柴芩解郁汤联合中药外敷治疗脾虚肝郁型非酒精性脂肪性肝病

Bupleurum⁃Scutellaria Depression⁃Releasing Decoction Combined with External Application of Chinese Medicinals for the Treatment of Non⁃alcoholic Fatty Liver Disease of Spleen Deficiency and Liver Depression Type

目的:观察柴芩解郁汤联合中药外敷治疗脾虚肝郁型非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的临床疗效。方法:将104例NAFLD患者按照随机数字表法分为对照组和观察组,每组各52例。对照组给予多烯磷脂酰胆碱胶囊治疗,观察组在对照组的基础上给予柴芩解郁汤联合中药外敷治疗。比较两组患者的临床疗效及治疗前后临床症状积分、糖脂代谢指标[三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(low density lipoprotein cholesterol,LDL-C)]、肝功能[谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartic acid transferase,AST)、γ-谷氨酰转肽酶(gamma-glutamyl transpeptidase,GGT)]、炎性因子水平[脂联素(adiponectin,APN)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)]变化情况。结果:观察组有效率为75.00%,对照组有效率为55.77%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后临床症状积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后TG、TC及LDL-C水平低于本组治疗前,HDL-C高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后ALT、AST及GGT低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后hs-CRP、IL-6和TNF-α低于本组治疗前,APN高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。结论:柴芩解郁汤联合中药外敷可明显缓解脾虚肝郁型NAFLD患者的临床症状,改善糖脂代谢水平以及肝功能情况,降低炎性因子水平。

Objective:To observe the clinical efficacy of Bupleurum⁃Scutellaria Depression⁃Releasing Decoction combined with external application of Chinese medicinals on non⁃alcoholic fatty liver disease(NAFLD)of spleen deficiency and liver depression type.Meth⁃ods:A total of 104 NAFLD patients were randomly divided into the control group and the observation group according to the random number table method,with 52 cases in each group.The control group was treated with Polyene Phosphatidylcholine Capsules,while the observation group was treated with Bupleurum⁃Scutellaria Depression⁃Releasing Decoction combined with external application of Chinese medicinals on the basis of the control group.The clinical efficacy,changes in the clinical symptom scores,glycolipid metabolic indexes[including triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL⁃C)],liver function[including alanine transaminase(ALT),aspartic acid transaminase(AST)]γ⁃gamma glutamyl transpeptidase(GGT)],inflammatory factor levels[in⁃cluding interleukin 6(IL⁃6),tumor necrosis factor⁃α(TNF⁃α),and high⁃sensitivity C⁃reactive protein(hs⁃CRP)]of the two groups before and after treatment were compared.Results:The effective rate of the observation group was 75.00%,while that of the control group was 55.77%.The difference between the two groups was statistically significant(P<0.05).After treatment,the clinical symp⁃tom scores of the two groups were lower than those of the same group before treatment,and the observation group′s scores were lower than those of the control group(P<0.05);The levels of TG,TC,and LDL⁃C in the two groups were lower than those of the same group before treatment,while HDL⁃C was higher than that before treatment,and all the differences of the two groups were statistically signifi⁃cant(P<0.05);The ALT,AST,and GGT levels of the two groups were lower than those of the same group before treatment,and the observation group′s above levels were lower than those of the control group(P<0.05).The hs⁃CRP,IL⁃6,and TNF⁃αof the two groups were lower than those of the same group before treatment,while the APN was higher than that before treatment,and all the differences between the two groups were statistically significant(P<0.05).Conclusion:Bupleurum⁃Scutellaria Depression⁃Releasing Decoction combined with external application of Chinese medicinals can significantly alleviate the clinical symptoms of NAFLD patients with spleen deficiency and liver stagnation syndrome,improve glucose and lipid metabolism levels and liver function,and reduce the level of inflammatory factors.