降脂平肝汤对非酒精性脂肪性肝病患者降脂保肝作用的临床观察

摘要

Objective To discuss the clinical efficacy of decoction for lipid-lowering to calm liver on patients with nonalcoholic fatty liver ( NAFLD ) disease. Methods One hundred and sixty NAFLD patients screened from the routine health examination from March 2007 to December 2010 were randomly divided into two groups, each with 80 cases. Both groups took fluvastatin 20 mg orally once daily; the treatment group additionally took homemade decoction for lowering lipid to calm the liver (basic prescription: bupleurum Chinese 12 g, atractylodes 15 g, polygonum multiflorum thunb 20 g, immature bitter orange 15 g, red peony root 15 g, white peony root 15 g, salvia miltiorrhiza 15 g, raw hawthorn 30 g, alisma 20 g, cassia seed 20 g, poria cocos 15 g, liquorice 6 g), and according to the disease situation, the items in the prescription were regulated, one dose a day. Four weeks constituted one therapeutic course, and 3 therapeutic courses were for observation period. The changes of alanine aminotransferase (ALT) , aspartate aminotransferase (AST), total cholesterol (TC) , and triglyceride (TG) before and after treatment along with liver ultrasound inspection were checked. Results After treatment, the total therapeutic effect in treatment group was clearly better than that in control group (88.75% vs. 77.50% , P<0.05); ALT (U/L) , AST (U/L) , TC (mmol/L) and TG (mmol/L) in both groups were decreased obviously (control group: ALT: 56.26±5.22 vs. 84.12±5.37, AST: 54.14+4.67 vs. 66.2314.02, TC: 6.87±2.01 vs. 7.98±1.16, TG: 2.24±1.07 vs. 2.71 ±1.21; treatment group: ALT: 34.31±5.32 vs. 86.2613.06, AST: 41.01±5.89 vs. 65.13±5.16, TC: 5.92±1.02 vs. 8.06±1.03, TG: 1.8411.86 vs. 2.67 + 1.24) , and the effectiveness in the treatment group was significantly higher than that in the control group (ALT: 34.3115.32 vs. 56.2615.22, AST: 41.0115.89 vs. 54.1414.67, TC: 5.9211.02 vs. 6.8712.01, TG: 1.8411.86 vs. 2.2411.07, all /><0.05). Conclusion Decoction for lowering lipid to calm the liver has remarkable clinical efficacy of regulating blood lipid and protecting liver function on NAFLD patients.%目的 探讨降脂平肝汤对非酒精性脂肪性肝病(NAFLD)患者降脂保肝作用的临床疗效.方法 将2007年3月至2010年12月本院教职工常规体检筛查出的160例NAFLD患者按随机原则分为两组,每组80例.对照组患者口服氟伐他汀,每日1次,每次20 mg.治疗组在对照组基础上加用自拟降脂平肝汤(基本方:柴胡12 g,白术15 g,何首乌20 g,枳实15 g,赤芍15 g,白芍15 g,丹参15 g,生山楂30 g,泽泻20 g,决明子20 g,茯苓15 g,甘草6 g)随症加减,每日1剂.4周为1个疗程,观察3个疗程.治疗前后检测丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆固醇(TC)、甘油三酯(TG)的变化并行肝脏超声检查.结果 治疗后治疗组总有效率明显高于对照组(88.75％比77.50％,P＜0.05)；两组治疗后ALT (U/L)、AST (U/L)、TC (mmol/L)、TG (mmol/L)均较治疗前明显降低(对照组:ALT:56.26±5.22比84.12±5.37,AST:54.14±4.67比66.23±4.02,TC:6.87±2.01比7.98± 1.16,TG:2.24±1.07比2.71±1.21;治疗组:ALT:34.31±5.32比86.26±3.06,AST:41.01±5.89比65.13±5.16,TC:5.92±1.02比8.06± 1.03,TG:1.84±1.86比2.67± 1.24),且以治疗组改善程度更显著(ALT:34.31±5.32比56.26±5.22,AST:41.01±5.89比54.14±4.67,TC:5.92±1.02比6.87±2.01,TG:1.84±1.86比2.24± 1.07,均P＜0.05).结论 降脂平肝汤能明显降低NAFLD患者的血脂水平,保护肝功能,临床疗效显著.