芪参汤治疗痰瘀互结型非酒精性脂肪性肝炎的临床疗效观察

Clinical Efficacy of Qishen Decoction in the Treatment of Nonalcoholic Steatohepatitis with Phlegm and Blood Stasis Syndrome

目的观察芪参汤治疗非酒精性脂肪性肝炎(NASH)痰瘀互结证患者的临床疗效及其对外周巨噬细胞表型的影响。方法选取2023年1月至2023年8月黑龙江省中医药科学院接诊的80例NASH患者,采用随机数字表法将其分成对照组和观察组,每组各40例。两组的治疗疗程均为12周。对照组给予水飞蓟宾胶囊口服治疗,观察组在对照组的基础上给予芪参汤口服治疗。比较两组患者治疗前后的血清细胞因子以及M1型和M2型巨噬细胞百分比的变化,并评估临床疗效。结果观察组临床疗效优于对照组(P<0.05)。治疗后两组IL-6、IL-8、M1型巨噬细胞的百分比及M1/M2的比值较治疗前均显著降低(P<0.01),IL-10、IL-25和M2型巨噬细胞的百分比较治疗前均显著增加(P<0.01),且观察组均优于对照组(P<0.01)。结论芪参汤联合水飞蓟宾治疗NASH效果明显,可能与其调控巨噬细胞极化有关。

Objective To observe the clinical efficacy of Qishen decoction in the treatment of nonalcoholic steatohepatitis(NASH)patients with phlegm and blood stasis syndrome and its effect on the phenotype of peripheral macrophages.Methods 80 NASH patients from Heilongjiang academy of traditional Chinese medicine during January 2023 to August 2023 were selected,and they were divided into the control group and observation group using the randomized numerical table method,with 40 cases in each group.The treatment course of both groups was 12 weeks.Patients in the control group was given oral treatment with Silymarin capsules,and the observation group was given oral treatment with Qishen decoction on the basis of the control group.The serum cytokines and the percentages of Ml-type and M2-type macrophages in the two groups were compared before and after treatment,and the clinical eficacy was evaluated.Results The clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the percentages of IL-6,IL-8,M1-type macrophages and the ratio of M1/M2 in both groups were significantly decreased compared with that before treatment(P<0.01),and the percentages of IL-10,IL-25 and M2-type macrophages were significantly increased compared with that before treatment(P<0.01),and all of them in the observation group were better than that in the control group(P<0.01).Conclusion The effect of observation group combined with silymarin capsules on NASH is obvious,which may be related to its regulation of macrophage polarization.