降脂方联合穴位埋线治疗非酒精性脂肪性肝炎疗效观察

Observation on therapeutic effect of Jiangzhi Decoction combined with acupoint catgut embedding on nonalcoholic steatohepatitis

目的探讨降脂方联合穴位埋线治疗非酒精性脂肪性肝炎的临床疗效。方法将2018年1月—2019年12月珠海市中西医结合医院诊治的120例非酒精性脂肪性肝炎患者随机分为对照组、降脂方组、穴位埋线组、联合组,每组30例。4组患者均给予饮食指导、运动指导、心理健康指导等基础治疗。在此基础上,对照组给予多烯磷脂酰胆碱胶囊口服;降脂方组给予自拟降脂方口服,穴位埋线组给予穴位埋线,联合组给予降脂方口服及穴位埋线治疗,4组患者均连续治疗12周。观察4组患者治疗前后血清肝功能指标[总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)]、血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肝脏/脾脏CT比值及肝脏B超病变程度分级变化,治疗结束后评定临床疗效。结果治疗后4组患者血清ALT、AST、TBil、ALP、TG、TC、LDL-C水平均明显降低(P均<0.05),HDL-C水平、肝脏/脾脏CT比值均显著升高(P均<0.05),且联合组上述指标改善情况均明显优于其他组(P均<0.05);4组肝脏B超病变程度均明显改善(P均<0.05),且联合组改善情况明显优于其他组(P均<0.05);联合组临床总有效率为90.0%(27/30),降脂方组、埋线组、对照组临床总有效率均为80.0%(24/30),联合组临床总有效率显著高于其他组(P均<0.05)。结论降脂方联合穴位埋线治疗非酒精性脂肪性肝炎可有效改善患者病情,减轻肝功能损伤,调节血脂,效果优于单纯西医疗法及采用中药治疗或者穴位埋线治疗。

Objective It is to explore the clinical efficacy of Jiangzhi Decoction combined with acupoint catgut embedding in the treatment of non-alcoholic steatohepatitis.Methods 120 patients with non-alcoholic steatohepatitis diagnosed and treated in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to August 2019 were randomly divided into control group,Jiangzhi Decoction group,acupoint embedding group,and combination group,each group had 30 cases.All the patients in the 4 groups were given basic treatments such as diet guidance,exercise guidance,and mental health guidance.Additionally,the control group was given polyene phosphatidylcholine capsules orally;on the basis of the treatment of the control group,the Jiangzhi Decoction group was given the self-made Jiangzhi prescription orally,the acupoint catgut embedding group was given acupoint catgut embedding,and the combination group was given Jiangzhi Decoction and acupoint embedding,all the groups were treated continuously for 12 weeks.The changes of the serum liver function indexes[total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP)],blood lipid indexes[triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],liver/spleen CT ratio and classification of liver lesions by B-ultrasound of the patients in the 4 groups were observed before and after treatment,the clinical curative effects were evaluated at the end of treatment course.Results The levels of serum ALT,AST,TBil,AKP,TG,TC,LDL-C were significantly reduced(all P<0.05),and HDL-C levels and liver/spleen CT ratio were significantly increased in the patients of the 4 groups after treatment(P all<0.05),and the improvement of the above indicators in the combined group was significantly better than that of the other groups(P<0.05).The classification of liver lesions by B-ultrasound in the 4 groups were significantly improved after treatment(all P<0.05),and the improvement of the combination group was significantly better than that of the other groups(all P<0.05).The total clinical effective rate of the combination group was 90.0%(27/30),and the total clinical effective rates of the Jiangzhi Decoction group,the catgut embedding group,and the control group were all 80.0%(24/30),the total clinical effective rate of the combination group was significantly higher than that of the other groups(all P<0.05).Conclusion Jiangzhi Decoction combined with acupoint catgut embedding can effectively improve the patient's condition,reduce liver damage,and regulate blood lipids in the treatment of non-alcoholic steatohepatitis.The effect is better than simple western medicine and traditional Chinese medicine or acupoint catgut embedding.