健脾祛湿消脂方治疗脾虚湿阻型代谢相关脂肪性肝病临床研究  

Clinical Study on Jianpi Qushi Xiaozhi Prescription in Treating Metabolic-Associated Fatty Liver Disease of Spleen-Deficiency and Dampness-Obstruction Type

作　　者：吴小叶 梁瑞华[1] 张丽霞 王海燕[1] WU Xiaoye;LIANG Ruihua;ZHANG Lixia;WANG Haiyan(Department of Gastroenterology and Hepatology,Huizhou Hospital of Guangzhou University of Chinese Medicine/Huizhou Hospital of Traditional Chinese Medicine,Huizhou Guangdong 516001,China;Graduate School,Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510006,China)

机构地区：[1]广州中医药大学惠州医院/惠州市中医医院脾胃肝病科,广东惠州516001 [2]广州中医药大学研究生院,广东广州510006

出　　处：《新中医》2025年第7期105-109,共5页New Chinese Medicine

基　　金：广东省中医药局科研项目(20231352)。

摘　　要：目的:观察健脾祛湿消脂方治疗脾虚湿阻型代谢相关脂肪性肝病(MAFLD)临床疗效及对糖脂代谢的影响。方法:选择2023年1月—2024年3月在广州中医药大学惠州医院诊断为脾虚湿阻型MAFLD的患者60例,按数字表法随机分成对照组和观察组各30例。2组均接受运动和饮食指导,对照组给予多烯磷脂酰胆碱治疗,观察组在对照组基础上加用健脾祛湿消脂汤治疗,2组均治疗12周。比较2组肝脂肪受控衰减参数(CAP)值、中医证候积分、肥胖指标、血脂及血糖水平。结果:治疗后,2组肝CAP值、中医证候积分、均较治疗前降低(P<0.05);观察组肝CAP值、中医证候积分均低于对照组(P<0.05)。2组甘油三酯(TG)、血清低密度脂蛋白胆固醇(LDL-C)水平均较治疗前降低,观察组LDL-C水平低于对照组(P<0.05),组间TG水平比较(P>0.05);2组高密度脂蛋白胆固醇(HDL-C)水平与本组治疗前及组间比较,差异均无统计学意义(P>0.05)。2组体脂率均较治疗前降低(P<0.05),观察组体脂率、体质量指数(BMI)均低于对照组(P<0.05)。2组空腹胰岛素(FINS)水平、胰岛素抵抗指数(HOMA-IR)值均较治疗前降低(P<0.05),观察组FINS水平、HOMA-IR值均低于对照组(P<0.05)。2组空腹血糖(FBG)水平与本组治疗前及组间比较,差异均无统计学意义(P>0.05)。2组观察期间均无明显不良反应发生。结论:健脾祛湿消脂汤对脾虚湿阻型MAFLD具有显著疗效,可有效降低肝脏脂肪含量,调节糖脂代谢和减轻体质量。Objective:To investigate the clinical effects of Jianpi Qushi Xiaozhi Decoction in treating metabolicassociated fatty liver disease(MAFLD)of the spleen-deficiency and dampness-obstruction type and its effects on carbohydrate and lipid metabolism.Methods:A total of 60 patients diagnosed with MAFLD of the spleen-deficiency and dampness-obstruction type at Huizhou Hospital of Guangzhou University of Chinese Medicine from January 2023 to March 2024 were selected and randomly divided into a control group and an observation group by random number table method,each with 30 cases.Both groups received exercise and dietary guidance.The control group was treated with polyene phosphatidylcholine,while the observation group was additionally treated with Jianpi Qushi Xiaozhi Decoction based on the control group's treatment.The treatment duration was 12 weeks for both groups.Liver fat-controlled attenuation parameter(CAP)values,traditional Chinese medicine(TCM)syndrome scores,obesity indicators,and levels of blood lipid and glucose were compared between the two groups before and after treatment.Results:After treatment,the liver CAP values and TCM syndrome scores in both groups were decreased compared to those before treatment(P<0.05).The observation group had lower liver CAP values and traditional Chinese medicine syndrome scores than the control group(P<0.05).Serum triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)levels in both groups were declined compared to those before treatment,with the observation group showing lower levels of LDL-C than the control group(P<0.05),comparison of TG levels between the two groups(P>0.05).There was no significant difference high-density lipoprotein cholesterol(HDL-C)levels compare with those before treatment and between the two groups(P>0.05).Body fat percentage in both groups were decreased compared to those before treatment(P<0.05),with the observation group having lower body fat percentage and body mass index(BMI)than the control group(P<0.05).Fasting insulin(FINS)levels and h

关 键 词：代谢相关脂肪性肝病 脾虚湿阻证 健脾祛湿消脂汤 糖脂代谢 多烯磷脂酰胆碱 

分 类 号：R256.4[医药卫生—中医内科学]