疏肝解郁汤联合电针治疗肝郁气滞型非酒精性脂肪性肝病临床研究  

Clinical efficacy of Shugan Jieyu Decoction combined with electroacupuncture for nonalcoholic fatty liver disease of liver qi stagnation

作　　者：杨小艳 李刘英[1] 陈新[1] 周丽[1] 廖鹏飞[1] YANG Xiaoyan;LI Liuying;CHEN Xin;ZHOU Li;LIAO Pengfei(Department of Integrated Traditional and Western Medicine,Zigong First People's Hospital,Zigong,Sichuan 643000)

机构地区：[1]四川省自贡市第一人民医院中西医结合科,四川自贡643000

出　　处：《河北中医》2025年第3期391-395,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：自贡市卫生健康委员会资助项目(编号:19zd003)。

摘　　要：目的观察疏肝解郁汤联合电针治疗肝郁气滞型非酒精性脂肪性肝病(NAFLD)的效果。方法选取2020年1月至2022年3月四川省自贡市第一人民医院中西医结合科收治的160例肝郁气滞型NAFLD患者为研究对象,按照随机数字表法分为4组,每组40例。对照组予常规西药治疗,电针组在对照组基础上加电针治疗,中药组在对照组基础上加疏肝解郁汤治疗,联合组在对照组基础上加疏肝解郁汤联合电针治疗,均治疗3个月后统计疗效。比较4组治疗前后症状评分、肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰氨基转移酶(GGT)]、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素22(IL-22)]变化,并比较4组不良反应。结果对照组有1例失访,中药组有2例失访,均剔除本研究。治疗后,4组主症、次症评分和总分,以及ALT、AST、GGT水平均较本组治疗前下降(P<0.05),且治疗后联合组均低于其他3组(P<0.05),电针组和中药组均低于对照组(P<0.05)。治疗后,4组TNF-α、IL-6水平均较本组治疗前下降(P<0.05),且治疗后联合组均低于其他3组(P<0.05),电针组和中药组均低于对照组(P<0.05)。治疗后,4组IL-22水平均较本组治疗前升高(P<0.05),且治疗后联合组高于其他3组(P<0.05),电针组和中药组均高于对照组(P<0.05)。4组疗效比较差异有统计学意义(P<0.05),联合组总有效率高于对照组(P<0.05)。4组不良反应发生率比较差异无统计学意义(P>0.05)。结论疏肝解郁汤、电针治疗肝郁气滞型NAFLD患者均可减轻症状、改善肝功能、减轻炎症反应,且二者配合使用的效果更佳,安全可靠。Objective To observe the effect of Shugan Jieyu Decoction combined with electroacupuncture(EA)for nonalcoholic fatty liver disease(NAFLD)of liver qi stagnation.Methods Totally 160 patients with NAFLD(liver qi stagnation)admitted in the Department of Integrated Traditional and Western Medicine,Zigong First People's Hospital from January 2020 to March 2022 were enrolled,and they were randomised 1∶1∶1∶1 to receive routine Western medicine(RWM)(control group)or RWM+EA(EA group)or RWM+Shugan Jieyu Decoction(traditional Chinese medicine[TCM]group)or RWM+EA+Shugan Jieyu Decoction(combined group).A 3-month treatment was performed to compare symptom scores,liver function(alanine aminotransferase[ALT],aspartate aminotransferase[AST],gamma-glutamyl transferase[GGT]),inflammatory factors(tumor necrosis factor alpha[TNF-α],interleukine-6[IL-6],interleukine-22[IL-22]),adverse reactions.The curative effect was assessed.Results One case in the control group and two cases in the TCM group were lost to follow-up.After treatment,the dimension score and total score of syndromes(main and secondary symptoms),the levels of ALT,AST,GGT in the four groups were significantly decreased(P<0.05),which in the comparison of the four,combined group was significantly lower than the other three groups(P<0.05),and EA group and TCM group were significantly lower than control group(P<0.05).Significantly decreased TNF-αand IL-6,and increased IL-22 were found in the four groups after treatment(all P<0.05),which in the comparison of the four,combined group was superior to the other three groups(all P<0.05),and EA group and TCM group were superior to the control group(all P<0.05).The difference was statistically significant in the grades of curative effect among the four groups(P<0.05).The overall effective rate in the combined group was significantly higher than that in the control group(P<0.05).None of the incidence of adverse reactions differed significantly among the four groups(P>0.05).Conclusion For patients with NAFLD(liver qi stagnation)

关 键 词：非酒精性脂肪性肝病 电针疗法 疏肝解郁药 

分 类 号：R575.505.31[医药卫生—消化系统] R245.319[医药卫生—内科学]