祛湿化瘀方对非酒精性脂肪性肝炎患者血清游离脂肪酸的作用及机制研究

Effects and Mechanisms of Qushi Huayu Decoction on serum Free Fatty Acid in Patients with Non-alcoholic Steatohepatitis

目的:研究祛湿化瘀方对非酒精性脂肪性肝炎患者血清游离脂肪酸(free fatty acid,FFA)的作用,并探讨其部分作用环节。方法:选择非酒精性脂肪性肝炎痰瘀互结证患者164例,随机分为两组,其中祛湿化瘀方组(试验组)82例,多烯磷脂酰胆碱组(对照组)82例,疗程均为24周,观察患者血清FFA含量、血清脂联素含量及胰岛素抵抗指数的变化。并通过血清FFA含量与血清脂联素含量及胰岛素抵抗指数的相关分析探讨其相关性。结果:两组治疗后血清FFA含量较治疗前均明显降低(P<0.01),两组间治疗后比较差异有统计学意义(P<0.01),试验组优于对照组。两组治疗后血清脂联素含量较治疗前均明显升高(P<0.01),两组间治疗后比较差异有统计学意义(P<0.01),试验组优于对照组。试验组治疗后胰岛素抵抗指数较治疗前明显下降(P<0.01),对照组治疗后胰岛素抵抗指数较治疗前有所下降,但差异无统计学意义(P>0.05),两组间治疗后比较差异无统计学意义(P>0.05)。血清FFA含量与血清脂联素含量呈显著负相关,与胰岛素抵抗指数无显著相关性。结论:祛湿化瘀方可显著降低非酒精性脂肪性肝炎患者血清FFA含量,提高血清脂联素含量和改善胰岛素抵抗可能是其重要药理环节。

Objective：To study the efficacy and mechanisms of Qushi Huayu Decoction on serum free fatty acid in patients with non-alcoholic steatohepatitis.Methods：A randomized controlled trial was conducted on the treatment of non-alcoholic steatohepatitis.Totally 184 patients accorded with the diagnosis standards of non-alcoholic steatohepatitis and phlegm intrinsic syndrome were randomized into Qushi Huayu Decoction group（trial,82 cases） and polyene phosphatidyl choline group（control,82 cases）.The course of treatment was 24 weeks.The changes of serum free fatty acid contents,serum adiponection contents and insulin resistance index in patients were observed to study their correlation through correlation analysis of serum FFA content,serum adiponectin levels and insulin resistance index.Results：After treatment,the serum free fatty acid contents of both groups were decreased significantly（P〈0.01）,and the difference between two groups of serum free fatty acid contents was statistically significant（P〈0.01） the trial group was superior to the control group.After treatment,the serum adiponection contents of both groups were elevated significantly（P〈0.01）,and the difference between two groups of serum adiponection contents was statistically significant（P〈0.01） the trial group was superior to the control group.The insulin resistance index of trial group after treatment was significantly alleviated,which was significantly different from that before treatment（P〈0.01）,the insulin resistance index of control group after treatment was decreased,however,the difference had no statistical significance（P〈0.05）.And the difference between two groups of insulin resistance index had no statistically significance（P〈0.01）.Serum free fatty acid contents were negatively correlated with serum adiponection contents,while there was no significant correlation between serum free fatty acid content and insulin resistance index.Conclusion：Qushi Huayu Decoction has high strength inhibitory effect on serum free fatty acid in patients with non-alcoholic steatohepatitis,the key mechanism of which may be based on increasing adiponectin content in serum and improving insulin resistance.