针刺联合加味茵陈蒿汤在非酒精性脂肪肝中的应用效果研究  

Effect of acupuncture combined with modified Yinchenhao Decoction on non-alcoholic fatty liver

作　　者：宋丽 石蕊 赵香君 SONG Li;SHI Rui;ZHAO Xiangjun(Department of Traditional Chinese Medicine,Peking University Third Hospital Qinhuangdao Hospital,Qinhuangdao,Hebei 066000;Department of Pathology,Xianghe County People's Hospital,Xianghe,Hebei 065400)

机构地区：[1]北京大学第三医院秦皇岛医院中医内科,河北秦皇岛066000 [2]河北省香河县人民医院病理科,河北香河065400

出　　处：《河北中医》2025年第4期642-649,共8页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2021378)。

摘　　要：目的观察针刺联合加味茵陈蒿汤治疗非酒精性脂肪肝(NAFLD)的临床疗效。方法选择2020年1月至2021年5月收治的112例NAFLD患者为研究对象,按照随机数字表法分为2组,对照组59例予加味茵陈蒿汤治疗,治疗组53例在对照组的基础上联合针刺治疗。2组均连续治疗2个月后统计疗效,比较2组治疗前后体质量指数(BMI)、体质量、腰围、肝功能指标[包括天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转移酶(GGT)]、糖脂代谢指标[包括空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)]、肝硬度测定值(LSM)、控制衰减指数(Cap)、肝脏脂肪含量、自噬相关蛋白指标[包括血清肌球蛋白样BCL2结合蛋白(Beclin1)、自噬相关基因7(ATG7)]、肠道菌群含量、氧化应激指标[包括丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]、肝纤维化指标[包括层黏连蛋白(LN)、Ⅲ性胶原蛋白(PC-Ⅲ)、透明质酸(HA)]、细胞因子[包括肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)、转化生长因子β(TGF-β)]、肌肉量、骨质量、世界卫生组织(WHO)生活质量调查简表(QOL-BREF)评分[包括社会关系领域、心理领域、生理领域、环境领域、自身健康状况总体主观感受、最近生活质量总体主观感受6个方面]、中医证候评分变化情况。结果治疗后2组BMI、体质量、腰围水平均较治疗前降低(P<0.05),且治疗组治疗后BMI、体质量、腰围水平均低于对照组(P<0.05)。治疗后2组AST、ALT、GGT水平均较治疗前降低(P<0.05),且治疗组治疗后AST、ALT、GGT水平均低于对照组(P<0.05)。治疗后2组FBG、TG、TC水平均较治疗前降低(P<0.05),且治疗组治疗后FBG、TG、TC水平均低于对照组(P<0.05)。治疗后2组LSM、CAP、肝脏脂肪含量均较治疗前降低(P<0.05),且治疗组治疗后LSM、CAP、肝脏脂肪含量均低于对照组(P<0.05)。治疗后2组自噬相关蛋白Beclin1、ATG7水平均�Objective To analyze the effect of acupuncture combined with modified Yinchenhao Decoction in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods Totally 112 patients with NAFLD admitted to our hospital from January 2020 to May 2021 were enrolled.They were divided into the study group(acupuncture+modified Yinchenhao Decoction)and control group(modified Yinchenhao Decoction)according to the random number table method.The changes in body mass index(BMI),body weight(BW),waist circumference(WC),liver function indexes,glucose and lipid metabolism level,liver stiffness measurement(LSM),controlling attenuation parameter(CAP),liver fat content,autophagy-related protein index,liver fibrosis index,muscle mass,bone mass,WHO Quality of Life Brief Version(WHO QOL-BREF)score,traditional Chinese medicine(TCM)syndrome score were assessed.Results After treatment,the both groups had significantly lower BMI,BW,WC,decreased aspartate aminotransferase(AST),alanine aminotransferase(ALT),glutamyl transpeptidase(GGT),reduced fasting blood glucose(FPG),triacylglycerol(TG),total cholesterol(TC),downgraded liver stiffness measurement(LSM),CAP,liver fat content,lower Beclin-1(BECN1),autophagy-related gene 7(ATG7)relative to before treatment(all P<0.05),and the improvements were more pronounced in the study group than the control group(ALL P<0.05).After treatment,significantly lower Escherichia coli and Enterococcus,and higher Bifidobacterium and Lactobacillus in the intestinal flora of the two groups were found than those before treatment(all P<0.05),and the improvements were more common in the study group than the control group(all P<0.05).After treatment,the both groups presented significantly lower malondialdehyde(MDA),hyaluronic acid(HA),type III procollagen III(PC-III),laminin(LN),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),transforming growth factor-β(TGF-β),and higher glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),muscle mass,bone mass compared to those before treatment(all P<0.05),and the study gro

关 键 词：非酒精性脂肪肝 加味茵陈蒿汤 肝功能 肝脏脂肪沉积 

分 类 号：R575.1[医药卫生—消化系统]