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基于肝脏超声衰减参数观察茵陈苓桂剂干预非酒精性脂肪性肝炎的作用研究 被引量:4

Observing the effect of Yinchen Linggui prescription on NASH based on liver ultrasonic attenuation parameters
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摘要 [目的]以痰浊内阻、湿热瘀结型非酒精性脂肪性肝炎(NASH)患者为观察对象,从超声衰减参数(CAP值)、肝功能、血脂水平、中医证候评分、腹部B超等指标来对比茵陈苓桂剂与易善复的临床疗效,探讨温运清利法治疗NASH的作用机理。[方法]收集来源于北京中医药大学东方医院符合诊断标准与纳入标准的痰浊内阻、湿热瘀结型NASH患者72例,随机分为治疗组与对照组,各36例。治疗组给予口服茵陈苓桂剂,每日1剂,早晚饭后1h口服;对照组给予口服易善复,每次2粒(456mg),每日3次,2组均服用3个月。治疗期间2组均进行饮食、运动干预。观察2组患者治疗前后临床症状、CAP值、腹部B超、肝功能、血脂等的变化情况。[结果](1)治疗组改善NASH患者的CAP值优于对照组(P<0.01),提示茵陈苓桂剂对降低肝脏脂肪含量有明显的效果。(2)治疗组改善NASH患者的ALT优于对照组(P<0.01),2组治疗后AST比较差异无统计学意义,二者无明显差别。(3)治疗组临床症候疗效总有效率为93.1%,优于对照组的84.4%(P<0.05)。(4)治疗组在改善右胁胀痛、右胁下痞块、口干口苦的方面优于对照组(P<0.05);在体态丰腴、身目发黄、上腹胀满、大便不爽、恶心欲吐的改善方面与对照组差异无统计学意义。(5)血脂方面,2组治疗效果差异无统计学意义。(6)腹部B超方面,2组疗效差异无统计学意义。[结论]茵陈苓桂剂能够有效治疗痰浊内阻、湿热瘀结型NASH患者的临床症状、降低CAP值、改善肝脏影像学变化、改善肝功能、纠正脂质代谢紊乱,明确了温运清利法既能温化痰浊、清利肝胆,又能改善肝功能及肝脏脂肪含量,恢复整体功能以治其本。 [Objective]To observe the clinical curative effect of Yinchen Linggui prescription and Yishanfu on patient with turbid internal resistance and damp-heat phlegm-associated from ultrasonic attenuation parameters(CAP value),liver function,blood lipid levels,TCM syndrome scores,abdominal ultrasound and other indicators,and explore the mechanism of qing li wen yun method in the treatment of NASH.[Methods]A total of 72 patients with turbid internal resistance and damp-heat phlegm-associated NASH who were diagnosed according to the diagnostic criteria and inclusion criteria from the Dongfang Hospitalof Beijing University of Chinese Medicine.were randomly divided into treatment group and control group,36 cases in each group.The treatment group was given oral Yinchen Linggui prescription,one dose per day,one hour after breakfast and dinner;the control group was given oral Yishanfu,2 capsules(456 mg)each time,3 times a day,and both groups were taken for three months.Dietary and exercise interventions were performed in both groups during the treatment period.The changes of clinical symptoms,CAP value,abdominal B-ultrasonography,liver function,and blood lipids were observed before and after treatment in the two groups of patients.[Results](1)The treatment group was better than the control group in improving the CAP value of patients with NASH(P<0.01),suggesting that Yinchen Linggui prescription has obvious effect on reducing liver fat content.(2)The treatment group was better than the control group in improving the ALT of patients with NASH(P<0.01).There was no significant difference in AST between the two groups after the treatment.(3)The total effective rate of clinical symptoms in the treatment group was 93.1%,which was better than 84.4%in the control group(P<0.05).(4)The treatment group was better than the control group in improving right-thorax pain,right-lower hemorrhoid mass,and dry mouth bitterness(P<0.05);No significant difference between the control group and the improvement of body fatness,yellowing of the body,fullness of the upper abdomen,uncomfortable bowel movements,nausea and vomiting.(5)No difference between the two groups in blood lipids.(6)Abdominal B-mode ultrasound showed no significant difference between the two groups(P>0.05).[Conclusion]Yinchen Linggui prescription can effectively treat the clinical symptoms of turbid internal resistance,damp-heat phlegm-associated NASH patients,reduce CAP value,improve liver imaging changes,improve liver function,and correct lipid metabolism disorders.It was clarified that the Wenyun Qingli method could not only warm the phlegm,clear the liver and gallbladder,but also improve the liver function and liver fat content,and restore the overall function to cure its roots.
作者 吴迪 李军祥 谢春娥 薛晓轩 韩海啸 孟捷 张厂 胡立明 陈润花 余轶群 WU Di;LI Jun-xiang;XIE Chun-e;XUE Xiao-xuan;HAN Hai-xiao;MENG Jie;ZHANG Chang;HU Li-ming;CHEN Run-hua;YU Yi-qun(Beijing University of Chinese Medicine,Beijing 100029,China;Department of Gastroenterology,Dong-fang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)
出处 《中国中西医结合消化杂志》 CAS 2018年第10期817-822,共6页 Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金 北京市中医药科技项目(No:JJ2014-68)
关键词 茵陈苓桂剂 肝脏超声衰减参数 非酒精性脂肪性肝炎 温运清利法 Yinchen Linggui prescription liver attenuation parameters non-alcoholic steatohepatitis Wenyun Qingli method
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