健脾益肾方无饥饿治疗代谢相关脂肪性肝病疗效评价

Evaluation of the Efficacy of Jianpi Yishen Prescription without Starvation in the Treatment of Metabolic Associated Fatty Liver Disease

[目的]观察健脾益肾方无饥饿疗法对代谢相关脂肪性肝病(metabolic associated fatty liver disease,MAFLD)患者生理生化指标的影响,探讨中药代餐无饥饿疗法的安全性及可行性。[方法]采用自身前后对照研究,共纳入43例患者,观察患者治疗前后体质量(body weight,BW)、体质量指数(body mass index,BMI)、腹围(waist circumference,WC)、生理生化指标、临床证候改善情况,治疗结束1个月后电话随访患者BW变化情况,并分析患者肥胖指标与睾酮(total testosterone,TT)的相关性。[结果]患者治疗后BW、BMI、WC、空腹血糖(fasting blood glucose,FBG)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high density lipoprotein,HDL)水平较前明显降低(P<0.05,P<0.01),低密度脂蛋白(low density lipoprotein,LDL)较前无明显变化(P>0.05),临床证候显著改善(P<0.05)。整个治疗期间患者不良反应少,电话随访治疗1个月后患者BW较治疗结束时仍有不同程度下降。相关性分析提示,本研究中男性患者的TT与BMI水平呈负相关(r=-0.422,P<0.05),女性患者的TT与WC、BMI呈正相关(r=0.600、0.721,P<0.05)。[结论]健脾益肾方代餐能够明显改善肥胖型MAFLD患者的生理生化指标,并能够对患者生育能力产生积极影响,该疗法安全性及可行性良好。

[Objective] To observe the effect of Jianpi Yishen Prescription without starvation therapy on the physiological and biochemical indexes of patients with metabolic associated fatty liver disease(MAFLD), and explore the safety and feasibility of traditional Chinese medicine(TCM) meal replacement therapy without starvation. [Methods] A total of 43 patients were included in the self-control study before and after treatment. The body weight(BW), body mass index(BMI), waist circumference(WC), physiological and biochemical indicators,clinical parameters and clinical parameters of patients before and after treatment were observed. Syndrome relief, BW changes in patients were followed up by telephone 1 month after treatment, and the correlation between obesity indicators and total testosterone(TT) was analyzed. [Results] After treatment, BW, BMI, WC, fasting blood glucose(FBG), triglyceride(TG), total cholesterol(TC) and high density lipoprotein(HDL) were significantly reduced(P<0.05, P<0.01);there was no significant change in low density lipoprotein(LDL)(P>0.05), and the clinical symptoms of patients were significantly relieved(P <0.05). During the whole treatment period, the patients had few adverse reactions, and the BW of the patients still decreased to varying degrees after one month of telephone follow-up treatment compared with the end of the treatment. Correlation analysis showed that male patients’ TT was negatively correlated with BMI levels(r=-0.422, P<0.05),and female patients’ TT was positively correlated with WC and BMI(r=0.600, 0.721, P<0.05). [Conclusion] Jianpi Yishen Prescription meal replacement can significantly reduce physiological and biochemical indexes in obese patients with MAFLD, and may have a positive impact on the fertility of patients, and the therapy had good safety and feasibility.