柴郁清肝汤治疗非酒精性脂肪性肝病肝郁脾虚证患者的疗效观察及对Th17/Treg和相关炎症因子的影响

Clinical Observation on Effect of Chaiyu Qinggan Decoction(柴郁清肝汤)in Treatment of NAFLD Patients with Liver Stagnation and Spleen Deficiency Syndrome and Its Effects on Th17/Treg,Inflammatory Factors

目的:观察柴郁清肝汤治疗非酒精性脂肪性肝病(NAFLD)肝郁脾虚证患者的临床疗效及对外周血Th17/Treg和相关炎症因子的影响。方法:将60例NAFLD患者随机分为观察组(30例)和对照组(30例),其中观察组给予柴郁清肝汤治疗,对照组给予维生素E软胶囊治疗,治疗8周评价疗效;分别观察2组患者治疗前后肝功、血脂、外周血T淋巴细胞Th17、Treg的百分比及其相关炎症因子(IL-17、IL-22、IL-10)的变化。结果:治疗8周,观察组显效16例,有效12例,对照组显效8例,有效13例,2组比较差异具有统计学意义(P<0.05)。与治疗前比较,2组患者ALT、AST、GGT、ALP、TC、TG、LDL-C、Th17、IL-17和IL-22明显降低,Treg明显升高,差异具有统计学意义(P<0.05),2组间比较观察组均明显优于对照组(P<0.05)。结论:柴郁清肝汤能够有效治疗NAFLD患者,改善肝功能和血脂,调节Th17/Treg平衡及其相关炎性因子分泌是其作用机制之一。

Objective:To observe the clinical effect of Chaiyu Qinggan Decoction on nonalcoholic fatty liver disease(NAFLD)patients with liver stagnation and spleen deficiency syndrome and its effects on Th17/Treg in peripheral blood and serum inflammatory factors.Methods:60 patients with NAFLD were randomly divided into observation group(30 cases)and control group(30 cases).The observation group was treated with Chaiyu Qinggan Decoction,and the control group was treated with Vitamin E soft capsule,they were treated for 8 weeks,the curative effect was evaluated,The liver function,blood lipid,inflammatory factors(IL-17,IL-22)and the percentage of Th17 and Treg in peripheral blood T lymphocytes were observed before and after treatment in the two groups.Results:After treatment for 8 weeks,16 cases were markedly effective and 12 cases were effective in the observation group,and 8 cases were markedly effective and 13 cases were effective in the control group,the difference of effect between the two groups was statistically significant(P<0.05).Compared with before treatment,ALT,AST,GGT,ALP,TC,TG,LDL-C,Th17,IL-17 and IL-22 in the two groups were significantly decreased,Treg was significantly increased,and the difference was statistically significant(P<0.05).The effects of observation group were significantly better than those in the control group,and the diffe-rences were statistically significant(P<0.05).Conclusion:Chaiyu Qinggan Decoction can effectively treat NAFLD patients,improve liver function and blood lipids,regulating the balance of Th17/Treg and the secretion of related inflammatory factors is one of the mechanisms.