荷叶调脂疏肝汤对非酒精性脂肪性肝病患者脂代谢的影响研究

Short-term efficacy of Heye Tiaozhi Shugan Decoction in dealing with patients with nonalcoholic fatty liver diseases

目的探讨应用荷叶调脂疏肝汤治疗非酒精性脂肪性肝病(NAFLD)患者对脂代谢的影响。方法2019年4月~2021年4月我院收治的56例NAFLD患者,被随机分为对照组28例和观察组28例,在给予所有患者健康教育、运动和饮食干预下,给予对照组多烯磷脂酰胆碱和天晴甘平胶囊治疗,观察组在对照组治疗的基础上加用荷叶调脂疏肝汤,两组用药治疗观察12 w。比较两组中医证候积分及血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等血生化指标的变化。结果在治疗观察结束时,观察组胁肋胀痛、抑郁不舒、食欲不振、脘腹胀满和便溏评分分别为(1.0±0.3)分、(0.8±0.2)分、(0.7±0.2)分、(0.7±0.2)分和(1.0±0.1)分,显著低于对照组【分别为(1.4±0.7)分、(1.3±0.3)分、(1.3±0.3)分、(1.2±0.3)分和(1.4±0.3)分,P<0.05】;观察组血清TG和LDL-C水平分别为(1.8±0.5)mmol/L和(2.7±0.6)mmol/L,显著低于对照组【分别为(2.4±0.8)mmol/L和(3.9±0.8)mmol/L,P<0.05】,而血清HDL-C水平为(1.8±0.6)mmol/L,显著高于对照组【(1.1±0.4)mmol/L,P<0.05】;观察组血清ALT、AST、GGT和ALP水平分别为(46.1±8.9)U/L、(31.9±9.0)U/L、(38.7±11.2)U/L和(66.1±12.2)U/L,均显著低于对照组【分别为(55.7±9.4)U/L、(44.3±10.7)U/L、(49.7±12.5)U/L和(74.4±14.7)U/L,P<0.05】。结论在综合治疗的干预下,应用荷叶调脂疏肝汤治疗NAFLD患者可获得较好的短期效果,值得进一步研究。

Objective The aim of this study was to investigate the short-term efficacy of Heye Tiaozhi Shugan,a kind of herbal medicine,decoction in dealing with patients with nonalcoholic fatty liver diseases(NAFLD).Methods 56 patients with NAFLD were recruited in our hospital between April 2019 and April 2021,and were randomly divided into control and observation group,with 28 patients in each group.All patients were supervised for health education,like exercise and diet guidance.The patients in the control group were treated with polyene phosphatidylcholine and glycyrrhizinic acid tables,and those in the observation group were treated with the herbal medicine at base of medication in the control.The regimen lasted for 12 weeks.The TCM syndrome scores were evaluated,and serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)levels were assayed.Results At the end of three month treatment,the hypochondriac pain,depression,poor appetite,abdominal distension and loose stool scores as obtained by TCM evaluation were(1.0±0.3),(0.8±0.2),(0.7±0.2),(0.7±0.2)and(1.0±0.1),significantly lower than[(1.4±0.7),(1.3±0.3),(1.3±0.3),(1.2±0.3)and(1.4±0.3),P<0.05]in the control;serum TG and LDL-C levels in the observation group were(1.8±0.5)mmol/L and(2.7±0.6)mmol/L,significantly lower than[(2.4±0.8)mmol/L and(3.9±0.8)mmol/L,respectively,P<0.05],while serum HDL-C level was(1.8±0.6)mmol/L,significantly higher than[(1.1±0.4)mmol/L,P<0.05]in the control;serum alanine aminotransferase,aspartate aminotransferase,gamma glutamine transferase and alkaline phosphatase levels in the observation group were(46.1±8.9)U/L,(31.9±9.0)U/L,(38.7±11.2)U/L and(66.1±12.2)U/L,all significantly lower than[(55.7±9.4)U/L,(44.3±10.7)U/L,(49.7±12.5)U/L and(74.4±14.7)U/L,respectively,P<0.05].Conclusion The Heye Tiaozhi Shugan decoction,a herbal medicine compound,in treatment of NAFLD patients with special TCM syndrome,could improve blood lipid metabolism,and needs further investigation.