摘要
目的:探讨中药涤痰消脂方治疗非酒精性脂肪性肝病(NAFLD)的临床效果。方法:选择2022年1月至2024年7月收治的108例NAFLD患者,随机分为观察组和对照组,每组54例。观察组予以西医常规治疗和中药涤痰消脂方;对照组予以西医常规治疗和水飞蓟宾胶囊,疗程均为12周。比较两组患者治疗前后中医证候评分、受控衰减参数(CAP)、脂代谢相关指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肝功能相关指标[γ-谷氨酰转移酶(GGT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、肝纤维化相关指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)],并比较两组患者血清紧密连接蛋白-1(Claudin-1)、连蛋白(Zonulin)、闭锁小带蛋白-1(ZO-1)水平及治疗总有效率。结果:治疗后,观察组患者中医证候评分、CAP值均低于对照组(P<0.01),TC、TG、LDL-C、GGT、ALT、AST、HA、LN、PCⅢ、Claudin-1、Zonulin水平均低于对照组(P<0.01),HDL-C、ZO-1均高于对照组(P<0.01)。观察组患者治疗总有效率高于对照组(P<0.05)。结论:涤痰消脂方可有效降低患者中医证候评分和CAP值,改善脂代谢,保护肝功能,抑制肝纤维化进展,治疗肝郁脾虚型NAFLD效果显著,其机制可能与保护肠道黏膜屏障功能有关。
Objective:To explore the clinical effect of traditional Chinese medicine Ditan Xiaozhi formula in the treatment of non-alcoholic fatty liver disease(NAFLD).Methods:A total of 108 NAFLD patients admitted between January 2022 and July 2024 were selected and randomly divided into the observation group and the control group,with 54 cases in each group.The observation group received conventional Western medical treatment plus the traditional Chinese medicine formula Ditan Xiaozhi,while the control group received conventional Western medical treatment plus silymarin capsules.The treatment course for both groups was 12 weeks.The traditional Chinese medicine symptom scores,controlled attenuation parameters(CAP),lipid metabolism related indicators[total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],liver function related indicators[gamma glutamyltransferase(gamma GT),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],liver fibrosis related indicators[hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)]before and after treatment in two groups were compared.The serum levels of tight junction protein-1(Claudin-1),fibronectin(Zonulin)was compared.The total effective rate of treatment between two groups based on the level of Zo-1 in the locked small band protein were compared.Results:After treatment,the traditional Chinese medicine symptom score and CAP value of the observation group were lower than those of the control group(P<0.01).TC,TG,LDL-C,γ-GT,ALT,AST,HA,LN,PCⅢ,Claudin-1,and Zonulin were lower than those of the control group(P<0.01),while HDL-C and Zo-1 were higher than those of the control group(P<0.01).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Ditan Xiaohi formula can effectively reduce the traditional Chinese medicine syndrome score and CAP value,improve lipid metabolism,protect liver function,inhibit the progression of liver fibrosis.And it has significant therapeutic effects on NAFLD with liver depression and spleen deficiency,the mechanism may be related to the protection of intestinal mucosal barrier function.
作者
李媛媛
曹玉娟
王爽
张彦芳
LI Yuan-yuan;CAO Yu-juan;WANG Shuang;ZHANG Yan-fang(Fifth Department of Liver Diseases Cangzhou Third Hospital(Cangzhou Hebei,061001),China;不详)
出处
《中西医结合肝病杂志》
2025年第12期1480-1484,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
河北省中医药管理局科研计划项目(No.2020527)。
关键词
非酒精性脂肪性肝病
涤痰消脂方
脂代谢
肝纤维化
肠道屏障功能
non-alcoholic fatty liver disease
traditional Chinese medicine
Ditan Xiaozhi Formula
lipid metabolism
liver fibrosis
intestinal barrier function
