苍附导痰汤联合阿昔莫司治疗66例肝功能异常高脂血症患者的临床观察

Clinical observation on 66 cases of Cangfu Daotan Decoction combined with acipimox in treating hyperlipidemia with abnormal liver function

目的评价苍附导痰汤对肝功能异常高脂血症患者的有效性与安全性。方法选取我院门诊及病房收治的肝功能异常高脂血症患者129例,随机分为对照组与治疗组,治疗组66例,对照组63例,对照组给予阿昔莫司治疗,治疗组在此基础上联合中药苍附导痰汤,观察两组患者治疗4、8周后的甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)的水平、不良反应及临床疗效。结果对照组TG水平,治疗4、8周后与治疗前比较差异有统计学意义(P<0.05,P<0.01);治疗8周与4周比较,差异有统计学意义(P<0.01)。治疗组TG水平,治疗4、8周后与治疗前比较差异有统计学意义(P<0.01);治疗8周与治疗4周比较,差异有统计学意义(P<0.01)。治疗组HDL-C水平治疗8周后与治疗前比较差异有统计学意义(P<0.01);治疗8周与治疗4周比较,差异有统计学意义(P<0.05)。治疗8周后两组间HDL-C水平同期比较,差异有统计学意义(P<0.01)。对照组低LDL-C水平治疗8周后与治疗前比较差异有统计学意义(P<0.05)。治疗组LDL-C水平治疗8周后与治疗前比较差异有统计学意义(P<0.01);治疗8周与4周比较,差异有统计学意义(P<0.05)。治疗8周后两组间LDL-C水平同期比较,差异有统计学意义(P<0.05)。治疗组ALT、AST水平治疗4、8周后与治疗前比较,差异有统计学意义(P<0.05,P<0.01);治疗8周与4周ALT、AST比较,差异有统计学意义(P<0.05)。两组间治疗4、8周后ALT、AST同期比较,差异有统计学意义(P<0.05,P<0.01)。治疗8周后两组患者治疗前后中医症状积分比较,差异有统计学意义(P<0.01)。治疗8周后两组间中医症状积分比较,差异有统计学意义(P<0.01)。治疗8周后两组患者治疗前后生活质量积分比较,差异有统计学意义(P<0.01),治疗8周后两组间生活质量积分比较,差异有统计学意义(P<0.01)。结论苍附导痰汤联合阿昔莫司可使肝功能异常之高脂血症患者血脂水平、肝功能明显改善,临床症状减轻,生活质量提高,降低了不良反应发生率,用药安全性好,值得临床推广。

Objective To investigate the efficacy and safety of Cangfu Daotan Decoction in treating hyperlipidemia with abnormal liver function.Methods A total of 129 hyperlipidemia patients with abnormal liver function admitted to our hospital were included and randomized into the treatment group(62)and the control group(63).The control group was given acipimox,while the treatment group was given Cangfu Daotan Decoction combined with acipimox.At the end of the 4 th week and the 8 th week of treatment,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),alanine transaminase(ALT),aspartic transferase(AST)levels,adverse events and clinical effect in both groups were observed.Results At the end of the 4 th week and the 8 th week,the TG level in the control group was improved with statistical significance(P<0.05,P<0.01),and there was significant difference between the two time points(P<0.01);the TG level in the treatment group was also improved with statistical significance(P<0.01),and there was significant difference between the two time points(P<0.01).In the treatment group,the HDL-C level was improved significantly at the end of the 8 th week(P<0.01),and there was significant difference between the 4 th week and the 8 th week(P<0.05).At the end of the 8 th week,there was significant difference in the HDL-C level between the two groups(P<0.01).The LDL-C level in the control group at the end of the 8 th week was improved,compared with that before treatment,with statistical significance(P<0.05).In the treatment group,the LDL-C level at the end of the 8 th week was significantly improved compared with that before treatment(P<0.01),and compared with the level at the end of the 4 th week(P<0.05).At the end of the 8 th week,the difference in the LDL-C level between two groups was statistically significant(P<0.05).Levels of ALT and AST at the end of the 4 th week and the 8 th week in the treatment group were improved,compared with those before treatment,with statistical significance(P<0.05,P<0.01),and there was significant difference in the ALT and AST levels between the two time points(P<0.05).There was significant difference in the levels of ALT and AST between the two groups at the end of the 4 th week and the 8 th week(P<0.05,P<0.01).At the end of the 8 th week,the TCM syndrome score in both groups was improved,with statistical significance(P<0.01),and there was statistical significance in the TCM score between the two groups(P<0.01).At the end of the 8 th week,the quality of life score in both groups was improved,with statistical significance(P<0.01),and there was statistical significance in the quality of life score between the two groups(P<0.01).Conclusion The therapy improves serum lipid level and liver function of hyperlipidemia with abnormal liver function,alleviates clinical symptoms,gets quality of life improved,reduces adverse reactions,improves medication safety,which is worthy to be widely applied in clinic.