中西医结合治疗对非酒精性脂肪肝患者血清肝纤维化指标和炎症因子的影响

Effect of integrative Chinese and Western medicine on hepatic fibrosis indicators and inflammatory factors in patients with nonalcoholic fatty liver disease

目的探讨中西医结合治疗对非酒精性脂肪肝(NAFLD)患者血清肝纤维化指标和炎症因子的影响。方法选取2014年1月～2017年8月在我院急诊科就诊NAFLD患者80例,采用抛硬币法分为中西医组和西医组各40例。两组均给予控制饮食、适当体育锻炼及保护肝功能等治疗。西医组予以多烯磷脂酰胆碱胶囊456 mg/次,3次/d,口服。中西医组在西医组治疗基础上加用自拟的疏肝降脂汤治疗,两组均治疗6周,分别于治疗前后检测肝功能、肝纤维化指标和血清IL-6和TNF-α水平的变化。结果治疗6周后,两组ALT、AST、γ-GT、HA和LN指标较前显著下降(P<0.05或P<0.01),且中西医组下降幅度较西医组更明显(P<0.05);同时两组血清IL-6和TNF-α较前显著下降(P<0.05或P<0.01),且中西医组下降幅度较西医组更明显(P<0.05)。结论中西医结合治疗NAFLD能降低肝功能和肝纤维化指标,加快肝功能恢复,抑制肝纤维组织增生,并能显著降低血清IL-6和TNF-α指标,抑制肝局部炎症反应。

Objective To investigate the effect of integrated traditional Chinese and Western medicine on serum fibrosis markers and inflammatory factors in patients with nonalcoholic fatty liver(NAFLD).Methods80patients with NAFLD were treated in the emergency department of our hospital from January2014to August2017were selected.They were divided into the Chinese and Western medicine group and the Western medicine group by the coin-throwing method,with40patients in each group.Both groups were given dietary control,proper physical exercise,and protection of liver function.Western medicine group was given polyene phosphatidylcholine capsules456mg/times,3times/d,orally.The Chinese and Western medicine group was treated additionally with the self-made Shugan Jiangzhi Decoction on the basis of the treatment of Western medicine group.Both groups were treated for6weeks.The changes of indexes of liver function,liver fibrosis and serum IL-6and TNF-αlevels were measured before and after treatment.Results After6weeks of treatment,the ALT,AST,γ-GT,HA,and LN of the two groups were significantly lower than those before(P<0.05or P<0.01),and the degree of declining was more significant in the Chinese and Western medicine groups than that in the Western medicine group(P<0.05).At the same time,the serum levels of IL-6and TNF-αin the two groups were significantly lower than those before(P<0.05or P<0.01),and the degree of declining was more obvious in the Chinese and Western medicine groups than that in the Western medicine group(P<0.05).Conclusion Treatment of NAFLD with integrated traditional Chinese and Western medicine can reduce liver function and hepatic fibrosis indexes,accelerate liver function recovery,inhibit hepatic fibrosis,and significantly reduce serum IL-6and TNF-αlevels and inhibit hepatic local inflammation.