化痰活血汤联合非诺贝特对非酒精性脂肪肝患者血脂、胰岛素抵抗和肝纤维化指标的影响

Effect of Huatan Huoxue Decoction combined with fenofibrate on blood lipid,insulin resistance and hepatic fibrosis indexes in patients with nonalcoholic fatty liver

[目的]探讨化痰活血汤联合非诺贝特对非酒精性脂肪肝患者血脂、胰岛素抵抗和肝纤维化指标的影响。[方法]选自我院于2014年8月~2015年8月期间收治的非酒精性脂肪肝患者95例,依据随机数字表法随机分为观察组48例与对照组47例。对照组采用非诺贝特治疗,观察组在对照组基础上结合化痰活血汤治疗。2组疗程均为12周。比较2组治疗疗效,治疗前后血脂、胰岛素抵抗、肝纤维化指标、肝功能指标水平变化,及不良反应发生情况。[结果]观察组总有效率（93.75%）高于对照组（72.34%）（P〈0.05）;2组TG、TC水平治疗后下降（P〈0.05）;观察组TG、TC水平治疗后低于对照组（P〈0.05）;2组胰岛素抵抗指数治疗后下降（P〈0.05）;观察组胰岛素抵抗指数治疗后低于对照组（P〈0.05）;2组血清LN、PC III、HA水平治疗后下降（P〈0.05）;观察组血清LN、PC III、HA水平治疗后低于对照组（P〈0.05）;2组血清AST、ALT水平治疗后下降（P〈0.05）;观察组血清AST、ALT水平治疗后低于对照组（P〈0.05）;2组均未见严重不良反应。[结论]化痰活血汤联合非诺贝特治疗非酒精性脂肪肝患者疗效明显,可改善患者血脂、胰岛素抵抗及肝纤维化,且安全可靠,值得研究。

[Objective]To investigate the effect of Huatan Huoxue Decoction combined with fenofibrate on blood lipid,insulin resistance and hepatic fibrosis indexes in nonalcoholic fatty liver patients.[Methods]Ninety-five cases of non-alcoholic fatty liver patients,who were selected from our hospital from August2014 to August 2015,were randomly divided into observation group 48 cases and control group 47 cases.Control group were given fenofibrate treatment,while the observation group were given Huatan Huoxue decoction in in addition to fenofibrate.The course of treatment was 12 weeks in two groups.Effects of treatment were compared between the two groups.The changes of blood lipid,insulin resistance,liver fibrosis,liver function indexes before and after treatment,as well as the incidence of adverse reaction were observed.[Results]The total effective rate of the observation group was 93.75%,which was higher than72.34%in the control group（P〈0.05）.TG,TC levels in the two groups were decreased after treatment（P〈0.05）.After treatment,the TG and TC levels in the observation group were lower than those in the control group（P〈0.05）.Insulin resistance index of the two groups decreased after treatment（P〈0.05）.Theinsulin resistance index in observation group was lower than the control group after treatment（P〈0.05）.Serum LN,PC III,and HA level in the two groups decreased after treatment（P〈0.05）.The serum levels of LN,PC III,and HA in observation group were lower than those of control group after treatment（P〈0.05）.Serum AST and ALT levels in the two groups decreased after treatment（P〈0.05）,with lower levels of serum AST and ALT in observation group than those of control group after treatment（P〈0.05）.There were no severe adverse reactions in the two groups.[Conclusion]The combined therapy of Huatan Huoxue Decoction with fenofibrate is effective in treating non-alcoholic fatty liver.It can improve serum lipids,insulin resistance and hepatic fibrosis,which is also safe and reliable.