降脂益肝汤治疗非酒精性脂肪性肝炎临床观察

Clinical effect of Jiangzhi yigan decoction on non-alcoholic steatohepatitis

目的:观察降脂益肝汤治疗非酒精性脂肪性肝炎的临床疗效,探讨肝脾同调、化痰祛瘀疗法的作用。方法:将100例NASH患者随机分为治疗组50例和对照组50例。治疗组患者服用以肝脾同调、痰瘀并治法而选用的降脂益肝汤,1剂/d;对照组患者口服水飞蓟宾葡甲胺片,100mg/次,3次/d。两组疗程均为3个月。治疗前后分别检测两组患者血清丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、总胆固醇(TC)、甘油三酯(TG),并行肝脏B超检查。结果:治疗组和对照组总有效率分别为94.00%和74.00%,治疗组总有效率明显优于对照组(P<0.05)。治疗组患者治疗后ALT、TBil、TC、TG较治疗前明显降低(P<0.05);对照组患者治疗后ALT、TC、TG较治疗前降低明显(P<0.05),而TBil治疗前后差异无统计学意义(P>0.05);两组间治疗后4项指标比较,治疗组降低更加明显,差异均有显著性意义(P<0.05)。结论:肝脾同调、痰瘀并治法治疗NASH可明显改善患者的肝功能、血脂水平,临床疗效肯定。

Objective： To observe the clinical effectg of Jiangzhi Yigan decoction on non-alcoholic steatohepatitis （ NASH） and explore the function of therapeutic method by regulating liver and spleen combined with eliminating phlegm and removing bolld stasis.Methods： One hundred patients with NASH were randomly divided into treatment group and control group, 50 cases in each group.The patients in the treatment group were treated by Jiangzhi yigan decoction （ dose/d） for regulating the liver and spleen and eliminating phlegm and removing blood stasis, whereas patients in the control group were treated by taking silibin meglumine tablets, 100 mg each time and 3 times a day.Two groups were treated for 3 months.The efficacy of therapies for two groups was evaluated after three month course.Some important indexes of the patients in two groups were observed before and af-ter treatment, including alanine aminotransferase （ALT）, total bilirubin （TBil）, total cholesterol （TC）, triglyceride （TG）, and liver B-ultrasound examination.Results： The total effective rate of the treatment group and the control group were 94%and 74%, comparing the 2 groups, the difference was statistically significant （ P〈0.05） .ALT, TBil, TC and TG of the patients in the treatment group decreased significantly after treatment （P〈0.05） .ALT, TC, TG of patients in the control group were also reduced significantly after the treatment （ P〈0.05 ） , but their TBil was not statistically significant before and after the treatment （ P〉0.05） .The treatment group decreased ALT, TBil, TC and TG role more obvious, comparing the 4 indexes of the 2 groups after treatment, and the differences were statistically significant （ P〈0.05） .Conclusion： Regulating liver and spleen combined with treatment of eliminating phlegm and removing blood stasis can greatly improve liver function and serum lipid levels of the patients with NASH, and has better curative effect on them.