健脾清热化湿法治疗非酒精性脂肪性肝病患者的临床观察

Clinical Observation of Jianpi Qingre Huashi Therapy in the Treatment of Patients with Non-Alcoholic Fatty Liver Disease

目的探讨多学科诊疗模式下健脾清热化湿法治疗非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者的临床疗效和安全性。方法选取2018年8月—2019年8月期间在江苏省中医院脂肪肝多学科协同门诊治疗的NAFLD患者,采用随机数字表法,将80例患者分为对照组和治疗组,每组各40例。对照组在多学科联合管理下予以饮食及运动的宣教和指导,治疗组在对照组基础上给予健脾清热化湿法,疗程均为3个月。观察比较两组患者治疗前后身体质量指数(BMI),肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)],血脂指标[总胆固醇(TC)、甘油三酯(TG)],肝脏三点(肝Ⅱ、Ⅳ、Ⅵ段)脂肪含量变化,评估临床疗效及安全性。结果治疗后治疗组总有效率为97.5%(39/40),对照组为85.0%(34/40),两组比较,差异有统计学意义(P<0.05)。治疗后两组患者BMI水平均低于治疗前,差异有统计学意义(P<0.01);且治疗组治疗后BMI水平明显低于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组患者ALT、AST、TC、TG水平均低于治疗前,差异有统计学意义(P<0.05);且治疗组治疗后,在降低ALT、TC、TG水平方面优于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组肝脏三点脂肪含量水平均低于治疗前,差异有统计学意义(P<0.01);且治疗组治疗后肝脏三点脂肪含量水平明显低于对照组,两组比较,差异有统计学意义(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论NAFLD患者在多学科联合管理的基础上,采用健脾清热化湿法能显著提高临床疗效。

Objective To explore the clinical efficacy and safety of self-made Jianpi Qingre Huashi Therapy in the treatment of patients with non-alcoholic fatty liver disease(NAFLD)under the multidisciplinary diagnosis and treatment model.Methods Using random number table method,80 patients with NAFLD who were treated in the fatty liver multidisciplinary cooperative outpatient clinic of Jiangsu Provincial Hospital of Traditional Chinese Medicine from August 2018 to August 2019 were divided into control group and treatment group,40 cases in each group,the control group provides education and guidance on diet and exercise under the multidisciplinary joint management,the treatment group was given Jianpi Qingre Huashi Therapy on the basis of the control group,and the course of treatment was 3 months.The body mass index,liver function index(Alanine aminotransferase,aspartate aminotransferase),blood lipid index(Total cholesterol,triglycerides)and liver three-point fat content(Ⅱ,Ⅳ,Ⅵsegment of liver)were compared between the two groups before and after treatment to evaluate the clinical efficacy.Results After treatment,the total effective rate was 97.5%(39/40)in the treatment group and 85.0%(34/40)in the control group.The difference between the two groups was statistically significant(P<0.05).After treatment,the BMI level of the two groups of patients was lower than before treatment,the difference was statistically significant(P<0.01);and the BMI level of the treatment group after treatment was significantly lower than that of the control group,the difference between the two groups was statistically significant(P<0.05).After treatment,the ALT,AST,TC,and TG levels of the two groups of patients were lower than before treatment,and the difference was statistically significant(P<0.05);and the treatment group was superior in reducing ALT,TC and TG levels aftertreatment.In the control group,the difference between the two groups was statistically significant(P<0.05).After treatment,the three-point fat content in the liver of the two groups was lower than before treatment,and the difference was statistically significant(P<0.01);and the three-point fat content in the liver after treatment in the treatment group was significantly lower than that in the control group.There were differences between the two groups.Statistically significant(P<0.05).There were no serious adverse reactions during the treatment of the two groups of patients.Conclusion On the basis of multidisciplinary joint management,Jianpi Qingre Huashi Therapy can significantly improve the clinical efficacy of patients with NAFLD.