摘要
目的 评价健脾疏肝方颗粒治疗肝郁脾虚型非酒精性脂肪性肝病(NAFLD)的临床效果,探讨其对肠道菌群的影响。方法 选取2019年12月至2021年12月来自北京中医药大学东方医院脾胃肝胆科门诊NAFLD肝郁脾虚证患者40例,采用随机数字表法分为中药组与西药组各20例,中药组予健脾疏肝方颗粒和多烯磷脂酰胆碱胶囊模拟剂,西药组予多烯磷脂酰胆碱胶囊和健脾疏肝方颗粒模拟剂,治疗12周。入组前后检测谷丙转氨酶(GPT)、中医证候评分、肝脏B超、Fibro Scan受控衰减参数(CAP)、安全性指标及中药治疗前后肠道菌群改变。结果 受试者脱落3例,剔除1例,最终纳入36例(中药组19例,西药组17例)。治疗后,两组GPT低于治疗前,差异有统计学意义(P<0.05)。治疗后,两组中医证候积分、CAP值低于治疗前,且中药组低于西药组,差异有统计学意义(P<0.05)。治疗后,两组肝脏B超改善有效率比较,差异无统计学意义(P>0.05)。中药治疗后,患者粪便普雷沃菌属、拟杆菌属等比例相对有所提高,变形菌门比例明显下降。结论 健脾疏肝方能降低肝郁脾虚型NALFD患者GPT水平,改善中医证候,降低肝脏脂肪含量,调节肠道菌群组成,显示出良好的安全性。
Objective To evaluate the clinical efficacy of Jianpi Shugan Fang Granules in the treatment of non-alcoholic fatty liver disease(NAFLD) of liver-qi and spleen-deficiency type,and to explore its influence on intestinal flora.Methods From December 2019 to December 2021,a total of 40 patients with NAFLD of liver-qi and spleen-deficiency syndrome from the Spleen,Department of Gastroenterdogy,Dongfang Hospital of Beijing University of Chinese Medicine were selected and divided into Chinese medicine group and western medicine group by random number table method,20 cases in each group.The Chinese medicine group was given Jianpi Shugan Fang Granules and Polyene Phosphatidylcholine Capsules simulator.The western medicine group was treated with Polyene Phosphatidylcholine Capsules and Jianpi Shugan Fang Granules Simulator for 12 weeks.Glutamic-pyruvic transaminase(GPT),traditional Chinese medicine syndrome score,liver B-ultrasound,Fibro Scan controlled attenuation parameter(CAP),safety index,and intestinal flora changes before and after traditional Chinese medicine treatment were detected.Results Three cases fell off,one case was excluded,and 36 cases were included(19 cases in the Chinese medicine group and 17 cases in the western medicine group).After treatment,GPT of the two groups were lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the scores of traditional Chinese medicine syndrome and CAP value in the two groups were lower than before treatment,and those of the traditional Chinese medicine group were lower than those of the western medicine group,with statistical significance(P<0.05).After treatment,there was no significant difference in the improvement efficiency of liver B-ultrasound between the two groups(P >0.05).After treatment with Chinese medicine,the proportion of Prevotella and Bacteroides in the stool of the patients increased relatively,while the proportion of Proteobacteria decreased significantly.Conclusion Jianpi Shugan Fang Granules can reduce GPT level,improve traditional Chinese medicine syndromes,reduce liver fat content,and regulate intestinal flora in patients with NALFD with liver-qi and spleen-deficiency,showing good safety.
作者
施晓军
侯秀娟
李军祥
章妍
姚玉璞
谢春娥
王允亮
SHI Xiaojun;HOU Xiujuan;LI Junxiang;ZHANG Yan;YAO Yupu;XIE Chune;WANG Yunliang(Department of Rheumatology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing100078,China;Department of Gastroenterology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing100078,China)
出处
《中国医药导报》
CAS
2024年第3期14-18,共5页
China Medical Herald
基金
国家自然科学基金资助项目(81503407)
北京中医药大学科研创新岐黄团队项目(2019-JYB-TD004)。
关键词
非酒精性脂肪性肝病
临床研究
肠道菌群
健脾疏肝方
Non-alcoholic fatty liver disease
Clinical research
Intestinal flora
Jianpi Shugan Fang