自拟解郁疏肝汤治疗肝郁气滞型非酒精性脂肪肝临床疗效及作用机制研究

Clinical Effect and Mechanism of Using Jieyu Shugan Decoction in the Treatment of Liver-Qi Stagnation Type Nonalcoholic Fatty Liver Disease

目的:研究自拟解郁疏肝汤治疗肝郁气滞型非酒精性脂肪肝的作用机制研究。方法:选取94例肝郁气滞型非酒精性脂肪肝患者,将所选患者随机分为2组,对照组和观察均47例。口服当飞利肝宁片,4粒/次,3次/日,4周为1个疗程;观察组:采用自拟解郁疏肝汤治疗,水煎至200ml,每日1剂,分早晚2次温服,4周为1个疗程,2组均连续治疗3个疗程后评价疗效。结果:2组治疗后肝功能指标比较,观察组以上各项指标的水平明显较对照组低(P<0.05),而观察组的GGT水平在治疗后明显降低(P<0.05),而对照组则没有明显变化(P>0.05);2组治疗后血脂指标比较,观察组的TC、TG、LDL-C及LDL-C的水平则显著较对照组低(P<0.05);2组炎性因子比较,观察组患者血清中IL-6、TNF-α及TGF-β1水平均明显较对照组低(P<0.05)。结论:自拟解郁疏肝汤气治疗肝郁气滞型非酒精性脂肪肝效果显著,其作用机制可能与炎性因子IL-6、TNF-α及TGF-β1相关,值得临床上广泛应用。

Objective： To study the mechanism of Shugan Jieyu Decoction in the treatment of liver-Qi stagnation type nonalcoholic fatty liver disease. Methods： A total of 94 patients with stagnation of liver-Qi stagnation type non alcoholic fatty liver patients. The selected patients were randomly divided into 2groups,47 cases in each group. The controlled group Orally took Dangfei Liganning Tablets,4grains / time,3times / day,4weeks for a course of treatment; the observation group using Self-made Jieyu Shugan Decoction in treating,water frying to 200 ml,daily 1agent,sooner or later,2times a day,4weeks for a course of treat-ment,two groups were treated continuously for 3courses after efficacy evaluation. Results： Comparing the liver function index of the 2groups,the observation group above index was significantly lower than that in the controlled group（ P〈0. 05）,while the observation group of GGT levels after treatment decreased significantly（ P〈0. 05）,and the controlled group had no significant change（ P〉0. 05）; comparing blood lipid index of the two groups after treatment,the observation group of TC,LDL-C,TG and LDL-C level was significantly lower than that of the controlled group（ P〈0. 05）; inflammatory factors were observed and compared between the 2group. Serum IL-6,TNF-αand TGF- 1levels of the observation group were significantly higher compared to the controlled group（ P〈0. 05）. Conclusion： It has significant effect of using Self-made Jieyu Shugan Decoction in the treatment of liver depression and Qi stagnation type non-alcohol fatty liver,the mechanism may be related to the inflammatory factor IL-6,TNF and TGF beta 1,it is worthy of wide clinical application.