健脾活血软肝汤治疗非酒精性脂肪肝病的临床研究中期总结

Clinical research on treating NAFLD with the Jianpi Huoxue Ruangan decoction

目的：观察健脾活血软肝汤对非酒精性脂肪肝病患者症状、体征、肝功能及血脂指标的影响，为进一步深化研究提供指导。方法：将我院2011年1月-2012年12月收治的60例非酒精性脂肪肝病患者按随机数字表分为观察组30例和对照组30例，对照组给予多烯磷脂酰胆碱（易善复）胶囊，450mmg／次,tid，观察组在对照组的基础上再口服健脾活血软肝汤，两组均治疗3个月，并随访3个月，治疗前、治疗3个月、随访后观察患者症状体征改善情况，并进行评分，检测患者ALT、AST、TG、TC，同时行B超检查，比较两组临床B超疗效与症候疗效。结果：①观察组和对照组B超疗效分别为90％和63．33％，X^2=8．384，P〈0．05；观察组和对照组症候疗效分别为96．67％和66．67％，X^2=11．116，P〈0．05；观察组和对照组总体疗效分别为86．67％和60．00％，X^2=11．107，P〈0．05；②观察组和对照组治疗后丙氨酸基转氨酶（ALT）、谷草转氨酶（AST）、甘油三酯（TG）、总胆固醇（TC）均明显降低，但治疗后观察组ALT、AST、TG、TC明显低于对照纽，均P〈0．05。结论：健脾活血软肝汤联合多稀磷脂酰胆碱治疗非酒精性脂肪肝病疗效确切，有效改善临床症状及体征，明显改善肝功能、肝脂肪浸润和胆囊壁毛糙程度，降低血脂，优于多稀磷脂酰胆碱治疗效果，值得进一步深化研究，指导，临床合理治疗。

Objective： To observe the influence of the Jianpi Huoxue Ruangan decoction on symptoms, liver function and blood lipid indexes of non-alcoholic fatty liver patients, to provide guidance for the further deepening of research. Methods： From January 2011 to December 2012 in our hospital, 60 cases of NAFLD were randomly divided into observation group and control group, 30 patients in each. The control group was given polyene phosphatidylcholine （Essentiale） capsules, 450mmg/time, tid, observation group was given oral Jianpi Huoxue Ruangan decoction on the basis of the control group. Both treated for three months and followed for three months, to observe the improvement of symptoms and signs before treatment and 3 month＇ treatment and after follow-up, and to score. To detect ALT, AST, TG; TC in patients, while accept the line B-ultrasound, compare two clinical efficacy of B-ultrasound and symptoms. Results： ~B-ultrasound efficacy of observation group and control group were 90% and 63.33%, xZ=8.384, P〈0.05; the symptom efficacy of observation group and control group were 96.67% and 66.67%, x2=l 1.116, P〈0.05; the overall efficacy of observation group and control group were 86.67% and 60.00%, x2=l 1.107, P〈0.05; ~Observation group and control group after treatment ALT, AST, TC~ TC were significantly reduced, but the observation group was significantly lower than the control group, all P〈0.05. Conclusion： Jianpi Huoxue Ruangan decoction with phosphatidylcholine treatment has curative effect on NAFLD, effectively improve the clinical symptoms and signs, has significant improvement in liver function, fatty infiltration of the liver and gallbladder wall rough, lowering blood lipids, better than more dilute phosphatidylcholine treatment, worthy of further deepening study, guide clinical treatment.