护肝降脂方治疗非酒精性脂肪肝50例

Clinical Research of Hugan Jiangzhi Decoction in the Treatment of 50 Patients with Non-alcoholic Fatty Liver Disease

目的:观察护肝降脂方治疗非酒精性脂肪肝(NAFLD)的临床疗效及对血清脂联素、瘦素和超氧化物歧化酶(SOD)水平的影响。方法:98例NAFLD患者采用随机数字法分为对照组和观察组各49例。对照组口服盐酸二甲双胍片,0.25 g/次,3次/d;洛伐他汀片,20 mg/次,1次/d,口服;多烯磷脂酰胆碱胶囊,2粒/次,3次/d,口服。观察组在对照组治疗的基础上采用护肝降脂方加减治疗,1剂/d。两组疗程均为12周。进行治疗前后肝脏CT值和肝脾CT比值评价;检测治疗前后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平;检测治疗前后血清脂联素、瘦素和血清超氧化物歧化酶(SOD)水平;测量治疗前后体重指数(BMI)、腰臀围比和胰岛素抵抗指数(HOMA-IR)。结果:观察组总有效率为95.92%,对照组为81.63%,观察组优于对照组(P<0.05);治疗后观察组肝/脾CT比值的改善优于对照组(P<0.05);观察组治疗后ALT,AST,TC,TG和LDL-C低于对照组,HDL-C高于对照组(P<0.01);治疗后观察组SOD和脂联素高于对照组,瘦素低于对照组(P<0.01);治疗后两组BMI和腰臀围均较治疗前改善,但组间差异无统计学意义;治疗后观察组IR低于对照组(P<0.01)。结论:护肝降脂方具有护肝、降脂作用,能显著改善NAFLD,提高临床疗效,其作用机制可能是通过调节炎性因子,提高机体抗氧化能力,改善IR来实现的。

Objective：To observe the clinical curative efficacy of Hugan Jiangzhi decoction and the influence on levels of serous adiponectin,leptin and superoxide dismutase （SOD） in patients with non-alcoholic fatty liver disease （NAFLD）.Method：Ninety-eight patients with NAFLD were randomly divided into control group and observation group of 49 patients each by random number table.Patients in control group received metformin hydrochloride tablets （0.25 g orally 3 times daily）,lovastatin tablets （20 mg orally once daily）,and polyene phosphatidylcholine capsules （2 capsules orally 3 times daily）.Based on the treatment of control group,patients in observation group added modified Hugan Jiangzhi decoction 1 dose daily.The patients in both groups received two 12 weeks periods of treatment.Patient underwent abdominal computed tomography （CT） before and after treatment,and liver/spleen CT ratio was calculated.Levels of alanineaminotransferase （ALT）,aspertate aminotransferase （AST）,triglyceride （TG）,total cholesterol （TC）,high density lipoprotein-cholesterol （HDL-C） and low density lipoprotein-cholesterol （LDL-C） were detected.Levels of serum adiponectin,leptin and superoxide dismutase （SOD） were detected.Body mass index （BMI）,waist hip rate and homeostasis model assessment of insulin resistance （HOMA-IR） were measured before and after treatment.Result：The total effective rate in observation group was 95.92％,which is superior to that in control group （81.63％,P ＜0.05）.The liver/spleen CT ratio was higher in observation group than that in control group after treatment （P ＜ 0.05）.The levels of ALT,AST,TC,TG and LDL-C were lower,and the level of HDL-C was higher in observation group than those in control group （P ＜ 0.01）.The SOD and adiponectin level were higher,leptin level was lower in observation group than those in control group after treatment （P ＜ 0.01）.The BMI and waist,hip circumference in both two groups after treatment increased as compared with those before,but there was no statistically significant difference between two groups.IR levelin observation group was lower than that in control group after treatment （P ＜0.01）.Conclusion：Hugan Jiangzhi decoction haseffectsonliver protection and lipidloweringin patientswith NAFLD.Beside it has obvious effect in improving NAFLD and increasing clinical curative effect.The mechanism may be achieved by regulating inflammatory cytokines,increasing antioxidant capacity and improving IR of patients.