疏肝消脂方对酒精性脂肪肝有效性和安全性的研究Effectiveness and Safety of the Shuganxiaozhi Tea on Alcoholic Fatty Liver
伍月红,冯崇廉,刘丽莹,幸宇坚
WU Yuehong,FENG Chonglian,LIU Liying,XING Yujian
摘要(Abstract):
目的探讨疏肝消脂方治疗酒精性脂肪肝的有效性和安全性。方法将64例符合诊断标准的患者随机分为两组,各32例。治疗组应用疏肝消脂方,随证加减。对照组给予易善复治疗。比较两组的临床疗效、肝功能、血脂的变化情况。观测两组治疗前后血常规、肾功能、心电图等实验室指标及不良反应,评价其安全性。结果治疗组总有效率87.5%明显高于对照组的71.9%,差异具有统计学意义(P<0.05)。两组患者经治疗后AST、ALT、GGT等肝功能指标均较治疗前下降(P<0.05),且治疗组下降程度较对照组明显(P<0.05)。与治疗前比较,两组患者治疗后TC,TG,LDL-C均明显降低(P<0.05),HDL-C明显升高(P<0.05),且治疗后治疗组TC,TG改善程度优于对照组(P<0.05),而治疗组HDL-C、LDL-C改善程度与对照组相比,差异无统计学意义(P>0.05)。两组治疗前后血常规、肾功能、心电图比较,差异无统计学意义(P>0.05);两组患者在治疗期间均未出现不良反应。结论疏肝消脂方治疗酒精性脂肪肝有较好的疗效,它能明显改善肝功能ALT、AST、GGT;调节血脂TC、TG;且未发现不良反应,安全性较好。
OBJECTIVE To evaluate the effectiveness and safety of the Shuganxiaozhi tea on alcoholic fatty liver. METHODS A total of 64 patients were randomly divided into two groups,with 32 cases in each group. The treatment was given the Shuganxiaozhi tea,while the control was given Yishanfu capsules. The clinical efficacy,liver function and blood lipid in the two groups were observed and compared. In addition,blood routine,kidney function,electrocardiogram and other laboratory indicators,and adverse reactions were evaluated and comapred. RESULTS The total efficacy in the treatment group( 87. 5%) was higher than that in the control group(71.9%),with statistically significant difference(P<0.05). After treatment,the liver function(AST,ALT and GGT) in both groups decreased compared with that before treatment( P<0.05),and the decrease in the treatment was more significant than that in the control group( P< 0. 05). Compared with before treatment,TC,TG and LDL-C in both groups were significantly decreased after treatment(P<0.05),while HDL-C was increased( P < 0. 05). Moreover,the improvement of TC and TG in the treatment group was more significant than that in the control group,with no significant difference on the effects of HDL-C and LDL-C between the two groups(P>0.05).There was no significant difference in blood routine,renal function and electrocardiogram between the two groups before and after treatment( P>0.05). No adverse reactions occurred during the treatment in both groups. CONCLUSION The Shuganxiaozhi tea was effective in the treatent of alcoholic fatty liver,with good safety.
关键词(KeyWords):
疏肝消脂方;酒精性脂肪肝;安全性;临床疗效
Shuganxiaozhi tea;alcoholic fatty liver;safety;clinical study
基金项目(Foundation): 广东省中医药局科研项目(20172107)
作者(Author):
伍月红,冯崇廉,刘丽莹,幸宇坚
WU Yuehong,FENG Chonglian,LIU Liying,XING Yujian
参考文献(References):
- [1]Wang X F,Yue M.Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study[J].Hepatobiliary and Pancreatic Diseases International,2011,10(3):276-279.
- [2]张洁,虞朝辉.酒精性肝病的流行病学与自然史[J].现代医药卫生,2017,33(1):3-4,6.
- [3]Kharbanda K K,Ronis M,Shearn C T,et al.Role of Nutrition in Alcoholic Liver Disease:Summary of the Symposium at the ESBRA2017 Congress[J].Biomolecules,2018,8(2):16.
- [4]刘露露,王炳元.肠道微生态与酒精性肝病[J].实用肝脏病杂志,2017,20(6):660-662.
- [5]夏婷,张瑾,姚佳慧,等.氧化应激在酒精性肝病中作用机制的研究进展[J].中国药理学通报,2017,33(10):1353-1356.
- [6]冯志强,沈志祥,谭诗云.酒精性脂肪肝的发病机制研究进展[J].世界华人消化杂志,2002,10(3):346-348.
- [7]孔维宗,王迎春.酒精性肝病的治疗进展[J].现代医药卫生,2017,33(1):15-17.
- [8]侯羽菲,陈吉.酒精性肝病治疗的新进展[J].世界最新医学信息文摘,2018,18(72):156-159.
- [9]Suk K T,Kim M Y,Baik S K.Alcoholic liver disease:Treatment[J].World Journal of Gastroenterology,2014,20(36):12934-12944.
- [10]刘彩容,高炽彪,谢续赢.非诺贝特对非酒精性脂肪肝患者肝纤维化指标和脂代谢的影响[J].广州医科大学学报,2017,45(2):52-54.
- [11]赵钊,陈道云.酒精性脂肪肝的中医辨治研究概况[J].光明中医,2012,27(1):191-193.
- [12]罗晨,杨嘉恩,梁惠卿.酒精性肝病中西医辨治研究进展[J].医学信息,2018,31(15):16-19,24.
- [13]肖玲辉,扈晓宇.退黄消脂方治疗酒精性脂肪性肝炎疗效观察[J].现代中西医结合杂志,2018,27(23):2599-2600,2603.
- [14]王进博,李正,赵远红.赶黄草复方治疗酒精性脂肪肝临床观察[J].中国实验方剂学杂志,2016,22(13):156-160.
- [15]庄义昭.血府逐瘀汤加减治疗酒精性脂肪肝的临床疗效观察[J].中医临床研究,2018,10(19):57-59.
- [16]伍月红,黄乐珊,方锦霞.疏肝消脂颗粒剂的制备工艺及质量控制研究[J].中国现代药物应用,2008,2(1):3-5.
- [17]王志平,冯崇廉.疏肝消脂Ⅲ号方对大鼠酒精性脂肪肝模型的影响[J].中国中西医结合消化杂志,2009,17(3):160-163.
- [18]中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南[J].中国肝脏病杂志(电子版),2010,2(4):49-53.
- [19]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:88-91.
- [20]谢松生,钟万芬,李文郎,等.8项生化指标对酒精性脂肪肝诊断的临床价值研究[J].临床和实验医学杂志,2013,12(21):1752-1754.
- [21]凌果元,冯崇廉.疏肝消脂Ⅲ方胶囊慢性毒理学实验研究[J].广州医学院学报,2014,42(2):65-69.