脂肝合剂联合多烯磷脂酰胆碱胶囊治疗非酒精性脂肪性肝病临床研究

Clinical Study on Zhigan Mixture Combined with Polyene Phosphatidylcholine Capsules for Non-alcoholic Fatty Liver Disease

目的:观察脂肝合剂联合多烯磷脂酰胆碱胶囊治疗痰湿内阻型非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:选取76例痰湿内阻型NAFLD患者,按随机数字表法分为对照组与治疗组各38例,对照组剔除1例,治疗组剔除4例,最终纳入研究对照组37例,治疗组34例。2组均给予饮食控制加适量锻炼,对照组在此基础上给予多烯磷脂酰胆碱胶囊治疗,治疗组给予脂肝合剂联合多烯磷脂酰胆碱胶囊治疗。2组均治疗8周。比较2组临床疗效、中医证候积分、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)]、血脂指标[甘油三酯(TG)、总胆固醇(TC)]、受控衰减参数(CAP)及肝/脾CT比值。结果:治疗后,治疗组总有效率91.18%,高于对照组72.97%(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。2组血清ALT、AST、GGT、TG、TC水平均较治疗前降低(P<0.05),治疗组血清ALT、AST、GGT、TG、TC水平均低于对照组(P<0.05)。2组CAP均较治疗前降低(P<0.05),肝/脾CT比值均较治疗前升高(P<0.05);治疗组CAP低于对照组(P<0.05),肝/脾CT比值高于对照组(P<0.05)。结论:脂肝合剂联合多烯磷脂酰胆碱胶囊治疗痰湿内阻型NAFLD,可有效缓解临床症状,调节肝功能和血脂指标,减轻肝脏脂肪变性程度。

Objective:To observe the clinical effect of Zhigan Mixture combined with Polyene Phosphatidylcholine Capsules for non-alcoholic fatty liver disease(NAFLD) of internal obstruction of phlegm-damp type.Methods:A total of 76 cases of NAFLD patients of internal obstruction of phlegmdamp type were selected and divided into the control group and the treatment group according to the random number table method,with 38 cases in each group;1 case was excluded from the control group,4 cases were excluded from the treatment group,and ultimately 37 cases in the control group and 34 cases in the treatment group were included.Both groups were given dietary control and moderate exercise;the control group was additionally treated with Polyene Phosphatidylcholine Capsules,and the treatment group was treated with Zhigan Mixture combined with Polyene Phosphatidylcholine Capsules.Both groups were treated for 8 weeks.The clinical effects,traditional Chinese medicine(TCM) syndrome scores,liver function indicators [alanine aminotransferase(ALT),aspartate aminotransferase(AST),and γ-glutamyl transpeptidase(GGT)],blood lipid indicators [triglycerides(TG) and total cholesterol(TC)],controlled attenuation parameters(CAP),and CT-based liver-to-spleen ratio were compared between the two groups before and after treatment.Results:After treatment,the total effective rate was 91.18% in the treatment group,higher than that of 72.97% in the control group(P<0.05).The TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the score in the treatment group was lower than that in the control group(P<0.05).The levels of ALT,AST,GGT,TG,and TC in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of ALT,AST,GGT,TG and TC in serum in the treatment group were lower than those in the control group(P<0.05).The CAP in the two groups were decreased when compared with those before treatment(P<0.05),and CT-based liver-to-spleen ratios were increased when compared with those before treatment(P<0.05);CAP in the treatment group was lower than that in the control group(P<0.05),and CT-based liver-to-spleen ratio in the treatment group was higher than that in the control group(P<0.05).Conclusion:Zhigan Mixture combined with Polyene Phosphatidylcholine Capsules for NAFLD of internal obstruction of phlegm-damp type can effectively relieve clinical symptoms,regulate the liver function and blood lipid indicators,and reduce the degree of liver steatosis.