二陈汤加减治疗非酒精性脂肪性肝病的临床疗效及作用机制研究  

Clinical Efficacy and Mechanism of Action of Modified Erchen Decoction(二陈汤加减)in Treatment of Non-Alcoholic Fatty Liver Disease

作　　者：陈锡培 周正[1] CHEN Xipei;ZHOU Zheng(Dongguan Hospital of Guangzhou University of Chinese Medicine,Dongguan 523000,Guangdong,China)

机构地区：[1]广州中医药大学东莞医院,广东东莞523000

出　　处：《中华中医药学刊》2025年第3期210-214,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局重点研究项目(2021-315号);广东省中医药局科研项目(20221421)。

摘　　要：目的观察二陈汤加减治疗非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的临床疗效,并分析该治法对患者肝功能、血脂等指标的影响。方法收集2022年1月—2023年6月广州中医药大学东莞医院收治的80例非酒精性脂肪性肝病患者的临床资料,按照自愿原则分为对照组和观察组,各40例,对照组患者予以阿托伐他汀钙片口服治疗;观察组患者在对照组的基础上予以二陈汤加减治疗。观察并比较两组患者的临床疗效、肝功能、血脂水平以及炎症指标水平变化。结果对照组的有效率为75.00%(30/40),观察组的有效率为92.50%(37/40),相较于对照组,观察组患者的有效率明显上升,差异具有统计学意义(P<0.05)。治疗完成后,观察组患者的天门冬氨酸转移酶(Aspartate aminotransferase,AST)、丙氨酸转移酶(Alanine aminotransferase,ALT)以及总胆红素(Total bilirubin in serum,TBIL)水平相较于对照组显著下降(P<0.01)。给药前两组患者的受控衰减参数(controlled Attenuation Parameter,CAP)值和体质量指数(body mass index,BMI)水平差异无统计学意义(P>0.05)。干预完成后,观察组患者的CAP值和BMI水平相较于对照组均明显下降(P<0.01)。给药前两组患者的血脂水平差异无统计学意义(P>0.05)。干预完成后,相较于对照组,观察组患者的甘油三酯(Triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high density lipoprotein,HDL-C)以及低密度脂蛋白(low density lipoprotein,LDL-C)水平显著下调,而HDL-C水平则显著上调,差异具有统计学意义(P<0.05,P<0.01)。给药前两组患者的炎症指标水平差异无统计学意义(P>0.05)。干预完成后,相较于对照组,观察组患者的白介素(IL)-6、肿瘤坏死因子(tumor necrosis factor,TNF)-α以及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平均明显下降(P<0.05)。对照组患者中有4例出现不良反应,发生率为10.00%(4/40),观察组有3例不Objective To observe the clinical efficacy of Modified Erchen Decoction(二陈汤加减)in the treatment of non-alcoholic fatty liver disease,and analyze the impact of this treatment on liver function,blood lipids and other indicators in pa-tients.Method The clinical data of 80 patients with non-alcoholic fatty liver disease admitted to Dongguan Hospital of Guang-zhou University of Chinese Medicine from January 2022 to June 2023 were collected.They were randomly divided into a control group and an observation group,with 40 patients in each group.The patients of the control group were treated with Atorvastatin Calcium Tablets.Those of the observation group were treated with Modified Erchen Decoction on the basis of the control group.The clinical efficacy,liver function,blood lipid levels and changes in inflammatory markers were observed and compared between the two groups.Result The effective rate of the control group was 75.00%(30/40),while that of the observation group was 92.50%(37/40).Compared with that of the control group,the effective rate of the observation group significantly increased,with a statistically significant difference(P<0.05).After treatment,the levels of aspartate aminotransferase(AST),alanine amin-otransferase(ALT)and total bilirubin in serum(TBIL)in the observation group significantly decreased compared to those in the control group(P<0.01).There was no significant difference in values of controlled attenuation parameter(cap)or body mass index(BMI)between the two groups before administration(P>0.05).After the intervention,the values of CAP and BMI of the observation group significantly decreased compared to those of the control group(P<0.01).There was no significant difference in blood lipid levels between the two groups before administration(P>0.05).After intervention,compared to those of the control group,the levels of triglycerides(TG),low density lipoprotein cholesterol(LDL-C)and total cholesterol(TC)of the observation group patients were significantly reduced,while the high density lipo

关 键 词：二陈汤 非酒精性脂肪性肝病 肝功能 血脂 炎症 临床疗效 

分 类 号：R256.4[医药卫生—中医内科学]