健脾降脂方治疗非酒精性脂肪性肝炎40例临床观察

Clinical Observation of 40 Cases of Nonalcoholic Steatohepatitis Treated with Jianpi Jiangzhi Formula

目的观察健脾降脂方治疗脾虚浊瘀内阻型非酒精性脂肪性肝炎(NASH)的临床疗效。方法将80例患者随机分为治疗组40例和对照组40例,治疗组给予口服健脾降脂方,对照组给予水飞蓟宾胶囊,治疗3个月后,观察两组临床疗效及治疗前后血清肝功能、血脂、胰岛素抵抗指数和肝脏B超影像的变化及症状体征变化情况。结果治疗后两组症状积分均明显降低(P<0.05或P<0.01),但治疗组积分下降更明显(P<0.05);治疗组与对照组的临床总有效率分别为87.5%和70.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者的ALT、AST、TC、TG水平均显著降低(P<0.05或P<0.01);肝脏B超病情分级及治疗组的胰岛素抵抗指数均明显改善(P<0.05或P<0.01)。结论健脾降脂方对改善脾虚浊瘀内阻型NASH有较好的临床疗效,可明显改善患者肝功能、血脂、B超影像指标及临床证候。

Objective To observe the clinical efficacy of jianpi jiangzhi formula in the treatment of nonalcoholic steatohepatitis（NASH）of the pattern/syndrome of spleen deficiency and internal blockage by phlegm and stasis.Methods 80 cases were randomized into a treatment group（40 cases）and a control group（40 cases）.In the treatment group,jianpi jiangzhi formula was prescribed for oral administration.In the control group,silibinin capsules were prescribed.After treatment for 3 months,the clinical efficacy,serum liver functions,blood lipid,insulin resistance index（IRI）and the changes in liver ultrasonic B test,as well as the symptoms and the physical signs were observed in two groups.Results After treatment,the symptom scores were all reduced obviously in two groups（P0.05 or P0.01）,but the result in the treatment group was much more apparent（P0.05）.The clinical total effective rate was 87.5% in the treatment group and was 70.0% in the control group,presenting the statistical significant difference in comparison（P0.05）.After treatment,the levels of ALT,AST,TC and TG were all reduced significantly for the patients in two groups（P0.05 or P0.01）.The condition grade of liver ultrasonic B test and the level of IRI in the treatment group were all improved apparently（P0.05 or P0.01）.Conclusion Jianpi jiangzhi formula achieves the good clinical efficacy on NASH of the pattern/syndrome of spleen deficiency and internal blockage by phlegm and stasis.It improves apparently in liver functions,blood lipid,ultrasonic B imaging indexes and clinical symptoms of patients.