加味苓桂术甘汤联合短期极低热量饮食治疗脾虚痰湿型高脂血症合并脂肪肝的临床研究

摘要

目的:观察加味芩桂术甘汤联合短期极低热量饮食治疗脾虚痰湿型高脂血症合并脂肪肝的临床疗效.方法:115例高脂血症合并脂肪肝患者随机分为两组,治疗组65例,用加味苓桂术甘汤联合短期极低热量饮食治疗.对照组50例,用洛伐他汀治疗,两组疗程均为3个月.观察两组患者治疗前后临床疗效、血脂、转氨酶、体质指数(BMI)、血液流变学变化.结果:两组治疗后治疗组总有效率89.23%,对照组总有效率80.00%.治疗组临床疗效明显优于对照组(P<0.05);两组治疗后TC、TG、LDL、ALT、AST较治疗前明显下降(P<0.05),且治疗组治疗后TC、TG、LDL、ALT、AST、BMI较对照组下降显著(P<0.05);两组治疗前后全血粘度高切、全血粘度低切、还原粘度高切、红细胞聚集指数及纤维蛋白原均有改善(P<0.05),且治疗组全血粘度高切、红细胞聚集指数、纤维蛋白原较时照组明显好转(两组治疗后相比,P<0.05).结论:加味苓桂术甘汤联合短期极低热量治疗脾虚痰湿型高脂血症合并脂肪肝疗效明确.%Objective To observe the effects of modified Ling-Gui-Zhu-Gan decoction combined with short- term very low calorie diet (VLCD) for treatment of hyperlipidemia and fatty liver (splenic hypofunction and dampness accumulation type). Methods A total of 115 cases of hyperlipidemia and fatty liver were randomly divided into two groups .Treatment group (n = 65) was treated with modified Ling-Gui-Zhu-Gan decoction combined with short-term VLCD. Control group (n = 50) was treated with lovastatin. The therapeutic course lasted for 3 month. The changes of clinical efficacy, aminotransferase , body mass index (BMI) , blood lipids, hemorheology were observed before and after treatment. Results The total effective rate for patients in treatment group was 89.23%, and that was 80.00% in control group. The clinical efficacy of the treatment group was better than the control group (P < 0.05) .TC , TG, LDL, ALT and AST were decreased in both groups after treatment (P < 0.05). TC , TG, LDL, ALT, AST and BMI were significantly decreased in the treatment group when compared with control group (P < 0.05). Whole blood viscosity high shear rate , whole blood viscosity low shear rate , reduced viscosity high shear rate, fibrinogen, index of erythrocyte aggregation were improved in both groups after treatment (P < 0.05). Whole blood viscosity high shear rate and the index of erythrocyte aggregation fibrinogen in treatment group was significantly improved comparing to that in control group (P < 0.05). Conclusion The efficacy of modified Ling-Gui-Zhu-Gan decoction combined with short-term very-low-calorie-diet for treatment of hyperlipidemia and fatty liver (splenic hypofunction and dampness accumulation type) is confirmed.