磁共振质子密度脂肪分数评价穴位埋线治疗非酒精性脂肪性肝病的临床疗效

Evaluation of clinical effect of acupoint catgut embedding therapy on non-alcoholic fatty liver disease by Magnetic Resonance Imaging derived Proton Density Fat Fraction

目的:以磁共振质子密度脂肪分数定量分析肝脏脂肪含量为主要疗效指标,评价穴位埋线对非酒精性脂肪性肝病(NAFLD)患者的临床疗效。方法:收集98例NAFLD患者,按随机数字表分为治疗组49例和对照组49例,脱落4例、剔除9例(治疗组7例,对照组6例),患者均给予基础治疗(地中海饮食及中等量的运动),治疗组在基础治疗上加用穴位埋线,对照组在基础治疗的同时加用针刺穴位但不埋线治疗,两组疗程均为12周,观察两组患者的肝脏脂肪含量,血脂(TG、TC),胰岛素抵抗指数(HOMA-IR)及体质量指数(BMI)。结果:治疗组和对照组治疗均可有效降低肝脏脂肪含量(P<0.01),且治疗组降低程度优于对照组,差异有统计学意义(P<0.01)。治疗后,两组TG、TC、HOMA-IR、BMI指标较治疗前均有改善,差异有统计学意义(P<0.01);且治疗组改善程度优于对照组,差异有统计学意义(P<0.05)。结论:使用穴位埋线治疗NAFLD,可以降低肝脏脂肪含量、改善患者血脂指标、体质量指数,有效改善患者胰岛素抵抗水平,提高治疗效果。

Objective:To evaluate the clinical efficacy of acupoint catgut embedding on patients with non-alcoholic fatty liver disease by quantitative analysis of liver fat content by Magnetic Resonance Imaging derived Proton Density Fat Fraction as the main therapeutic index.Methods:Ninty-eight patients with non-alcoholic fatty liver disease were divided into the control group(n=49)and treatment group(n=49)according to random number table.All patients were followed-up for 12 weeks,and 4 cases dropped out,9 cases were excluded(7 cases in the treatment group and 6 cases in control group).All patients were treated with basic treatment(Mediterranean diet and moderate exercise).Based on the basic treatment,the treatment group was treated with catgut implantaion,and the control group was treated with the acupuncture but without catgut embedding,with a course of 12 weeks.The liver fat content,insulin resistance index,blood lipid levels(TC and TG)and body mass index were observed in the two groups.Results:After treatment,The liver fat content of two group could be reduced effectively(P<0.01).And the degree of decrease in the treatment group was better than that in the control group,with statistically significant differences(P<0.01).The levels of TG,TC,HOMA-IR and BMI were improved in the two groups,and the improvement in the treatment group was better than control group(P<0.05).Conclusion:The treatment of non-alcoholic fatty liver disease with catgut implantation at acupoint can reduce the content of liver fat,improve the liver function,blood lipid index and body mass index,and effectively improve the level of insulin resistance and therapeutic effect.