健脾化浊方治疗脾虚痰湿型非酒精性脂肪肝疗效观察与机制探讨

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1、提要目的：通过临床观察，研究健脾化浊方治疗非酒精性脂肪性肝病（NAFLD）脾虚痰湿证的临床疗效和不良反应，客观地评价其治疗NAFLD的有效性及安全性。方法：以符合标准的60例NAFLD患者为研究对象，随机分为中药组（健脾化浊方）和对照组（水林佳）各30例，比较两组患者治疗前后的临床证候、血清肝酶(ALT、AST、γ-GT)、血脂(TC、TG)、血糖、胰岛素抵抗和肝脏B超等的改善情况。结果：经统计学分析，与治疗前相比，治疗后两组患者临床指标均有不同程度的改善（P<0.05或P<0.01）。两组间比较，除血清肝酶指标改善无统计学意义之外（P>0.05），余各指标改善情况中药组均不同程度优于对

2、照组，经比较具有统计学意义（P<0.05或P<0.01）。结论：健脾化浊方使NAFLD脾虚痰湿证患者临床症状得到缓解，保肝降酶、调脂降糖，同时肝脏B超影像学也得到改善，可作为安全有效的方剂指导临床治疗。关键词健脾化浊方；非酒精性脂肪性肝病；脾虚痰湿证ClinicalObservationandmechanismoftheTreatmentSpleenWeaknessPhlegmWetCardofNonalcoholicFattyLiverDiseasewithJianpihuazhuoDecoctionSpeciality:ClinicalStudyofIntegratedTCMandW

3、esternMedicineAuthor:WangqiongTutor:SunJianguangAbstractObjective:ToobservetheclinicaleffectandadversereactionsofJianpihuazhuoDecoctiontreatmentofSpleenweaknessPhlegmwetcardofNonalcoholicfattyliverdisease(NAFLD),tovaluateobjectivelyitseffectivenessandsafetyofthetreatmentofNAFLD.Methods:Selectedme

4、ttheinclusioncriteria60casesofoutpatients,WererandomlydividedintotraditionalChinesemedicine(TCM)group(JianpihuazhuoDecoction)andthecontrolgroup(ShuiLinjia)30patientsineachTherapyof12weeksinbothgroupscomparedinpatientswithTCMscore,serummarkers(ALT,AST,γ-GT),（TC,TG）,FBG,IRIandLiverB-imagingimprovet

5、hesituation..Results:Thestatisticalanalysisoftestdata,comparedwiththosebeforetreatmentandaftertreatment,theobservationoftwogroupsofindicatorshavedifferentlevelsofstatisticalsignificance(P<0.05orP<0.01).Toimprovethesituationforeachindicatorbetweenthetwogroupsexceptserumindicatorsofliverenzymesimpr

6、ovingnosignificantstatisticaldifference(P>0.05),varyingdegreesofTCMgroupweresuperiortothecontrolgroup(P<0.05orP<0.01).Conclusions:JianpihuazhuoDecoctionsuitablefortheSpleenweaknessPhlegmwetcardofNAFLD,bothcanguaranteetheliverandfalltheenzyme,fallthefatandthesugar,canalsoimproveLiverB-imagingandcl

7、inicalvarioussymptoms.Itcanbeusedasasafeandeffectivetreatmentofherbalclinicalguidance.KeywordJianpihuazhuoDecoction；Nonalcoholicfattyliverdisease；SpleenweaknessPhlegmwetcard.目录引言........................................