化痰助运通络方治疗痰瘀互结型非酒精性脂肪肝肝纤维化临床研究

Clinical Study on Treating Non Alcoholic Fatty Liver Fibrosis of Phlegm and Blood Stasis Pattern by Resolving-phlegm Promoting-transportation Dredging-collateral Prescription

目的:观察化痰助运通络方治疗痰瘀互结型非酒精性脂肪肝肝纤维化的临床疗效。方法:将痰瘀互结型非酒精性脂肪肝肝纤维化患者77例随机分为治疗组39例,对照组38例,治疗组予化痰助运通络方治疗,对照组予易善复治疗,共治疗24周,观察治疗前后两组患者临床症状、肝功能、血脂、血清肝纤维化指标及Fibro-scan硬度值。结果:治疗组治疗后临床症状积分,γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,γ-GT)、碱性磷酸酶(alkaline phosphatase,AKP)、透明质酸(hyaluronic acid,HA)、血清Ⅲ型前胶原氨端肽(procollagenⅢ,PcⅢ)、血清Ⅳ型胶原蛋白(typeⅣcollagen,Ⅳ-C)、层黏连蛋白(laminin,LN)等与对照组比较差异均有统计学意义(P<0.05)。两组患者谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low densith lipoprotein,LDL)及Fibro-scan硬度值等比较差异均无统计学意义(P>0.05)。总有效率治疗组为94.9%(37/39),高于对照组的81.6%(31/38),差异有统计学意义(P<0.05)。结论:化痰助运通络方能改善非酒精性脂肪肝肝纤维化患者的临床症状、部分肝功能指标、血脂及血清肝纤维化等指标。

Objective:To investigate clinical effects of resolving-phlegm promoting-transportation dredgingcollateral prescription in the treatment of non alcoholic fatty liver fibrosis of phlegm and blood stasis pattern.Methods:A total of 77 patients were randomized into 39 cases of the treatment group and 38 cases of the control group,the treatment group was treated by resolving-phlegm promoting-transportation dredging-collateral prescription,and the control group took polyene phosphatidylcholine capsules,to observe clinical symptoms,liver function,blood lipid,serum markers of liver fibrosis and Fibro-scan stiffness between both groups before and after treating for 24 weeks.Results:After treating,the difference was statistically significant when the treatment group was compared with the control group in clinical symptoms scores,γ-GT,AKP,PCⅢ,HA,Ⅳ-C,LN and others(P<0.05).The difference had no statistical meaning in ALT,AST,TG,TC,HDL,LDL,Fibro-scan stiffness between both groups(P>0.05).Total effective rate of the treatment group was 94.9%(37/39),higher than 81.6%(13/38)of the control group,and the difference had statistical meaning between both groups(P<0.05).Conclusion:Resolving-phlegm promoting-transportation dredging-collateral prescription could improve clinical symptoms,partial indexes of liver function,blood lipid,serum hepatic fibrosis of the patients with non alcoholic fatty liver fibrosis of phlegm and blood stasis pattern.