中药治疗非酒精性脂肪性肝炎的临床研究

Clinical research on Chinese medicinal formulae treatment of nonalcoholic steatohepatitis

目的观察自拟的中药方剂治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法选取70例符合NASH诊断标准的患者,按随机数字表法分为治疗组和对照组,给予对照组控制饮食,中等量有氧运动,并予多烯磷脂酰胆碱胶囊口服治疗;治疗组在对照组的基础上加上自拟的中药汤剂口服,疗程均为12周。观察两组治疗前后肝脏瞬时弹性测定(Fibroscan)的受控衰减参数(CAP)值、体质量指数、腹围、肝功能、血脂的变化情况。结果治疗后两组Fibroscan的CAP值、ALT、AST、TG、TC均有下降,治疗组的下降程度较对照组显著,差异有显著的统计学意义(P<0.01)。治疗组治疗后BMI、AC均较治疗前明显下降(P<0.01),而对照组治疗前后BMI及AC的变化无统计学意义(P>0.05)。结论中药方剂能显著改善NASH患者的CAP值及肝功能、血脂、体质量指数、腹围等,对NASH具有显著疗效。

Objective To evaluate the clinical effect of Chinese medicinal formulae developed by us on non-alcoholic steatohepatitis （ NASH ）. Methods Seventy patients with confirmed NASH were enrolled in the present research and were divided into trial group and control group at random. Tightly controlled diet and moderate aerobic exercise were prescribed for the patients in the control group in addition to oral polycnephosphatidyl choline. The trial group accepted the same treatment as the control group except an ad- ditional Chinese herbal decoction. Both the groups were treated for 12 weeks. Controlled attenuation parameter （CAP） detected by FibroScan, body mass index （BMI） , abdominal circumference （AC） , liver function and serum lipid were measured at baseline and the end of treatment. Results CAP, alanine aminotransferase （ ALT）, aspartate aminotransferase （ AST）, triglyceride （TG） and total cholesterol （TC） declined in both the groups. The trial group had significantly greater descents than the control group （P 〈 0.01 ）. BMI and AC remarkably decreased after the integrated therapy in the trial group （P 〈 0. 01 ）but not in the control group （ P 〉 0.05 ）. Conclusion Chinese medicinal formulae may notably improve indices of CAP, liver function, serum lipid, BMI and AC in patients with NASH and has an evident effect on it.