苦黄颗粒联合二甲双胍治疗湿热蕴结型非酒精性脂肪性肝炎的临床效果

Curative Effect of Kuhuang Keli Combined with Melbine in Treating Damp-heat Accumulation Type Non-alcoholic Steatohepatitis

目的探讨苦黄颗粒联合二甲双胍治疗湿热蕴结型非酒精性脂肪性肝炎(NASH)的临床疗效。方法选取2018年6月至2019年10月淮安市第四人民医院收治的92例湿热蕴结型NASH患者作为研究对象,随机分为观察组和对照组,各46例。对照组口服二甲双胍,0.25 g/次,3次/d,观察组在对照组基础上给予苦黄颗粒,6 g/次,3次/d,疗程2个月。比较两组患者临床疗效、中医证候积分、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及总胆红素(TBIL)]、血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)以及低密度脂蛋白胆固醇(LDL-C)]、肝脏超声检查结果以及体重指数(BMI)。结果观察组和对照组治疗有效率分别为82.6%和69.6%,差异有统计学意义(P<0.05);治疗后,观察组患者胁肋疼痛、口苦口干、大便溏评分显著低于对照组(P<0.05);治疗后,观察组患者ALT、AST、TBIL、TG、TC、LDL-C显著低于对照组(P<0.05),肝脏脂肪变性和BMI改善程度显著高于对照组(P<0.05)。结论苦黄颗粒联合二甲双胍治疗湿热内蕴型NASH临床疗效显著。

Objective To explore the clinical efficacy of Kuhuang granule combined with metformin in the treatment of damp heat accumulation type nonalcoholic steatohepatitis(NASH).Methods From June 2018 to October 2019,92 patients with Nash of damp heat accumulation type treated in Huai’an Fourth People’s hospital were selected as the research objects,and were randomly divided into observation group and control group,with 46 cases in each group.Patients in the control group took Melbine(0.25 g,3 times daily).Patients in the observation group took Kuhuang Keli on the basis of control group(6 g,3 times daily).Both groups were treated for 2 months.The clinical efficacy,TCM syndrome score,liver function indexes(ALT,AST,TBIL),blood lipid indexes(TG,TC,HDL-C,LDL-C),Ultrasonic examination results of liver,BMI of patients were evaluated before and after treatment.Results The effective rates of control group and treatment group were 82.6%and 69.6%respectively,the difference was statistically significant(P<0.05).After treatment,the scores of hypochondriac pain,bitter mouth,dry mouth and loose stool in the observation group were significantly lower than those in the control group(P<0.05).The levels of ALT,AST,TBIL,TG,TC,LDL-C in the two groups were significantly decreased(P<0.05),especially in the observation group(P<0.05).Also,the improvement of liver fatty degeneration and BMI in the observation group was significantly better than control group(P<0.05).Conclusion Kuhuang granule combined with metformin has a significant clinical effect on damp heat intrinsic Nash.