自拟柔肝消脂煎治疗非酒精性脂肪性肝炎的疗效评价

J4 ›› 2012, Vol. 38 ›› Issue (1): 142-147.

自拟柔肝消脂煎治疗非酒精性脂肪性肝炎的疗效评价

杨强¹|谢慧臣¹|潘庆华²|刘小琴³|许建华¹|赵晓琴¹|姜锦林¹

1.湖北民族学院附属医院中医科|湖北恩施 445000；2. 湖北省恩施州中心医院消化内科|湖北恩施 445000；3.湖北省恩施州疾病预防控制中心预防医学科|湖北恩施 445000

收稿日期:2011-06-29 出版日期:2012-01-28 发布日期:2012-01-28
通讯作者: 杨强（Tel:0718-8301389，E-mail:yq20010602@tom.com） E-mail:yq20010602@tom.com
作者简介:杨强(1979-)|男|湖北省恩施市人|讲师|主治医师,主要从事中西医结合治疗消化系统疾病和风湿免疫系统疾病研究。
基金资助:
湖北省教育厅指导性项目资助课题（B20092905）

Evaluation on curative effect of Self-prepared Softening Liver and Eliminating Fat Decoction in treatment of |non-alcoholic steatohepatitis

YANG Qiang¹,XIE Hui-chen¹,PAN Qing-hua²,LIU Xiao-qin³,XU Jian-hua¹,ZHAO Xiao-qin¹,JIANG Jin-lin¹

1. Department of Traditional Chinese Medicine,Affiliated Hospital,Hubei University |for Nationalities, Enshi 445000,China|2. Department of Digestive Medicine,Central Hospital,Enshi Autonomous Prefecture, Enshi 445000,China|3. Department of Preventive Medicine,Center for Disease Control and Prevention of Enshi,Enshi Autonomous Prefecture,Enshi 445000,China

Received:2011-06-29 Online:2012-01-28 Published:2012-01-28

摘要/Abstract

摘要：

目的：观察自拟柔肝消脂煎治疗非酒精性脂肪性肝炎（NASH）的临床疗效。方法：选择NASH患者172例，按患者意愿分为西药组50例、中药组56例和中西药联合组66例。西药组口服护肝降酶和降血脂西药，中药组口服自拟柔肝消脂煎，中西药联合组联合服用西药组和中药组药物。3个月为1个疗程。观察患者肝功能及血脂各项指标变化。结果：中西药联合组66例，治愈50例，有效12例，无效4例，治愈率75.8%，总有效率93.9%；中药组56例，治愈38例，有效15例，无效3例，治愈率67.9%，总有效率94.6%；西药组50例，治愈26例，有效17例，无效7例，治愈率52.0%，总有效率86.0%。中药组、中西药联合组治愈率和总有效率均明显高于西药组(P<0.01)；中西药联合组治愈率高于中药组(P<0.05)；中西药联合组与中药组总有效率比较差异无统计学意义(P＞0.05)。3组患者血清ALT、AST、GGT水平治疗后低于治疗前(P<0.01)；治疗后中药组、中西药联合组ALT、AST、GGT水平低于西药组（ P＜0.05或 P<0.01)；治疗后中西药联合组与中药组ALT、AST、GGT水平比较差异无统计学意义(P＞0.05)。3组患者血清TG、TC均低于治疗前(P<0.01)，治疗后中药组、中西药联合组TG、TC水平低于西药组(P＜0.05或P<0.01)，中西药联合组和中药组TC、TG水平差异无统计学意义(P＞0.05)。3组患者治疗后影像学检查变化比较，中药组、中西药联合组治愈率和有效率均高于西药组（P<0.01）。治疗过程中，西药组部分患者因服用降脂药短期内出现胃肠道不良反应，中药组和中西药联合组均无明显不良反应发生。结论：自拟柔肝消脂煎对非酒精性脂肪性肝炎有显著疗效，无明显不良反应；自拟柔肝消脂煎与西药联合运用治疗非酒精性脂肪性肝能提高临床治愈率，且能降低降脂西药胃肠道反应。

关键词: 非酒精性脂肪性肝炎；自拟柔肝消脂煎；疗效评价

Abstract:

Abstract:Objective To observe the clinical efficacy of Self-prepared Softening Liver and Eliminating Fat Decoction in treatment of non-alcoholic steatohepatitis (NASH).Methods 172 patients with NASH,according to the willingness of patients,were divided into western medicine treatment group (n=50),Chinese medicine treatment group (n=56),and combined treatment group with Chinese and western medicine (n=66).The patients in Western medicine treatment group were treated with oral western medicine for protecting the liver，reducing enzyme and lowering blood lipids,in traditional Chinese medicine group with Self-prepared Softening Liver and Eliminating Fat Decoction,in combined treatment group with western medicine combined with Chinese medicine,and lasted for 3 months.The liver function,serum lipids,liver image were observed.Results In combined treatment group,50 cases were cured,12 cases were effective,4 cases were ineffective,the cure rate was 75.8%,the total effective rate was 93.9%; in Chinese medicine treatment group,38 cases were cured,15 cases were effective,3 cases were ineffective,the cure rate was 67.9%,the total effective rate was 94.6%; in western medicine group,26 cases were cured,17 cases were effective,7 cases were ineffective,the cure rate was 52.0%,the total effective rate was 86.0%.In Chinese medicine treatment group and combined treatment group the cure rates and the total effective rates were significantly higher than those in western medicine group (P<0.05 or P<0.01); the cure rate in combined treatment group was higher than that in Chinese medicine treatment group (P<0.05); the difference in effective rate between combined treatment group and Chinese treatment group had no significant difference (P> 0.05).The serum ALT,AST,and GGT levels after treatment in three groups were lower than before treatment (P<0.01); the ALT,AST,and GGT levels in Chinese medicine group and combined treatment group were lower than those in western medicine group (P<0.05 or P<0.01); the ALT,AST,and GGT levels after treatment in combined treatment group and Chinese medicine group had no significant difference (P> 0.05).The serum TG and TC after treatment in three groups were decreased compared with before treatment,there were significant differences (P<0.01); the TG and TC levels in Chinese medicine treatment group and combined treatment group were lower than those in western medicine group (P<0.05 or P<0.01); there were no significant difference in the TG and TC levels between Chinese medicine treatment group and combined treatment group(P>0.05).In the course of treatment,some short-term gastrointestinal side effects occurred in western medicine group,but Chinese medicine treatment group and combined treatment group had no obvious adverse reactions.Conclusion Self-prepared Softening Liver and Eliminating Fat Decoction has the exact effect on NASH and has no adverse reactions; Self-prepared Softening Liver and Eliminating Fat Decoction combined with western medicine can significantly improve the clinical cure rate of NASH,and reduce the gastrointestinal tract reaction caused by western medicine.

Key words: non-alcoholic steatohepatitis, Self-prepared Softening Liver and Eliminating Fat Decoction, efficacy evaluation

中图分类号:

R575.1

杨强|谢慧臣|潘庆华|刘小琴|许建华|赵晓琴|姜锦林. 自拟柔肝消脂煎治疗非酒精性脂肪性肝炎的疗效评价[J]. J4, 2012, 38(1): 142-147.

YANG Qiang,XIE Hui-chen,PAN Qing-hua,LIU Xiao-qin,XU Jian-hua,ZHAO Xiao-qin,JIAN. Evaluation on curative effect of Self-prepared Softening Liver and Eliminating Fat Decoction in treatment of |non-alcoholic steatohepatitis[J]. J4, 2012, 38(1): 142-147.