益肾化痰法对非酒精性脂肪肝患者脂联素、瘦素、白介素18及肝纤维化的影响

Effect of Tonifying Kidney and Removing Phlegm on adiponectin,leptin,interleukin-18 and liver fibrosis in patients with non-alcoholic fatty liver

[目的]探讨益肾化痰法对非酒精性脂肪肝病(NAFLD)患者的脂联素(APN)、瘦素(Leptin)、白介素18(IL-18)及肝纤维化指标[透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ胶原(CⅣ)]的影响。[方法]将我院确诊的135例NAFLD患者随机分为益肾化痰法组67例(治疗组)和复方二氯醋酸二异丙胺片组68例(对照组)。2组均治疗2个月,于治疗前后检测患者的APN、Leptin、LI-18及肝纤维化指标。[结果]治疗后,2组细胞因子APN、Leptin、IL-18均较治疗前好转,差异有统计学意义(均P<0.05),且治疗组的Leptin、IL-18在治疗后比对照组下降更为明显,差异有统计学意义(P<0.05)。2组的肝纤维化指标治疗后均较治疗前下降,差异有统计学意义(P<0.05),且治疗组比对照组治疗后下降更为明显,差异有统计学意义(P<0.05)。[结论]益肾化痰法能够增加APN水平,抑制Leptin抵抗及炎性因子IL-18的水平,并改善肝纤维化指标,以起到防治NAFLD的作用。

[Objective]To investigate the effects of Tonifying Kidney and Removing Phlegm（TKRP）on adiponectin（APN）,leptin（Leptin）,interleukin 18（IL-18）and liver fiber in patients with non alcoholic fatty liver disease（NAFLD）.[Methods]One hundred and thirty-five patients with NAFLD were randomly divided into treatment group（n=67）and control group（n=68）,and both group were treated with TKRP method and compound dichloroacetic acid diisopropylamine tablets for 2 months.APN,Leptin,IL-18 and liver fiber were detected before and after treatment.[Results]After treatment,APN,Leptin,IL-18 in two groups were better than those before treatment（P〈0.05）,and the decrease of Leptin,IL-18 in the treatment group was more obvious than that in the control group（P〈0.05）.The hepatic fibrosis was declined in both groups after treatment with statistically significant（P〈0.05）,and the decrease of hepatic fibrosis in the treatment group was more obvious than that in the control group（P〈0.05）.[Conclusion]The method of TKRP can prevent and treat NAFLD due to its increasing the level of APN,inhibiting the level of Leptin resistance and inflammatory factor IL-18,and improving liver fiber.