摘要
目的探讨三仁汤合茵陈五苓散加减联合多烯磷脂酰胆碱治疗湿热蕴结型非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的临床疗效以及其对患者肝纤维化和血清白细胞介素(interleukin,IL)-1β、内脂素、血红素氧合酶1(heme oxygenase-1,HO-1)水平的影响。方法选择运城市中医医院2019年1月至2022年1月收治的120例NAFLD湿热蕴结证患者为研究对象,采用随机数字表法分成观察组与对照组,每组60例。观察组采用三仁汤合茵陈五苓散加减联合多烯磷脂酰胆碱治疗,对照组单用多烯磷脂酰胆碱治疗。均连续治疗12周后观察两组临床疗效。治疗前后采用全自动生化分析仪检测血脂[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)]和肝功能指标[丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰转肽酶(gamma-glutamyltransferase,GGT)],采用放射免疫法检测肝纤维化指标[Ⅲ型前胶原(typeⅢprocollagen,PC-Ⅲ)、层粘连蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)],并于治疗前后进行瞬时弹性超声成像检查检测肝脏硬度(liver stiffness measurement,LSM)值,采用酶联免疫法测定血清IL-1β、内脂素和HO-1水平。记录两组患者不良反应。结果观察组总有效率为95.00%(57/60),显著高于对照组的78.33%(47/60),差异有统计学意义(χ2=7.212,P=0.007)。观察组和对照组治疗后血清TG[(1.91±0.35)mmol/L vs(3.26±0.48)mmol/L;(2.44±0.42)mmol/L vs(3.24±0.51)mmol/L]、TC[(4.32±0.75)mmol/L vs(6.83±1.23)mmol/L;(5.46±0.86)mmol/Lvs(6.77±1.18)mmol/L]、LDL-C[(2.52±0.34)mmol/L vs(3.72±0.58)mmol/L;(2.89±0.42)mmol/L vs(3.68±0.64)mmol/L]、ALT[(46.56±7.03)U/Lvs(67.27±8.13)U/L;(55.42±7.34)U/Lvs(68.62±7.95)U/L]、AST[(69.23±8.25)U/L vs(94.21±10.24
Objective To investigate the clinical efficacy of Sanren decoction combined with Yinchen Wuling powder and polyene phosphatidylcholine on the treatment of non-alcoholic fatty liver disease(NAFLD)(dampness-heat retention syndrome)and its effects on liver fibrosis and serum levels of interleukin-1β(IL-1β),visfatin and heme oxygenase 1(HO-1).Methods A total of 120 patients with dampness and heat accumulation syndrome of NAFLD who were admitted to Yuncheng Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were selected and divided into observation group and control group by random number table method,60 cases in each group.Patients in observation group were treated with Sanren decoction plus Yinchen Wuling powder combined wtih polyene phosphatidylcholine,and patients in control group were treated with polyene phosphatidylcholine alone.After 12 weeks of continuous treatment,the clinical efficacy of the two groups were observed.Blood lipid indexes[triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)and gamma-glutamyltransferase(GGT)]were detected by automatic biochemical analyzer before and after treatment.Liver fibrosis indexes[typeⅢprocollagen(PC-Ⅲ),laminin(LN),hyaluronic acid(HA)]were detected by radioimmunoassay,and liver stiffness measurement(LSM)values were detected by transient elastic ultrasonography before and after treatment.Serum levels of IL-1β,visfatin and HO-1 were determined by enzyme-linked immunoassay.The adverse reactions of patients in two groups were recorded.Results The total effective rate of patients in observation group was 95.00%(57/60),which were significantly higher than that of control group[78.33%(47/60)],the difference was statistically significant(χ2=7.212,P=0.007).The levels of serum TG[(1.91±0.35)mmol/L vs(3.26±0.48)mmol/L;(2.44±0.42)mmol/L vs(3.24±0.51)mmol/L],TC[(4.32±0.75)mmol/L vs(6.83�
作者
姚春苗
杨玲
尚雪妍
曹永年
霍璞
Yao Chunmiao;Yang Ling;Shang Xueyan;Cao Yongnian;Huo Pu(Department of Liver Diseases,Yuncheng Hospital of Traditional Chinese Medicine,Yuncheng 044000,Shanxi Province,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2023年第3期56-63,共8页
Chinese Journal of Liver Diseases：Electronic Version
基金
山西省中医药管理局科研课题计划(2019ZYYC086)。
关键词
三仁汤
茵陈五苓散
多烯磷脂酰胆碱
脂肪性肝病
非酒精性
湿热蕴结证
肝纤维化
Sanren decoction
Yinchen Wuling powder
Polyene phosphatidylcholine
Fatty liver disease,non-alcoholic
Damp-heat accumulation syndrome,Liver fibrosis
