当归芍药散合枳术丸治疗非酒精性脂肪性肝病(肝郁脾虚型)临床观察
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摘要
目的观察当归芍药散合枳术丸治疗非酒精性脂肪性肝病(肝郁脾虚型)的疗效。方法将120例辨证属肝郁脾虚型的非酒精性脂肪性肝病患者按随机数字表法分为治疗组和对照组各60例,治疗组给予当归芍药散合枳术丸加减汤剂治疗,1剂/d,2次/d,对照组给予多烯磷脂酰胆碱胶囊,456 mg/次,3次/d,口服。治疗3个月后,观察2组临床疗效以及转氨酶、血脂、肝脾CT比值、证候评分改善情况。结果治疗组总有效率为88.3%,对照组总有效率为68.3%,2组间疗效差异有统计学意义(P<0.05);治疗后2组患者的转氨酶、血脂、肝脾CT比值、证候评分均较治疗前有显著改善,且治疗组改善情况均优于对照组(P<0.05)。结论当归芍药散合枳术丸治疗非酒精性脂肪性肝病(肝郁脾虚型)疗效肯定。
Objective To observe the curative effect of Danggui Shaoyao San and Zhizhu Pill on nonalcoholic fatty liver disease(liver stagnation and spleen deficiency type). Methods 120 patients with non-alcoholic fatty liver disease who were diagnosed as liver stagnation and spleen deficiency were randomly divided into treatment group and control group according to the random number table method, with 60 in each group. The treatment group received modified decoction of Danggui Shaoyao San and Zhizhu Pills, one dose per day, and two times one day, and the control group received basic treatment of polyene phosphatidylcholine capsules(Essential),456 mg every time,3 times per day,orally. After 3 months of treatment,the clinical efficacy of the two groups and the improvement of transaminase, blood lipid, liver and spleen CT ratio, and TCM syndrome score were observed. Results The total effective rate was 88.3% in the treatment group and 68.3% in control group. The difference between both groups was statistically significant(P<0.05). After the treatment, the transaminase, blood lipid, liver and spleen CT ratio and syndrome score of the two groups were significantly improved compared with those before treatment, and the improvement of the treatment group was better than that of the control group(P<0.05). Conclusion Danggui Shaoyao San and Zhizhu Pills is effective in the treatment of nonalcoholic fatty liver disease(liver stagnation and spleen deficiency type).
Objective To observe the curative effect of Danggui Shaoyao San and Zhizhu Pill on nonalcoholic fatty liver disease(liver stagnation and spleen deficiency type). Methods 120 patients with non-alcoholic fatty liver disease who were diagnosed as liver stagnation and spleen deficiency were randomly divided into treatment group and control group according to the random number table method, with 60 in each group. The treatment group received modified decoction of Danggui Shaoyao San and Zhizhu Pills, one dose per day, and two times one day, and the control group received basic treatment of polyene phosphatidylcholine capsules(Essential),456 mg every time,3 times per day,orally. After 3 months of treatment,the clinical efficacy of the two groups and the improvement of transaminase, blood lipid, liver and spleen CT ratio, and TCM syndrome score were observed. Results The total effective rate was 88.3% in the treatment group and 68.3% in control group. The difference between both groups was statistically significant(P<0.05). After the treatment, the transaminase, blood lipid, liver and spleen CT ratio and syndrome score of the two groups were significantly improved compared with those before treatment, and the improvement of the treatment group was better than that of the control group(P<0.05). Conclusion Danggui Shaoyao San and Zhizhu Pills is effective in the treatment of nonalcoholic fatty liver disease(liver stagnation and spleen deficiency type).
引文
[1] 牛海艳,李海,丁玉平.非酒精性脂肪性肝病的治疗进展[J].临床肝胆病杂志,2018,34(2):433-437.
[2] 谭前伟,金艳蓉,杨海燕.非酒精性脂肪性肝病中医研究进展[J].亚太传统医药,2016,12(12):54-55.
[3] 中华医学会肝病学分会脂肪肝和酒精性肝病学组.中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].中国医学前沿杂志(电子版),2012,4(7):4-10.
[4] 中华中医药学会脾胃病分会.非酒精性脂肪性肝病中医诊疗共识意见[J].北京中医药,2011,30(2):83-86.
[5] 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,2002:148.
[6] 范建高,曾民德.脂肪肝[M].上海:上海医科大学出版社,2000:101.
[7] DAY CP,JAMES OF.Steatohepatitis:a tale of two“hits”[J].Gastroenterology,1998,114(4): 842-845.
[8] 徐京杭.多烯磷脂酰胆碱在肝病临床应用的专家共识[J].中华实验和临床感染病杂志(电子版),2017,11(4):313-319.
[9] 孔祥廉.脂肪肝的中医治疗[M].北京:中国中医药出版社,2005:94-97.
[10] 邹芷均,孙劲晖,田德禄.当归芍药散治疗脂肪肝探析[J].辽宁中医杂志,2006, 33(10):1263-1264.
