降脂护肝方联合瑞舒伐他汀钙片治疗痰瘀互结型非酒精性脂肪肝的临床观察
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摘要
目的:探讨中西医结合治疗对痰瘀互结型非酒精性脂肪肝患者相关指标及中医证候积分的影响。方法:选取我科收治的128例痰瘀互结型非酒精性脂肪肝患者作为研究对象,随机分为治疗组(64例)和对照组(64例)。对照组应用瑞舒伐他汀钙片治疗,治疗组在对照组治疗的基础上加用降脂护肝方,10d为1个疗程,治疗共3个疗程。比较两组肝功、血脂、胰岛素抵抗指数(HOMA-IR)、鸢尾素(Irisin)、超氧化物歧化酶(SOD)、丙二醛(MDA)、体重指数(BMI)、腰围(WC)、肝/脾CT比值及中医症候积分。结果:治疗组中医症候疗效疗效(82.82%)明显高于对照组(65.62%),其差异具有统计学意义(P<0.05);两组患者治疗前各指标均无差异(P>0.05);较治疗前比较,两组治疗后各指标水平均有显著改善(P<0.05),且治疗组较对照组各指标改善更加明显,具有统计学差异(P<0.05)。结论:中西医结合治疗能够改善患者的症状,能够取得良好的临床疗效,且具有一定抗氧化应激的作用,值得临床推广或进一步研究。
Objective:To investigate the influence of integrated traditional Chinese and Western medicine on the related indexes and TCM syndrome scores of patients with non-alcoholic fatty liver disease.Methods:A total of 128 patients with nonalcoholic fatty liver disease who were admitted to our department from January 2017 to May 18,2017 were enrolled in the study.According to the hospital admission record number,they were randomly divided into treatment groups and control group,with 64 cases in each group.The control group was treated with rosuvastatin calcium tablets.The treatment group was treated with Jiangzhi Fanggan Recipe on the basis of the control group.The treatment was performed for 10 days for a total of 3 courses.Liver function,blood lipids,insulin resistance index(HOMA-IR),iris(Irisin),superoxide dismutase(SOD),malondialdehyde(MDA),body mass index(BMI),waist circumference(WC),Liver/spleen CT ratio and TCM syndrome scores were compared between the two groups.Results:The curative effect of TCM symptom in the treatment group(82.82%)was significantly higher than that in the control group(65.62%),and the difference was statistically significant(P<0.05).There was no difference between the two groups before treatment(P>0.05).Compared with before treatment,the levels of each index were significantly improved after treatment(P<0.05),and the improvement of the treatment group was more significant than that of the control group(P<0.05).Conclusion:The combination of traditional Chinese and Western medicine can improve the symptoms of patients,achieve good clinical efficacy,and have certain anti-oxidative stress effects,which is worthy of clinical promotion or further research.
Objective:To investigate the influence of integrated traditional Chinese and Western medicine on the related indexes and TCM syndrome scores of patients with non-alcoholic fatty liver disease.Methods:A total of 128 patients with nonalcoholic fatty liver disease who were admitted to our department from January 2017 to May 18,2017 were enrolled in the study.According to the hospital admission record number,they were randomly divided into treatment groups and control group,with 64 cases in each group.The control group was treated with rosuvastatin calcium tablets.The treatment group was treated with Jiangzhi Fanggan Recipe on the basis of the control group.The treatment was performed for 10 days for a total of 3 courses.Liver function,blood lipids,insulin resistance index(HOMA-IR),iris(Irisin),superoxide dismutase(SOD),malondialdehyde(MDA),body mass index(BMI),waist circumference(WC),Liver/spleen CT ratio and TCM syndrome scores were compared between the two groups.Results:The curative effect of TCM symptom in the treatment group(82.82%)was significantly higher than that in the control group(65.62%),and the difference was statistically significant(P<0.05).There was no difference between the two groups before treatment(P>0.05).Compared with before treatment,the levels of each index were significantly improved after treatment(P<0.05),and the improvement of the treatment group was more significant than that of the control group(P<0.05).Conclusion:The combination of traditional Chinese and Western medicine can improve the symptoms of patients,achieve good clinical efficacy,and have certain anti-oxidative stress effects,which is worthy of clinical promotion or further research.
