祛湿化瘀方治疗痰瘀互结型非酒精性脂肪性肝炎临床观察

Clinical Observation on Qushi Huayu Decoction for 82 Cases of Non-Alcoholic Steatohepatitis with Phlegm-Stasis Accumulation Syndrome

目的:评价祛湿化瘀方治疗痰瘀互结型非酒精性脂肪性肝炎的临床疗效。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,以治疗后中医证候、肝功能、血脂变化、B超改善情况评价有效性。结果试验组中医证候改善总有效率为86.11%,对照组为57.53%,两组比较差异有统计学意义(χ2=14.596,P<0.01)。两组治疗后脘腹胀满、胁肋胀痛评分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)。两组治疗后血清ALT、AST活性较治疗前差异有统计学意义(P<0.01),两组间治疗后比较差异有统计学意义(P<0.01)。两组治疗后血清TG、TC、LDL-C含量较治疗前差异均有统计学意义(P<0.01),两组间治疗后血清TG、TC含量比较差异有统计学意义(P<0.01)。治疗后试验组B超总改善率为87.50%,对照组B超总改善率为67.12%,两组比较差异有统计学意义(χ2=8.562,P<0.01)。随访12周时,试验组B超总改善率为81.94%,优于对照组的64.38%(χ2=5.685,P<0.05),与治疗结束时比较均无统计学差异(χ2=0.858,P>0.05)。结论:祛湿化瘀方对痰瘀互结型非酒精性脂肪性肝炎患者有较好的治疗作用,其疗效优于多烯磷脂酰胆碱胶囊。

Objective ： To evaluate the efficacy of Qushi Huayu Decoction for non - alcoholic steatohepatitis with phlegm - stasis aecmulation syndrome. 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 - stasis accumulation syndrome were randomized into Qushi Huayu Decoction group （trial, 82 cases ） and polyene phos- phatidylcholine group（ control, 82 cases）. The course of treatment was 24 weeks. The effect was evaluated by the chan- ges in the TCM syndromes, liver function, lipids and B - ultrasound. Results ： The total TCM syndromes improvement ef- fective rates of trial group and control group were 86.11% and 57.53% respectively, and the difference between two groups was statistically significant （x2 = 14. 596, P 〈 0.01 ）. The abdominal distention and flank pain of both groups af- ter treatment were significantly alleviated, which had significant difference between two groups （P 〈 0. 01 ）. After treat- ment, the ALT and AST activities in serum of both groups were significantly different from that of pre - treatment （ P 〈 0. 01 ）, and the difference between two groups was statistically significant （P 〈0. 01 ）. After treatment, the TG, TC and LDL - C contents in serum of both groups were significantly different from that of pre - treatment （ P 〈 0. 01 ）, and the difference between two groups of TG, TC contents in serum was statistically significant （P 〈 0. 01 ）. The B ultrasound im- provement rates of both group were 87.50% and 67.12% respectively, the difference was statistically significant （X2 = 8. 562, P 〈0. 01 ）. 12 weeks of follow - up, the B ultrasound improvement rate of trial group was 81.94%, better than 64.38% of the control group （x2 = 5. 685, P 〈 0. 01 ）, and there was no significant difference from that at the end of treatment （x2 = 0.858, P 〉 0.05）. Conclusion：Qushi Huayu Decoction has well efficacy on the treatment of non- alco- holic steatohepatitis with phlegm - stasis accumulation syndrome, and its efficacy is better than that of polyene phosphati- dylcholine capsule.