脂肪肝的中药治疗

Studies on treatment of fatty liver with traditional Chinese medicine

近年来对脂肪肝的中西医结合研究有较大发展 ,体现在诊断、治疗和实验研究等方面。多为利用西医的诊断方法或造模方法 ,应用中药复方、单味中药或中药成分治疗 ,观察疗效和探讨作用机制。由于脂肪肝的病机特点主要为本虚标实 ,表现为脾气虚弱、肝肾亏损、痰湿内蕴、气滞血瘀 ,涉及肝、脾、肾三脏。从而有利于我们以中西医结合的观点、“辨证”和“辨病”相结合 ,采用专方或基本方加减治疗。这种思路也是国内相当一部分研究者的共识 ,已成为目前国内脂肪肝研究的主流 ,取得了一些可喜的成果。本研究所研究的健脾活血方能显著改善脂肪肝患者的肝脏B超影像 ,治疗后的B超积分较治疗前有显著差异 ,还能减轻和缓解患者的症状 ,改善和恢复肝功能 ,降低腰臀围比值和血中甘油三酯、胆固醇的含量 ,其总有效率显著优于对照组东宝肝泰。实验研究也显示该方能明显减轻CCl4 诱导的大鼠肝细胞脂肪变性程度和炎性细胞的浸润 ,降低血清ALT和AST的活性 ,减少肝脏甘油三酯的含量和使肝脏的SOD活性恢复到正常水平 ,总体疗效优于东宝肝泰。进一步的相关研究还是要在中医理论的指导下 ,结合现代医学对脂肪肝研究的最新发现 ,研制高效的中药制剂 。

Great progress has been made in the stud y of fatty liver with integrated traditional Chinese and western medicine in aspec ts of diagnosis, treatment and experimental study, etc. Most researches were des igned to utilize diagnostic or model replicating method of western medicine to o bserve the effects or investigate the action mechanism of compound recipe, singl e Chinese herb or effective ingredients of Chinese herbs on fatty liver. Accordi ng to the pathological mechanism of traditional Chinese medicine (TCM), fatty li ver is characterized by deficiency in nature and repletion in appearance, which involves three Zang viscera such as liver, spleen and kidney and manifests as sp leen Qi deficiency, liver and kidney deficiency, phlegm and dampness heaping int ernally, and Qi stagnation and blood stasis. This facilitates us to use specific recipe or modified recipe to treat fatty liver from the points of integrated tr aditional Chinese and western medicine and combining syndrome differentiation wi th disease differentiation. With gratifying achievement, this kind of approach h as been the mainstream of the research on fatty liver and many researchers have reached an agreement on this point domestically. Spleen Fortifying and Blood Inv igorating Recipe (SFBVER in brief, invented by our institute) can significantly improve the B ultrasound outcome of the liver in patients with fatty liver, with significant difference in B ultrasound scoring between pre-and post-treatment . It can alleviate the patients’ symptoms, improve or regain liver function, de crease waist/buttocks ratio and the content of triglyceride and cholesterol in b lood. SFBVER is superior to Dongbao Gantai Recipe in general effective rate. Exp erimental study also reveals that SFBVER can alleviate CCl 4 induced liver cell fatty degeneration and the inflammatory cell infiltration in rats, decrease the activities of ALT and AST, lower the content of triglyceride in liver, recover SOD activity in liver to normal level. The overall efficacy of SFBVER is superio r to that of Dongbao Gantai Recipe. Further correlated study should be focused o n inventing new preparation of traditional Chinese medicine and investigating it s action mechanism with the guiding of the theory of TCM and referring to the la test discovery in fatty liver research in modern medicine.