黄连解毒汤联合水飞蓟宾胶囊对湿热蕴结型非酒精性脂肪性肝炎患者的治疗效果观察

Effect of Huanglian Jiedu Decoction Combined with Silybin Capsule on Non-alcoholic Steatohepatitis with Damp-heat Syndrome

目的:观察黄连解毒汤联合水飞蓟宾胶囊对湿热蕴结型非酒精性脂肪性肝炎的临床疗效及对血清内毒素和促炎性细胞因子的调节作用。方法:将50名非酒精性脂肪性肝炎(NASH)患者按随机数字表法分为试验组和对照组各25名,试验组使用水飞蓟宾胶囊联合黄连解毒汤治疗,对照组单用水飞蓟宾胶囊治疗观察周期为12周,检测指标包括治疗前后肝功能、血脂、肝静脉超声频谱图、中医证候疗效积分以及内毒素和促炎性细胞因子水平。结果:组内比较2组患者治疗后肝功能、血脂和中医证候疗效积分均较治疗前有不同程度改善,组间比较在血脂和中医证候疗效积分方面试验组治疗后较对照组改善更为显著,组内比较试验组内毒素、IL-1、TNF-α治疗后较治疗前显著改善,对照组内毒素、IL-1、IL-6和TNF-α治疗后较治疗前无明显改变;组间比较治疗后试验组和对照组在内毒素、IL-1和TNF-α方面改善更为显著。结论:黄连解毒汤在调节血脂、改善患者中医证候以及降低内毒素和炎症因子方面具有显著作用。

Objective： To observe the clinical efficacy of Huanglian Jiedu Decoction and silibinin capsules on nonalcoholic steatohepatitis and the regulation of serum endotoxin and proinflammatory cytokines. Methods： Fifty patients with nonalcoholic steatohepatitis（ NASH） were randomly divided into experimental group and control group,25 patients in each group. While the experimental group using silibinin capsule combined with Huanglian Jiedu Decoction treatment,the control group was treated with silibinin capsule alone,and the observation period was 12 weeks. Liver function,serum lipids,hepatic vein ultrasound spectrogram,TCM syndrome scores,serum endotoxin and proinflammatory cytokine levels were measured before and after treatment. Results： In both groups,the scores of liver function,blood lipid and TCM syndrome were improved than before treatment. Compared with the control group,the improvement of the patients in the experimental group were more remarkable in blood lipid and TCM syndrome score. The levels of endotoxin,IL-1 and TNF-α were significantly improved compared with those before treatment in the experimental group,while the change were not remarkable in endotoxin,IL-1,IL-6 and TNF-α in the control group. The improvement of endotoxin,IL-1 and TNF-α in the experimental group was more remarkable than those in the control group. Conclusion： Huanglian Jiedu Decoction has significant effect in regulating blood lipid,improving TCM syndromes and reducing endotoxin and inflammatory cytokines.