湖北某大学职工非酒精性脂肪性肝病流行病学调查及中西医结合治疗临床观察

Investigation of non-alcoholic fatty liver among Employees of a University in Hubei Province and Observation of Clinical Efficacy of Integrated Traditional Chinese and Western Medicine

目的:调查湖北某大学职工非酒精性脂肪性肝病(NAFLD)患病情况、影响发病的风险因素及中西医结合治疗的临床效果。方法:选取2016年7月至2017年12月湖北某大学参加健康体检的1 368名职工作为研究对象,所有受检者均行常规体格检查、血脂4项、葡萄糖耐量检验以及肝脏影像学检查。采用问卷咨询方式调查所有受检者一般资料,记录NAFLD发病率并分析影响其发病的风险因素。将确诊为NAFLD的168例患者随机分为试验组和对照组,分别给予中西医结合治疗及常规西药治疗,比较临床疗效。结果:①体检人员NAFLD总患病168例,发病率为12.3%,其中男性为17.6%,女性为8.2%。男性患病率高于女性(P<0.05)。单因素分析结果显示,性别、年龄、肥胖、高甘油三酯血症、高尿酸血症、高血糖和低高密度脂蛋白降低是影响NAFLD发病的相关风险因素(P<0.05);将单因素分析有显著性差异的变量纳入多因素Logistic回归模型中,分析结果证实年龄、性别、肥胖、高甘油三酯症、高尿酸血症、高血糖和低高密度脂蛋白降低是影响NAFLD发病的独立风险因素。②两组患者治疗总有效率比较,试验组明显高于对照组(P<0.05)。结论:引起NAFLD的风险因素多且复杂。中西医结合治疗NAFLD效果显著,能改善患者生化学指标,改善脂肪肝的病情。

Objective:To analyze the incidence of non-alcoholic fatty liver(NAFLD) and its risk factors in medical examination of university staff, and to explore the clinical effect of combined treatment of traditional Chinese and Western medicine.Methods:From July 2016 to December 2017, a university in Hubei Province was selected for 1,368 jobs to participate in a health examination. All the subjects were tested for regular physical fitness, blood fat, glucose tolerance, and liver imaging. The general information of all subjects was investigated by means of questionnaire consultation. Record the incidence of NASH and analyze the risk factors affecting its incidence. In addition, patients diagnosed with NAFLD were randomly divided into experimental group and control group. They were given combined Chinese and Western medicine treatment and conventional Western medicine treatment respectively, and the clinical efficacy was compared.Results:The total prevalence of NAFLD was 12.3% among the medical examiners, with 17.6% among men and 8.2% among women. Prevalence was higher among men than among women(P<0.05). The results of single factor analysis showed that sex, age, obesity, hypertriglyceridemia, hyperuricemia, hyperglycemia, and hypoHDL-Cemia were the relevant risk factors affecting the incidence of NAFLD(P<0.05);The variables with significant differences in single-factor analysis were incorporated into the multi-factor Logitic regression model. The analysis results confirmed that age, sex, obesity, high triglyceride, hyperuricemia, hyperglycemia, and low HDL-Cemia were independent risk factors that affected the onset of NAFLD;The total effective rate of treatment was significantly higher in the experimental group than in the control group(P<0.05). Conclusion:The risk factors that cause NAFLD are many and complex. According to the pathogenic factors, targeted preventive measures can effectively reduce the incidence of NAFLD. The combination of traditional Chinese and Western medicine is effective in the treatment of NAFLD. It can quickly improve the clinical symptoms of patients and has high safety. It is worth promoting and applying.