[11] 周强,张声生.张声生运用调肝理脾法辨治非酒精性脂肪性肝病经验[J].世界中西医结合杂志,2016,11(4):470-472.
[12] 廖芸,王静滨.谢晶日教授治疗非酒精性脂肪性肝病经验浅析[J].中国中医急症,2013,22(4):589-590.
[13] 张永利,王新颖,戈兴中,等.理脾调肝化痰活血中药治疗肝郁脾虚型非酒精性脂肪性肝炎的临床观察[J].北京中医药,2017,36(7):636-639.
[14] 张立宏.调肝理脾法治疗非酒精性脂肪肝临床观察[J].中国医药导报,2017,14(13):84-87.
[15] 郑琳颖,潘竞锵,杨以琳,等.白芍总苷对非酒精性脂肪性肝病大鼠Apelin 和Visfatin 表达的影响[J].中药新药与临床药理,2013,24(1):51-54.
[16] 陈静英,蓝显明,张雪芳,等.当归注射液治疗大鼠非酒精性脂肪肝的实验研究[J].北方药学,2014,11(3):77-78.
[17] 梅琼,李全胜,张静,等.当归川芎组合对血脂及冠状动脉组织结构影响的实验研究[J].湖北中医药大学学报,2015,17(5):47-49.
[18] 毛跟年,张诗韵,付超,等.茯苓皮总三萜的降血脂活性研究[J].陕西科技大学学报,2015,33(3):130-134.
[19] 田婷,陈华,冯亚龙,等.泽泻药理与毒理作用的研究进展[J].中药材,2014,37(11):2103-2108.
[20] 张霄潇,李正勇,马玉玲,等.中药枳实的研究进展[J].中国中药杂志,2015,40(2):185-190.
[21] 陈曦,戚进.荷叶中黄酮和生物碱的研究进展[J].中国实验方剂学杂志,2015,21(18):211-214.
[2] 谭前伟,金艳蓉,杨海燕.非酒精性脂肪性肝病中医研究进展[J].亚太传统医药,2016,12(12):54-55.
[3] 中华医学会肝病学分会脂肪肝和酒精性肝病学组.中国非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].中国医学前沿杂志(电子版),2012,4(7):4-10.
[4] 中华中医药学会脾胃病分会.非酒精性脂肪性肝病中医诊疗共识意见[J].北京中医药,2011,30(2):83-86.
[5] 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,2002:148.
[6] 范建高,曾民德.脂肪肝[M].上海:上海医科大学出版社,2000:101.
[7] DAY CP,JAMES OF.Steatohepatitis:a tale of two“hits”[J].Gastroenterology,1998,114(4): 842-845.
[8] 徐京杭.多烯磷脂酰胆碱在肝病临床应用的专家共识[J].中华实验和临床感染病杂志(电子版),2017,11(4):313-319.
[9] 孔祥廉.脂肪肝的中医治疗[M].北京:中国中医药出版社,2005:94-97.
[10] 邹芷均,孙劲晖,田德禄.当归芍药散治疗脂肪肝探析[J].辽宁中医杂志,2006, 33(10):1263-1264.
[11] 周强,张声生.张声生运用调肝理脾法辨治非酒精性脂肪性肝病经验[J].世界中西医结合杂志,2016,11(4):470-472.
[12] 廖芸,王静滨.谢晶日教授治疗非酒精性脂肪性肝病经验浅析[J].中国中医急症,2013,22(4):589-590.
[13] 张永利,王新颖,戈兴中,等.理脾调肝化痰活血中药治疗肝郁脾虚型非酒精性脂肪性肝炎的临床观察[J].北京中医药,2017,36(7):636-639.
[14] 张立宏.调肝理脾法治疗非酒精性脂肪肝临床观察[J].中国医药导报,2017,14(13):84-87.
[15] 郑琳颖,潘竞锵,杨以琳,等.白芍总苷对非酒精性脂肪性肝病大鼠Apelin 和Visfatin 表达的影响[J].中药新药与临床药理,2013,24(1):51-54.
[16] 陈静英,蓝显明,张雪芳,等.当归注射液治疗大鼠非酒精性脂肪肝的实验研究[J].北方药学,2014,11(3):77-78.
[17] 梅琼,李全胜,张静,等.当归川芎组合对血脂及冠状动脉组织结构影响的实验研究[J].湖北中医药大学学报,2015,17(5):47-49.
[18] 毛跟年,张诗韵,付超,等.茯苓皮总三萜的降血脂活性研究[J].陕西科技大学学报,2015,33(3):130-134.
[19] 田婷,陈华,冯亚龙,等.泽泻药理与毒理作用的研究进展[J].中药材,2014,37(11):2103-2108.
[20] 张霄潇,李正勇,马玉玲,等.中药枳实的研究进展[J].中国中药杂志,2015,40(2):185-190.
[21] 陈曦,戚进.荷叶中黄酮和生物碱的研究进展[J].中国实验方剂学杂志,2015,21(18):211-214.