泄浊化瘀方治疗非酒精性脂肪性肝炎的临床研究

Clinical Research on the Turbidity Relief Formula in the Treatment of Nonalcoholic Fatty Liver Disease

摘要: 目的：观察泄浊化瘀方治疗非酒精性脂肪性肝炎的临床疗效，探讨泄浊化瘀疗法的作用机制。方法：将200例符合非酒精性脂肪性肝炎诊断标准及中医辨证属浊瘀内积型患者，按随机数字表法分为治疗组和对照组。治疗组用泄浊化瘀方，对照组用硫普罗宁片合壳脂胶囊，疗程为8周。观察患者治疗前后的主要临床症状及体征，血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、总胆固醇(TC)、甘油三酯(TG)含量，肝脏B型超声及上腹部CT，比较两组的疗效。结果：两组总疗效比较，治疗组总有效率94%，对照组总有效率75%，差异有统计学意义(P < 0.05)。两组患者经治疗后ALT、AST、GGT、TC、TG均明显改善，与治疗前比较有统计学意义(P < 0.05)；组间比较差异有统计学意义(P < 0.05)。结论：泄浊化瘀方治疗浊瘀内积型非酒精性脂肪性肝炎，不但可以改善患者临床症状及体征，而且能有效恢复肝功能和改善血脂，对非酒精性脂肪性肝炎有较好疗效，总有效率达94%。

Abstract: Objective: To investigate the clinical efficacy and therapeutic mechanism of turbidity relief Formula on nonalcoholic steatohepatitis (NASH). Methods: Two hundred patients who were diagnosed as NASH according to nonalcoholic fatty liver disease diagnosis guideline and turbid phlegm and blood stasis types were randomly divided into the turbidity relief Formula group (100) and control group (100). The turbidity relief Formula group was given turbidity relief Formula, while the control group was given N-(2-Mercaptopropionyl) glycine Capsule. Both of the two groups’ courses of treatment were 8 weeks. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase (GGT), cholesterol total (TC), triglyceride (TG) levels, brightness-mode ultrasound of liver and the CT of the epigastrium were observed and compared. Results: The total effective rates of the turbidity relief Formula group and the control group were respectively 94% and 75% by Ridit method analyzed (P < 0.05). The levels of ALT, AST, GGT, TC and TG were decreased significantly after the treatment in both groups (P < 0.05) and the comparative difference between groups was statistically significant (P < 0.05). Conclusion: The turbidity relief formula in the treatment of the turbid phlegm and blood stasis type in NASH can ameliorate the clinical symptoms of, improve the liver function and reduce the blood lipids, and has a good effect on NASH. The total effective rate was 94%.