周末禁食联合加味苓桂术甘汤治疗非酒精性脂肪肝病的临床研究

Clinical Study on Weekend Fasting Joined with Modified Linggui ZhuGan Decoction in the Treatment for Non-alcoholic Fatty Liver Disease

目的:观察周末禁食联合加味苓桂术甘汤治疗非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)的临床疗效。方法:将NAFLD患者60例随机分为治疗组和对照组各30例。两组患者均采用低脂饮食,少荤多素,适当增加运动量。对照组给予熊去氧胆酸250 mg,每日3次,治疗组予加味苓桂术甘汤联合周末禁食,疗程均为12周。比较两组临床疗效、肝功能、血脂、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model of insulin resistance index,HOMA-IR)、体质指数(body mass index,BMI)和脂肪肝分级变化情况。结果:总有效率治疗组为80%(24/30),高于对照组的50%(15/30)(P<0.05);治疗后治疗组患者在降低丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰转肽酶(gamma-glutamyltransferase,GGT)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、FINS、HOMA-IR和BMI及改善脂肪肝分级方面均优于对照组(P<0.05)。结论:周末禁食联合加味苓桂术甘汤可能通过改善患者肝功能、降低血脂、减轻胰岛素抵抗和控制体质量来降低NAFLD患者脂肪肝分级。

Objective:To observe the clinical effects of weekend fasting combined with modified Linggui Zhugan decoction in treating non-alcoholic fatty liver disease(NAFLD).Methods:Sixty NAFLD patients were randomly divided into the treatment group and the control group.Both groups adopted low-fat diets,less meat,more vegetables,increasing the exercise amount appropriately.The control group was given ursodesoxycholic acid,250 mg,three times each day,and the treatment group weekend fasting combined with modified Linggui Zhugan decoction,the course was 12 weeks.To compare clinical effects,liver function,blood lipid,FBG,FINS,HOMA-IR,BMI and the classification of fatty liver between both groups.Results:Total effective rate of the treatment group was 80%(24/30),higher than 50%(15/30)of the control group(P<0.05);after treating,the treatment group was superior to the control group in lowering ALT,AST,GGT,TC,TG,FINS,HOMA-IR and BMI,and improving the classification of fatty liver(P<0.05).Conclusion:Weekend fasting comined with modified Linggui Zhugan decoction could lower the classfication of fatty liver in NAFLD patients which might be through improving liver function,lowering blood lipid,relieving insulin resistance and controling body weight.