摘要
目的:探讨大柴胡汤加黄芪桂枝五物汤对痰湿型非酒精性脂肪性肝炎(Non-alcoholic Steatohepatitis,NASH)的临床疗效。方法:采用前瞻性研究方法,将符合要求的58例NASH病患分为观察组(30例)和对照组(28例)。对照组患者提供非诺贝特与复方甘草酸苷药物进行治疗;观察组患者在对照组的治疗方案基础上加用大柴胡汤和黄芪桂枝五物汤,两组疗程均为12周。记录两组患者治疗前后丙氨酸氨基移换酶(Alanine Aminotransferase,ALT)和γ-谷氨酰转肽酶(γ-glutamyl Transpeptidase,GGT)、血清炎性因子、转化生长因子-β1(Transforming Growth Factor-β1,TGF-β1)水平、血脂水平和肝脏瞬时弹性纤维检测中的脂肪受控衰减参数(Controlled Attenuation Parameter,CAP),作出疗效评价。结果:观察组治疗的总有效率明显高于对照组,差异具有统计学该意义(P<0.05)。两组ALT、GGT、血清炎性因子、TGF-β1水平、血脂水平和CAP水平在治疗后均较治疗前显著降低(P<0.05);治疗后观察组ALT、GGT、血清炎性因子、TGF-β1水平、血脂水平均优于对照组(P均<0.05),而治疗12周后两组间CAP值的差异没有统计学意义(P>0.05)。按照非酒精性脂肪性肝病(Non-alcoholic Fatty Liver Disease,NAFLD)轻重程度分级,观察组有2例转为正常,对照组有1例转为正常;观察组有2例由重度转为中度,4例由中度转为轻度;而对照组中有2例由重度转为中度。结论:大柴胡汤加黄芪桂枝五物汤治疗能够改善NASH患者的肝功能,降低血清炎性因子、TGF-β1水平和血脂水平,效果优于对照组。
Objective:To investigate clinical effects of the Dachaihu decoction(大柴胡汤)plus the Huangqi Guizhi Wuwu decoction(黄芪桂枝五物汤)on non-alcoholic steatohepatitis of phlegm-dampness type.Methods:A prospective study was conducted in this paper.58 cases were divided into the observation group(30 cases)and the control group(28 cases).The control group were treated with fenofibrate and compound glycyrrhizin,and the observation group were treated with the Dachaihu decoction plus the Huangqi Guizhi Wuwu decoction more.The treatment course was 12 weeks in both groups.Results:The total efficiency in the observation group was obviously higher than the control group,and there was a statistically significant difference between the two groups(P<0.05).After 12 weeks of treatment,the levels of ALT,GGT,serum inflammatory factors,TGF-β1,blood lipid and CAP in the two groups were significantly lower than those before treatment(P<0.05),and ALT,GGT,serum inflammatory factors,TGF-β1 and blood lipid levels in the observation group were superior to those in the control group(P<0.05),while there was no statistically significant difference in CAP value between the two groups(P>0.05).According to the severity of NAFLD,2 cases in the observation group turned to normal,1 case in the control group turned to normal;2 cases in the observation group changed from severe to moderate,4 cases in the observation group changed from moderate to mild;while 2 cases in the control group changed from severe to moderate.Conclusion:The Dachaihu decoction plus the Huangqi Guizhi Wuwu decoction can improve the liver function,decrease the serum inflammatory factors,TGF-β1 level and blood lipid level in patients with NASH,and the effect is better than that in the control group.
出处
《中医临床研究》
2022年第5期11-15,共5页
Clinical Journal Of Chinese Medicine
基金
广东省中医药局项目(20201317)
深圳市宝安区科技创新项目(2019JD222)。
关键词
大柴胡汤
黄芪桂枝五物汤
非酒精性脂肪性肝炎
The Dachaihu decoction
The Huangqi Guizhi Wuwu decoction
Non-alcoholic steatohepatitis
