摘要
目的:探讨不同质量的行为干预和补肾益脾法治疗非酒精性脂肪性肝炎(NASH)的临床疗效。方法:210例NASH患者随机分为单纯强化行为干预组(A组)、强化行为干预结合补肾益脾组(B组)及一般行为干预结合补肾益脾治疗组(C组)。A组患者采用单纯健康管理,每两周患者来就诊,将干预量化表实施情况交医生,分析评分记录并指导患者进一步改善行为生活方式。B组患者行为干预同A组,同时口服补肾益脾汤药;C组患者在口服补肾益脾汤药治疗的基础上,给予一般健康教育。观察6个月,分析3组患者体质指数(BMI)、腰围臀围比、肝功能、血脂、B超、中医证候改善情况。治疗期间不同时服用其他降酶、降脂及保肝药。结果:治疗6个月后,3组患者BMI、腹围/臀围、B超分级程度、中医证候积分、肝功能、血脂、血糖水平均较治疗前有所改善,在降低脂肪肝B超分级程度、降低ALT水平方面B组优于A组和C组(P<0.01),在降低AST、提高HDL-C水平方面B、C两组明显优于A组(P<0.01)。结论:采用科学、合理的生活方式干预并跟踪患者遵医行为,可以有效地改善健康相关行为,并有助于NASH患者BMI、影像及相关的肝酶、血脂异常的控制,补肾益脾法治疗NASH不仅可以缩小患者腰围、减轻体重、减少BMI、改善中医证候,而且可降低转氨酶,升高HDL-C,改善糖代谢,通过多个环节治疗非酒精性脂肪性肝炎。
Objective：To observer the clinical efficacy of fatty liver with the treatment of strengthening behavior intervention combined with Bushenyipi.Methods：Tuo hundred and ten patients with fatty liver were divided into three groups and treated with only strengthening behavior intervention,strengthening behavior intervention combined with Bushenyipi and ordinary behavior intervention combined with Bushenyipi respectively.This is a randomized and parallel controlled clinical trials.Only strengthening behavior intervention group was treated with simple health managem〈ent,the intervention program was implemented and delivered to the doctor every two weeks,then the analysis was made to guide the patients to further improve the behavior life style;Strengthening behavior intervention combined with Bushenyipi：the same intervention as the only strengthening behavior intervention,besides,Bushenyipi Treatment was also given;General behavior intervention combined with Bushenyipi group were given health education and herb therapy Bushenyipi Treatment.All patients were told not to take other protect liver and lipid-lowering medicine during the treatment for 6 months.Outcome measures;body mass index（BMI）,waist circumference,hip,B-mode ultrasound,TCM syndromes,liver function,blood lipid,blood glucose.Results：the group of strengthening behavior intervention combined with Bushenyipi was more effective in body mass index（BMI）,waist circumference,hip,B-mode ultrasound,liver function and blood lipid（p0.01）.Conclusion：Adopting the scientific and reasonable lifestyle intervention and tracking patients according to the medical behavior will help to adipose sex hepatitis patients constitution of number,image,related liver enzyme and the control of dyslipidemia.Bushenyipi Treatment play an important part not only in reducing waist,body weight,BMI and TCM syndromes,But also reducing transaminase,increasing HDL and improving the sugar metabolism through multiple aspects to treat fatty liver.
出处
《中西医结合肝病杂志》
CAS
2016年第2期76-78,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
上海市卫生计划生育委员会中医药科研基金课题(No.2014LP067A)
