1. 上海市第八人民医院中医科,上海,200235
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杨旻昕, 洪庆祥, 岑怡. 清降保龄液治疗痰瘀互结型非酒精性脂肪性肝病的临床研究[J]. 上海中医药杂志, 2019,53(2):56-60.
YANG Minxin, HONG Qingxiang, CEN Yi. Clinical study on treatment of non-alcoholic fatty liver disease of phlegm-blood stasis type with Qinjiang Baoling Decoction[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(2):56-60.
杨旻昕, 洪庆祥, 岑怡. 清降保龄液治疗痰瘀互结型非酒精性脂肪性肝病的临床研究[J]. 上海中医药杂志, 2019,53(2):56-60. DOI: 10.16305/j.1007-1334.2019.02.015.
YANG Minxin, HONG Qingxiang, CEN Yi. Clinical study on treatment of non-alcoholic fatty liver disease of phlegm-blood stasis type with Qinjiang Baoling Decoction[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(2):56-60. DOI: 10.16305/j.1007-1334.2019.02.015.
目的:观察清降保龄液治疗痰瘀互结型非酒精性脂肪性肝病的临床疗效。 方法:将100例痰瘀互结型非酒精性脂肪性肝病患者随机分为治疗组和对照组,每组50例。对照组给予饮食控制、运动及降脂、降血糖等对症处理,治疗组在此基础上加服清降保龄液。两组疗程均为3个月,随访3个月,观察临床疗效,比较中医证候积分、肝功能、血脂、体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、腹部B超积分、肝/脾CT比值的变化情况。 结果:①=1\*GB3疗程结束3个月后,治疗组、对照组总有效率分别为64.0%、52.0%,治疗组临床疗效优于对照组(P<0.05)。②=2\*GB3治疗前后组内比较,两组胁肋疼痛、胁下痞硬、胸脘满闷、目胀口苦、腰酸肢沉积分均较治疗前减少(P<0.05);组间疗程结束3个月比较,胁肋疼痛、胸脘满闷、腰酸肢沉积分差异有统计学意义(P<0.05)。③=3\*GB3治疗前后组内比较,两组血清ALT、γ-GT、TC水平较治疗前降低(P<0.05);组间疗程结束3个月比较,治疗组血清ALT、γ-GT、TC水平低于对照组(P<0.05)。④=4\*GB3治疗前后组内比较,治疗组BMI、HOMA-IR值均较治疗前降低(P<0.05),对照组上述指标差异无统计学意义(P>0.05)。⑤=5\*GB3治疗前后组内比较,治疗组腹部B超积分、肝/脾CT比值差异均有统计学意义(P<0.05),对照组仅腹部B超积分差异有统计学意义(P<0.05);组间疗程结束3个月比较,腹部B超积分、肝/脾CT比值差异均有统计学意义(P<0.05)。 结论:清降保龄液治疗痰瘀互结型非酒精性脂肪性肝病疗效满意,能明显改善患者的临床症状,调节肝功能、血脂水平,抑制胰岛素抵抗,促进肝脏形态的恢复,且疗效持久。
Objective:To observe the clinical efficacy of Qinjiang Baoling Decoction in the treatment of non-alcoholic fatty liver disease (NAFLD) of phlegm-blood stasis type. Methods100 patients with NAFLD of phlegm-blood stasis type were randomly assigned into the treatment group and the control group, 50 patients in each group. Diet control, exercise therapy and symptomatic treatment including lowering blood fat and sugar were prescribed to patients in the control group and patients in the treatment group received Qinjiang Baoling Decoction in addition. Patients in the two groups were treated for 3 months and then followed up for 3 months. The clinical efficacy was observed, and the changes in TCM syndrome score, liver function [alanine transferase (ALT) and γ-glutamamide transferase (γ-GT)], blood fat [total cholesterol (TC) and high density lipoprotein (HDL-C)], body mass index (BMI), insulin resistance index (HOMA-IR), score of abdomen B-mode ultrasound and liver/spleen CT ratio were compared between the groups. Results:① At 3 months after treatment, the total effective rate was 64.0% and 52.0% in the treatment group and the control group respectively, and the clinical efficacy in the treatment group was superior to that in the control group (P<0.05). ② The scores of hypochondriac pain, fullness and rigidity, fullness of the chest and epigastrium, swollen eyes and bitter taste in the mouth, and waist soreness and limb heaviness decreased significantly in the groups after treatment compared to those before treatment (P<0.05); and at 3 months after treatment, there were statistically significant differences in the scores of hypochondriac pain, fullness of the chest and epigastrium and waist soreness and limb heaviness between the groups (P<0.05). ③ The levels of ALT, γ-GT and TC in serum decreased significantly in the groups after treatment compared to those before treatment (P<0.05); and at 3 months after treatment, the levels of ALT, γ-GT and TC in serum were lower in the treatment group than in the control group (P<0.05). ④ In the treatment group, the values of BMI and HOMA-IR decreased after treatment compared to those before treatment (P<0.05); and there were no statistically significant differences in the control group (P>0.05). ⑤ In the treatment group, there were statistically significant differences in the scores of abdomen B-mode ultrasound and liver/spleen CT ratio before and after treatment (P<0.05); and there was only statistically significant difference in the score of abdomen B-mode ultrasound in the control group (P<0.05). At 3 months after treatment, there were statistically significant differences in the score of abdomen B-mode ultrasound and liver/spleen CT ratio between the groups (P<0.05). Conclusion:Qinjiang Baoling Decoction shows satisfactory efficacy in the treatment of NAFLD of phlegm-blood stasis type. It improves the clinical symptoms, regulates liver function and the level of blood fat, inhibits insulin resistance and promotes recovery of liver morphology with sustained effects.
非酒精性脂肪性肝病痰瘀互结中医药疗法清降保龄液肝功能血脂
non-alcoholic fatty liver diseasephlegm-blood stasistherapy in traditional Chinese medicineQinjiang Baoling Decoctionliver functionblood fat
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