组AST水平降低(P<0.05);组间治疗后比较,治疗组血清ALT、AST、GGT水平低于对照组(P<0.05)。(5)治疗前后组内比较,治疗组血清TG、TC、LDL水平降低(P<0.05),对照组TG水平降低(P<0.05);组间治疗后比较,治疗组TG水平低于对照组(P<0.05)。结论参葛方联合生活饮食运动干预治疗脾虚痰湿兼有血瘀型肝功能异常MAFLD患者疗效满意,能有效缓解患者的临床症状,改善肝脏脂质沉积及肝功能异常,调节血脂水平,其机制可能与调节血清CD44表达有关。Objective To observe the clinical efficacy of Shenge Decoction combined with lifestyle,diet,and exercise interventions in treating abnormal liver function in patients with metabolic associated fatty liver disease(MAFLD)and its effect on serum CD44 levels.Methods Seventy MAFLD patients with abnormal liver function,and syndromes of spleen deficiency,phlegm dampness,and blood stasis were randomly divided into a control group(n=35)and a treatment group(n=35).Both groups received lifestyle,diet,and exercise interventions.Patients in the treatment group were additionally given Shenge Decoction,while those in the control group received a Shenge Decoction placebo.The treatment course lasted for 12 weeks.Clinical efficacy was observed,and changes in magnetic resonance imaging-proton density fat fraction(MRI-PDFF),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyl transpeptidase(GGT),triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL),and CD44 levels were compared.Results①A total of 64 patients completed the trial,with 32 in the treatment group and 32 in the control group.②The total effective rate was 75.0%in the treatment group and 46.9%in the control group,with the treatment group showing better clinical efficacy(P<0.05).③Comparison within groups before and after treatment showed a decrease in MRI-PDFF value in both groups(P<0.05)and a decrease in serum CD44 level in the treatment group(P<0.05).Post-treatment comparison between groups showed that the MRI-PDFF value and serum CD44 level in the treatment group were lower than those in the control group(P<0.05).④Comparison within groups before and after treatment showed a decrease in serum ALT,AST,and GGT levels in the treatment group(P<0.05),and a decrease in AST level in the control group(P<0.05).Post-treatment comparison between groups showed that the serum ALT,AST,and GGT levels in the treatment group were lower than those in the control group(P<0.05).⑤Compari

关 键 词：代谢相关脂肪性肝病 非酒精性脂肪性肝病 参葛方 肝功能 脂质代谢 中医药疗法 临床研究 

分 类 号：R575.5[医药卫生—消化系统]