清肝方治疗26例脂肪肝的CT疗效评价

CT Evaluation of Therapeutic Efficacy of Qinggan Prescription in Treatment of Fatty Liver:A Report of 26 Cases

目的采用CT定量测定作为主要诊断与疗效评价指标,观察清肝方治疗脂肪肝的疗效。方法将60例符合诊断标准的脂肪肝患者随机分为治疗组和对照组,对照组30例采取调整饮食及体育锻炼等方法进行基础治疗,治疗组30例在对照组治疗的基础上,给予中药清肝方随证加减治疗,两组疗程均为12周。观察两组患者治疗前后症状、体征、肝功能、血脂、空腹血糖、肝/脾CT值比值的变化。结果治疗组和对照组分别脱失4、3例。治疗组总有效率显著高于对照组(84.61%vs 51.85%,P<0.05);治疗后两组血清丙氨酸氨基转移酶水平显著降低(P<0.05),治疗组在降低总胆固醇、低密度脂蛋白,升高肝脏CT值和肝/脾CT值比值方面显著优于对照组(P<0.05,或P<0.01)。结论清肝方治疗脂肪肝疗效显著,肝/脾CT值比值可以更直接、客观地判定临床疗效。

Objective To assess the therapeutic efficacy of Qinggan liver based on the quantitative computed tomography indicators. Methods Sixty patients with fat randomly assigned to treatment group （n = group recelv ment group drome） in a ty 30 ed basic treatment including diet a were given trad to the b liver and （CT） scan data （meeting the di control group （ prescription as the major in the treatment of fatty diagnostic and eval agnostic criteria for fatty liver） were n = 30）. The pati ustment and physical exercise, while ents in the contro those in the treat itional Chinese medicine Qinggan prescription （modified according to the syn asic treatment. The course of treatment was 12 weeks for both groups. Th symptoms, signs, liver functions （alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, and AST/ALT）, blood lipids （total cholesterol （TCh）, triacylglycerol, low-density lipoprotein （LDL）, and high-density lipoprotein）, fasting blood glucose, and liver-to-spleen CT-value ratio （L/S ratio） were observed before and after treatment. Results Four cases in the treatment group and 3 cases in the control group did not complete the treatment. The treatment group showed a significantly higher overall response rate than the control group （84. 6% vs 51. 9%, P〈0.05）. The levels of alanine aminotransferase after treatmen with the levels and Conclusion S1 can be used significantly lower than those before treatment in the two groups（P〈0. 1 group, the treatment group showed significantly more decrease in serum gnificantly more increase in CT value of the liver and L/S ratio （P〈0. 05 Qinggan prescription has good therapeutic efficacy in the treatment of fatty 1 as a more direct and objective indicator for judging the therapeutic efficacy. 05 ）. Compared TCh and LDL or P〈0. 01）. iver. L/S ratio