基于FibroScan技术评价疏肝消脂方加减治疗非酒精性脂肪性肝病的临床疗效

Evaluating the Clinical Effect of Modified Shugan Xiaozhi Decoction(疏肝消脂方) in Treating Nonalcoholic Fatly Liver Disease Based on Fibro Scan Technique

目的评价疏肝消脂方加减配合行为干预治疗非酒精性脂肪性肝病(NAFLD)的临床疗效及FibroScan技术用于脂肪肝诊断的可行性。方法 80例NAFLD患者随机分为治疗组和对照组各40例。治疗组在行为干预基础上予疏肝消脂方加减口服,每日1剂。对照组在行为干预基础上予多烯磷脂酰胆碱胶囊口服,每次456 mg,每日3次。两组疗程均为24周。治疗前后用FibroScan技术测定两组患者受控衰减参数(CAP)值及肝硬度(E)值,并测定两组患者体重指数(BMI)、空腹血糖(FBG)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、总胆固醇(TC)、甘油三酯(TG)。同时比较FibroScan与B超在诊断脂肪肝程度上的差异。结果两组患者E、CAP、BMI、FBG、血脂及肝功能均较治疗前改善,除γ-GT外,治疗组改善均优于对照组(P<0.05或P<0.01)。FibroScan技术与B超在诊断脂肪肝程度上存在相关性,但一致性较差。结论疏肝消脂方加减配合行为干预能有效改善患者肝脏脂肪浸润,FibroScan技术可用于脂肪肝非创伤定量诊断。

Objective To evaluate the clinical effect of modified Shugan Xiaozhi Decoction（疏肝消脂方） combined with behavior intervention in treating nonalcoholic fatly liver disease（NAFLD） and to explore the feasibility of FibroScan technique in fatty liver diagnosis. Methods Eighty NAFLD patients were randomized into a treatment group（40 cases） and a control group（40 cases）. In addition to behavior intervention,the treatment group was given oral modified Shugan Xiaozhi Decoction 1 dose each day; the control group was given oral polyene phosphatidylcholine capsules 456 mg each time,3 times each day. The course was 24 weeks in both groups. Patients＇ controlled attenuation parameter（CAP） and liver stiffness（E） were detected in both groups by FibroScan technique before and after treatment. Patients＇ body mass index（BMI）,fasting blood-glucose（FBG）,alanine aminotransferase（ALT）,Aspartate aminotransferase（AST）,γ-glutamyl transpeptidase（γ-GT）,total cholesterol（TC） and triglyceride（TG）in both groups were detected. Meanwhile,the difference of FibroScan and B-ultrasound in the diagnosis of fatty liver level was compared. Results Patients＇ E,CAP,BMI,FBG,blood lipid and liver function in both groups were improved after treatment. The improvement in the treatment group was superior to that in the control group exceptγ-GT（P〈0. 05 or P〈0. 01）. There might be correlation between FibroScan technique and B-ultrasound in the diagnosis of fatty liver level,with poor consistency. Conclusion Modified Shugan Xiaozhi Decoction combined with behavior intervention might improve patients＇ fatty infiltration of liver. FibroScan technique could be applied in noninvasive quantitative diagnosis of fatty liver.