刺络泻血治疗肝郁脾虚痰瘀互结型非酒精性脂肪性肝病的临床研究

Clinic research of blood-letting puncture in the treatment of non-alcoholic fatty liver disease with syndrome of stagnation of liver qi and spleen deficiency combined with syndrome of intermingled phlegm and blood stasis

目的:通过刺血疗法治疗非酒精性脂肪性肝病,并与口服血脂康进行随机对照观察,评价其临床疗效。方法:将67例确诊为肝郁脾虚痰瘀互结型非酒精性单纯性脂肪肝的患者,按就诊顺序随机分为观察组34例,对照组33例。在基础治疗的同时,观察组取双侧1组穴位进行刺络泻血治疗(共3组穴位:1足三里、阴陵泉;2委阳、阳陵泉;3丰隆、曲泉);对照组予以口服血脂康胶囊0.6g 2次/d治疗。分别于治疗前后观察B超、TC、TG等指标的变化,并进行安全性检测,记录不良反应,最后统计分析临床疗效及安全性。结果:观察组临床总疗效总有效率为88.24%,对照组为87.87%,总疗效相当。刺血疗法可显著改善脂肪肝B超影像学,显著降低TG、TC水平,其中降TG、TC的疗效优于对照组(P<0.05),改善中医证候疗效与对照组相当。结论:刺络泻血疗法是治疗肝郁脾虚痰瘀互结型非酒精性脂肪性肝病(单纯性脂肪肝)的一种安全、有效的方法,值得推广应用。

Objective： To evaluate clinical effects of blood-letting puncture in the treatment of non-alcoholic fatty liver disease（NAFLD） with syndrome of stagnation of liver qi and spleen deficiency combined with syndrome of intermingled phlegm and blood stasis, in randomized controlled trial compared with oral Xuezhikang, and to provide evidence for enriching clinical treatment methods of NAFLD. Methods： 67 cases of NASFL pateints with syndrome of stagnation of liver qi and spleen deficiency combined with syndrome of intermin-gled phlegm and blood stasis were randomly divided into the treatment group（34 cases） and control group（33 cases） according to the treatment order. Based on basic treatment, the treatment group accepted pricking and spilled blood therapy selected one group from 3 groups of bilateral acupoints including Zusanli（ST36） ＋ Yanglingquan（SP9）, Weiyang（BL39） ＋ Yanglingquan（GB34）, Fenglong（ST40） ＋ Ququan（LR8）, and the control group accepted Xuezhikang capsule, 0.6g, po, Bid. Before and after the treatment, the changes of B ultrasonic, TC and TG were observed, and the safety and adverse reactions were recorded. Results： There were no significant difference in the gender, age, disease duration, body mass index between the two groups. The total effective rate in the treatment group was 88.24%, while the control group was 87.87%, with no significant difference in the total effective rate between the two groups（P〈0.05）. Pricking blood therapy obviously improved B ultrasonic imaging that was equal to the control group（P〈0.05）, and it significantly reduced the levels of TG and TC that was superior to the control group. There were no serious adverse reactions, and no significantly changes in liver and renal functions, and blood and urine routines before and after treatment. Conclusion： Pricking blood therapy is a safe and effective treatment method of NAFLD（SFL）, which belongs to syndrome of stagnation of liver qi and spleen deficiency combined with syndrome of intermin-gled phlegm and blood stasis, and it is worth promoting in practice.