丹荷六味地黄汤对绝经后NAFLD患者脂代谢及心理状态评分的影响

Effects of Danhe Liuwei Dihuang decoction on lipid metabolism and psychological status in postmenopausal patients with NAFLD

目的:探讨丹荷六味地黄汤对绝经后非酒精性脂肪性肝病(NAFLD)患者脂代谢及心理状态评分的影响。方法:选取2021年12月至2022年12月河南中医药大学第一附属医院收治的绝经后NAFLD患者68例,按随机数字表法分为观察组和对照组,每组34例。观察组给予丹荷六味地黄汤,对照组给予维生素E软胶囊,2周为1个治疗周期,对比两组患者治疗6个周期后的肝功能、脂代谢、雌激素E2、脂肪变和肝纤维化评分、改良Kupperman评分、焦虑自评量表评分(SAS)、自评抑郁量表评分(SDS)及不良反应。结果:治疗6个周期后,观察组患者总有效率88.2%,高于对照组的65.6%(P<0.05)。观察组患者BMI、腰围减少,ALT、AST、GGT、TG、TC、HDL、LDL、游离脂肪酸、雌激素E2水平改善,肝硬度指数(CAP)、肝硬度值(LSM)、APRI值降低,改良Kupperman评分、SAS和SDS降低均优于对照组(P<0.05)。结论:丹荷六味地黄汤治疗绝经后NAFLD疗效确切,具有改善肝功能、脂代谢、雌激素水平,减少肝脂肪变和纤维化评分的作用,且对绝经后NAFLD患者的心理状态具有一定调节作用。

Objective:To investigate the effect of Danhe Liuwei Dihuang decoction on lipid metabolism and psychological status in postmenopausal patients with nonalcoholic fatty liver disease(NAFLD).Methods:A total of 68 postmenopausal patients with NAFLD admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2021 to December 2022 were selected and divided into observation group and control group according to the random number table method,with 34 cases in each group.The observation group was given Danhe Liuwei Dihuang decoction,and the control group was given vitamin E soft capsule,2 weeks as a treatment cycle.The liver function,lipid metabolism,estradiol,steatosis and liver fibrosis score,modified Kupperman score,self-rating anxiety scale score(SAS),self-rating depression scale score(SDS)and adverse reactions were compared between the two groups after 6 cycles of treatment.Results:After 6 cycles of treatment,the total effective rate of the observation group was 88.2%,which was higher than 65.6%of the control group(P<0.05).The observation group was superior to the control group in reducing BMI and waist circumference of postmenopausal NAFLD patients,improving ALT,AST,GGT,TG,TC,HDL,LDL,FFA,E2 levels,reducing CAP,LSM,APRI values,and reducing modified Kupperman score,SAS and SDS scores(P<0.05).Conclusion:Danhe Liuwei Dihuang Decoction has been proven to be effective in treating postmenopausal NAFLD.It can improve liver function,lipid metabolism,estrogen level,reduce liver steatosis and fibrosis score,and has a certain regulatory effect on the psychological state of postmenopausal NAFLD patients.