引文
1谢长飞,黄笑梅,杨涛.脂肪肝常见中医证型与生化指标的关系分析[J].湖南中医药大学学报,2018,38(3):296-301.
2 Fan JG,Falrell GC.Epidemiology of non-alcoholic fatty liver disease in China[J].J Hepatol,2009,50(1):204-210.
3 张淑波,丁婷,陈文平.二甲双胍对非酒精性脂肪肝的影响[J].西北药学杂志,2015(2):56.
4 张顺贞,季章龙,姚政,等.从痰瘀理论探讨非酒精性脂肪肝的治疗[J].云南中医中药杂志,2016,36(6):21-23.
5 中华医学会肝病学分会脂肪肝和酒精性肝病学组.中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].中国医学前沿杂志(电子版),2012,4(7):4-9.
6 国家食品药品监督管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社.2002:85.
7 危北海,陈治水,张万岱.胃肠疾病中医证候评分表[J].世界华人消化杂志,2004,12(11):2701-2703.
8 彭汉光,王萍,艾长征,等.加味四逆散治疗脂肪肝的实验研究[J].中国中医药信息杂志,2003,10(7):32-33.
9 刘福平,张星光,陈彬.二甲双胍联合西格列汀或格列美脲对糖尿病血糖波动和氧化应激的影响[J].中国现代医学杂志,2015,25(33):71.
10 刘娜,杜爱书,贾静,等.茵栀黄联合二甲双胍治疗非酒精性脂肪肝病临床疗效及对患者血糖、血脂和氧化应激水平的影响[J].解放军杂志,2018,36(3),339-342.
11 秦锴.瑞舒伐他汀联合多烯磷脂酰胆碱治疗非酒精性脂肪肝合并颈动脉粥样硬化斑块疗效观察[J].齐齐哈尔医学院学报2014,35(15):2271-2272
12 刘锐,李劲平,伍娟娟,等.丹苘软胶囊对非酒精性脂肪肝模型大鼠肝脏SOCS-3mRNA表达的影响[J].中华中医药学刊,2012,30(1):191.
13 王康,郑通美.化痰祛瘀方加减治疗痰瘀互结型酒精性脂肪肝病疗效观察[J].辽宁中医杂志,2014,41(1):118-119.
2 Fan JG,Falrell GC.Epidemiology of non-alcoholic fatty liver disease in China[J].J Hepatol,2009,50(1):204-210.
3 张淑波,丁婷,陈文平.二甲双胍对非酒精性脂肪肝的影响[J].西北药学杂志,2015(2):56.
4 张顺贞,季章龙,姚政,等.从痰瘀理论探讨非酒精性脂肪肝的治疗[J].云南中医中药杂志,2016,36(6):21-23.
5 中华医学会肝病学分会脂肪肝和酒精性肝病学组.中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].中国医学前沿杂志(电子版),2012,4(7):4-9.
6 国家食品药品监督管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社.2002:85.
7 危北海,陈治水,张万岱.胃肠疾病中医证候评分表[J].世界华人消化杂志,2004,12(11):2701-2703.
8 彭汉光,王萍,艾长征,等.加味四逆散治疗脂肪肝的实验研究[J].中国中医药信息杂志,2003,10(7):32-33.
9 刘福平,张星光,陈彬.二甲双胍联合西格列汀或格列美脲对糖尿病血糖波动和氧化应激的影响[J].中国现代医学杂志,2015,25(33):71.
10 刘娜,杜爱书,贾静,等.茵栀黄联合二甲双胍治疗非酒精性脂肪肝病临床疗效及对患者血糖、血脂和氧化应激水平的影响[J].解放军杂志,2018,36(3),339-342.
11 秦锴.瑞舒伐他汀联合多烯磷脂酰胆碱治疗非酒精性脂肪肝合并颈动脉粥样硬化斑块疗效观察[J].齐齐哈尔医学院学报2014,35(15):2271-2272
12 刘锐,李劲平,伍娟娟,等.丹苘软胶囊对非酒精性脂肪肝模型大鼠肝脏SOCS-3mRNA表达的影响[J].中华中医药学刊,2012,30(1):191.
13 王康,郑通美.化痰祛瘀方加减治疗痰瘀互结型酒精性脂肪肝病疗效观察[J].辽宁中医杂志,2014,41(1):118-119.