柴芍六君子汤加减治疗非酒精性脂肪性肝炎肝郁脾虚证临床研究

Clinical Study on Modified Chaishao Liujunzi Decoction in Treatment of Nonalcoholic Steatohepatitis with Liver Stagnation and Spleen Deficiency Syndrome

目的观察柴芍六君子汤加减治疗非酒精性脂肪性肝炎(NASH)肝郁脾虚证的临床疗效。方法采用随机数字表法将90例患者分为对照组和观察组各45例。对照组在生活干预基础上予维生素E软胶囊,每次1粒,每日3次,口服;观察组在生活干预基础上予柴芍六君子汤加减,每日1剂,每日2次,口服。2组均连续治疗12周。观察2组肝脏超声疗效、肝脏脂肪含量疗效、中医疗效,比较2组治疗前后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平及脂肪衰减参数(CAP)、中医症状评分,观察2组不良反应。结果观察组肝脏超声疗效、肝脏脂肪含量疗效、中医疗效分别为91.11%、88.89%、93.33%,对照组分别为68.89%、66.67%、71.11%,观察组均明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后ALT、AST、TC、TG、LDL-C水平及CAP均明显降低(P<0.05);2组治疗后比较,观察组ALT、AST、TC、TG、LDL-C水平及CAP明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后右胁疼痛、右胁胀满、胸闷、善太息、神疲乏力评分均明显降低(P<0.05);2组治疗后比较,观察组上述症状评分明显低于对照组(P<0.05)。2组未见明显不良反应。结论柴芍六君子汤加减可降低NASH肝郁脾虚证肝酶及血脂水平,明显减轻患者临床症状,疗效显著,安全性较高。

Objective To study the clinical efficacy of modified Chaishao Liujunzi Decoction in the treatment of non-alcoholic steatohepatitis(NASH)with liver stagnation and spleen deficiency syndrome.Methods Totally 90 patients were divided into control group and observation group according to random number table method.The control group was given vitamin E on the basis of life intervention,1 capsule each time,3 times a day,orally.The observation group was given modified Chaishao Liujunzi Decoction on the basis of life intervention,1 dosage a day,twice a day,orally.Both groups were treated continuously for 12 weeks.Liver ultrasound efficacy,liver fat content efficacy,and TCM efficacy of both groups were observed.Levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triacylglycerol(TG),and low-density lipoprotein cholesterol(LDL-C),fat attenuation parameter(CAP)and TCM symptom score before and after treatment in the two groups were compared.Adverse reactions in the two groups were observed.Results The efficacy of liver ultrasound,liver fat content,and TCM in the observation group were 91.11%,88.89%,and 93.33%,respectively,while those in the control group were 68.89%,66.67%,and 71.11%,respectively.The observation group was significantly better than the control group(P<0.05).Compared with before treatment,the levels of ALT,AST,TC,TG,LDL-C and CAP in the two groups were significantly reduced after treatment(P<0.05).After treatment,the levels of ALT,AST,TC,TG,LDL-C and CAP in the observation group were significantly lower than those in the control group(P<0.05).Compared with before treatment,the scores of right side pain,right side fullness,chest tightness,sigh,and fatigue were significantly reduced after treatment in the two groups(P<0.05);after treatment,the above-mentioned symptom scores of the observation group were significantly lower than those of the control group(P<0.05).No obvious adverse reactions were found in the two groups.Conclusion The treatment of modified Chaishao Liujunzi Decoction for NASH with liver stagnation and spleen deficiency syndrome can effectively reduce enzymes and blood lipid levels,and significantly reduce the clinical symptoms of patients,with significant efficacy and high safety.