降脂消浊汤治疗湿浊蕴积型非酒精性脂肪性肝炎临床疗效观察

Clinical Observation of Using Jiangzhi Xiaozhuo Decoction in the Treatment of Nonalcoholic Steatohepatitis with Dampness and Turbidity Accumulation

目的:探究降脂消浊汤治疗湿浊蕴积型非酒精性脂肪性肝炎(NASH)临床疗效。方法:采用随机数字表法将2021年7月~2022年1月86例湿浊蕴积型NASH患者分为观察组及对照组,43例/组。对照组给予多烯磷脂酰胆碱胶囊治疗,观察组给予降脂消浊汤联合治疗。比较两组治疗疗效及治疗前后中医证候积分;分析两组患者治疗前后肝功能指标、血脂水平、炎性因子及免疫功能指标变化情况,并统计患者治疗期间药物不良反应发生率。结果:观察组治疗总有效率高于对照组,治疗后中医证候积分低于对照组(P<0.05);观察组治疗后总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转移酶(GGT)、天门冬氨酸氨基转移酶(AST)及甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组(P<0.05);观察组治疗后肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及超敏C反应蛋白(hs-CRP)水平均低于对照组,治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)值大于对照组(P<0.05);两组不良反应发生率对比无明显差异(P>0.05)。结论:降脂消浊汤治疗湿浊蕴积型NASH有效率高,可缓解患者临床症状,降低机体炎症水平,改善血脂代谢,并能促进肝功能及免疫功能恢复。

Objective:To explore the clinical curative effect of Jiangzhi Xiaozhuo Decoction on non-alcoholic steatohepatitis(NASH)of dampness-turbidity accumulation.Methods:According to the random number table method,86 patients with NASH of dampness-turbidity accumulation were divided into an observation group and a controlled group between July 2,021 and January 2,022,43 cases in each group.The controlled group was treated with Polyene Phosphatidyl Choline Capsules,while the observation group was additionally treated with Jiangzhi Xiaozhuo Decoction.The curative effect and scores of TCM syndromes before and after treatment were compared between the two groups.The changes of liver function indexes,blood lipid level,inflammatory factors and immune function indexes before and after treatment in both groups were analyzed.The incidence of adverse drug reactions during treatment was statistically analyzed.Results:The total response rate of treatment in the observation group was higher than that in the controlled group,and scores of TCM syndromes were lower than those in the controlled group(P<0.05).After treatment,levels of total bilirubin(TBIL),alanine aminotransferase(ALT),gamma-glutamyltransferase(GGT),aspartate aminotransferase(AST),triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the observation group were lower than those in the controlled group(P<0.05),levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were lower than those in the controlled group,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the controlled group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The curative effect of Jiangzhi Xiaozhuo Decoction is significant on NASH of dampness-turbidity accumulation,which can relieve clinical symptoms,reduce inflammation level,improve blood lipid metabolism,and promote the recovery of liver function and immune function in patients.