减肥降脂贴穴位敷贴治疗非酒精性脂肪性肝病的临床研究

Clinical Study on the Treatment of Nonalcoholic Fatty Liver Disease by Weight-Loss and Lipid-Lowering Sticking Acupoint Application

目的观察减肥降脂贴穴位贴敷治疗痰湿型非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD)的临床效果。方法选取2017年5月—2019年12月期间上海市浦东新区传染病医院暨上海中医药大学附属曙光医院肝病分院收治的150例非酒精性脂肪性肝病患者,通过随机单盲对照方法,平均分成3组(观察1、2、3组),每组各50例。3组患者均给予饮食运动处方,其中观察1组给予减肥降脂贴穴位贴敷,选穴为复方穴位;观察2组将减肥降脂贴敷贴于神阙穴;观察3组采用大黄穴位贴敷贴于神阙穴。3组患者均持续治疗24周后,观察比较3组患者肝功能[丙氨酸氨基转移酶(Alaine Aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)和γ-谷氨酰转肽酶(γ-glutamyl transferase,GGT)]、血脂[总胆固醇(Total Cholesterol,TC)和甘油三酯(Triglyceride,TG)]、瞬时弹性成像(Fibroscan)受控衰减参数(CAP)脂肪变性指数、中医证候评分情况。结果3组经治疗后,ALT、AST、GGT、TC、TG水平及Fibroscan CAP脂肪变性指数与治疗前比较均有改善,差异有统计学意义(P<0.05);治疗后观察1组ALT、AST、GGT、TC、TG水平及Fibroscan CAP脂肪变性指数均优于观察2组,而观察2组各指标均优于观察3组,差异有统计学意义(P<0.05)。3组经治疗后,腹胀、胁痛、乏力、神疲、肥胖中医证候评分均较治疗前均有改善,差异有统计学意义(P<0.05);且观察1组治疗后各中医证候评分优于观察2组,观察2组优于观察3组,差异均有统计学意义(P<0.05)。结论减肥降脂贴敷贴治疗非酒精性脂肪性肝病的临床疗效较好,能够保护肝细胞、降低血脂水平、改善中医证候及脂肪变性指数,提高临床疗效。

Objective To observe the clinical effect of weight-loss and lipid-lowering sticking acupoint application in the treatment of phlegm-dampened non-alcoholic fatty liver.Methods A total of 150 cases of non-alcoholic fatty liver disease patients admitted to Shanghai Pudong New Area Infectious Disease Hospital and Shanghai University of Traditional Chinese Medicine Affiliated Shuguang Hospital Liver Disease Branch from May 2017 to December 2019 were selected.They were divided into 3 groups with 50 cases in each group by a randomized,single blind control method.All of the 3 groups were given dietary exercise prescriptions.Among them,observation group 1 was given weight-loss and fat-lowering sticking acupoints,which were selected as compound acupoints.Observation group 2 was applied weight-loss and lipid-lowering patch on Shenque acupoint.Observation group 3 was applied at Shenque acupoint with rhubarb patch Stick.After 24 weeks of continuous treatment in the three groups,the liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST)andγ-glutamyl transpeptidase(GGT)]and blood lipids[total cholesterol(TC)and triglyceride(TG)],transient elastography(Fibroscan)controlled attenuation parameter(CAP)steatosis index,TCM syndrome score were observed were observed and compared.Results After treatment,the levels of ALT,AST,GG,TC,TG and elastic ultrasound controlled attenuation parameter CAP steatosis index improved compared with those before treatment,and the difference was statistically significant(P<0.05).After treatment Observation 1 group ALT,AST,GG,TC,TG levels and elastic ultrasound CAP steatosis index are better than observation 2 group,and observation 2 groups are better than observation 3 groups,the difference is statistically significant(P<0.05).After treatment,the scores of TCM syndromes of abdominal distension,hypochondriac pain,fatigue,fatigue,and obesity in the three groups were all improved compared with those before treatment,and the difference was statistically significant(P<0.05).The TCM syndromes of the 1 group were observed after treatment.The score is better than the observation group 2,and the observation group 2 is better than the observation group 3.The differences are statistically significant(P<0.05).Conclusion The weight-loss and lipid-lowering patch has a good clinical effect in the treatment of non-alcoholic fatty liver disease.It can protect liver cells,reduce blood lipid levels,improve TCM syndromes and steatosis index,and improve clinical efficacy.