解郁消脂方对非酒精性脂肪性肝炎的临床疗效及生活质量的影响
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摘要
目的探讨解郁消脂方治疗非酒精性脂肪性肝炎的临床疗效及对生活质量的影响。方法收集2016年1月～2017年12月非酒精性脂肪性肝炎患者81例,采用随机数字法分为治疗组和对照组,治疗组41例,对照组40例。两组均给予多烯磷脂酰胆碱胶囊,治疗组加用解郁消脂方,疗程12周。结果两组愈显率比较,治疗组82.93%,对照组62.50%,差异明显(P<0.05);治疗后ALT:治疗组(38.80±9.36)U/L,对照组(46.13±12.48)U/L,差异有统计学意义(P<0.05)。治疗后慢性肝病问卷量表(CLDQ)综合评分:治疗组(5.71±0.13)分,对照组(5.34±0.17)分,差异有统计学意义(P<0.05)。结论解郁消脂方应用在非酒精性脂肪性肝炎患者中可以明显提高临床疗效,降低转氨酶,减轻患者临床症状,改善生活质量,值得在临床上推广应用。
Objective To investigate the clinical effectiveness and influence of Jieyuxiaozhi formula on life quality in patients with non-alcoholic steatohepatitis(NASH). Methods 81 NASH patients from January 2016 to December 2017 were collected and randomized into treatment group and control group using random number. 41 patients were in treatment group and 40 in control group. Patients in two groups were treated with polyene phosphatidylcholine capsules. Patients in treatment group were treated with additional Jieyuxiaozhi formula. The course lasted 12 weeks. Results Cure rate in treatment group(82.93%) was significantly different from control group(62.50%)(P<0.05). After treatment, ALT in treatment group was(38.80±9.36)U/L, which was statistically different from that in control group(46.13±12.48)U/L(P<0.05).After treatment, the score of chronic liver disease questionnaire(CLDQ) in treatment group was(5.71±0.13), which was statistically different from that in control group(5.34±0.17)(P<0.05). Conclusion Jieyuxiaozhi formula could improve the clinical effectiveness in NASH patients significantly. It could reduce ALT, alleviate clinical symptoms and improve quality of life. It was worth clinical promotion and application.
Objective To investigate the clinical effectiveness and influence of Jieyuxiaozhi formula on life quality in patients with non-alcoholic steatohepatitis(NASH). Methods 81 NASH patients from January 2016 to December 2017 were collected and randomized into treatment group and control group using random number. 41 patients were in treatment group and 40 in control group. Patients in two groups were treated with polyene phosphatidylcholine capsules. Patients in treatment group were treated with additional Jieyuxiaozhi formula. The course lasted 12 weeks. Results Cure rate in treatment group(82.93%) was significantly different from control group(62.50%)(P<0.05). After treatment, ALT in treatment group was(38.80±9.36)U/L, which was statistically different from that in control group(46.13±12.48)U/L(P<0.05).After treatment, the score of chronic liver disease questionnaire(CLDQ) in treatment group was(5.71±0.13), which was statistically different from that in control group(5.34±0.17)(P<0.05). Conclusion Jieyuxiaozhi formula could improve the clinical effectiveness in NASH patients significantly. It could reduce ALT, alleviate clinical symptoms and improve quality of life. It was worth clinical promotion and application.
引文
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[12]Ratziu V,Goodman Z,Sanyal A.Current efforts and trends in the treatment of NASH[J].J Hepatol,2015,62(1):S65-S75.
[13]Ratziu V,Harrison SA,Francque S,et al.Elafibranor,an Agonist of the Peroxisome Proliferator-Activated Receptor-αand-δ,Induces Resolution of Nonalcoholic Steatohepatitis Without Fibrosis Worsening e[J].Gastroenterology,2016,150(5):1147-1159.
[14]Sanyal AJ,Chalasani N,Kowdley KV,et al.Pioglitazone,vitamin E,or placebo for nonalcoholic steatohepatitise[J].N Engl J Med,2010,362(18):1675-1685.
[15]Pai V,Paneerselvam A,Mukhopadhyay S,et al.A Multicenter,Prospective,Randomized,Double-blind Study to Evaluate the Safety and Efficacy of Saroglitazar 2 and 4 mg Compared to Pioglitazone 45 mg in Diabetic Dyslipidemia(PRESS V)[J].Journal of Diabetes Science&Technology,2014,8(1):132-141.
[16]Neuschwander-Tetri BA,Loomba R,Sanyal AJ,et al.Farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic,non-alcoholic steatohepatitis(FLINT):A multicentre,randomised,placebo-controlled trial[J].Lancet,2015,385(9972):956-965.
[17]Nash Biotechs.NGM282(EB/OL).Available from:URL:http://www.nashbiotechs.com/drugs_en/NGM282.php.
[18]Safadi R,Konikoff FM,Mahamid M,et al.The fatty acidbile acid conjugate Aramchol reduces liver fat content in patients with nonalcoholic fatty liver disease[J].Clinical Gastroenterology and Hepatology,2014,12:2085-2091.
[19]Dongiovanni P,Petta S,Mannisto V,et al.Statin use and non-alcoholic steatohepatitis in at risk individuals[J].Journal of Hepatology,2015,63(3):705-712.
[20]冷雪君,颜学兵.非酒精性脂肪性肝炎的药物治疗进展[J].世界华人消化杂志,2017,25(18):1645-1654.
[21]康年松,韩旭丰,陈笑腾,等.马伟明辨治功能性消化不良重叠肠易激综合征经验[J].浙江中医杂志,2014,49(7):473-474.
[2]Chalasani N,Younossi Z,Lavine JE,et al.The diagnosis and management of nonal-coholic fatty liver disease:practice guideline by the American a ssociation for the study of liver diseases,American College of Gastroenterology,and the American College of Gastroenterological Association[J].Hepatology,2012,55:2005-2023.
[3]王璐,董卫国,吕晓光,等.非酒精性脂肪性肝病患者的循证治疗[J].中国全科医学,2013,16(10):3529-3532.
[4]Lee SS,Park SH.Radiologic evaluation of nonalcoholic fatty liver disease[J].World J Gastroenterol,2014,20(23):7392-7402.
[5]中华医学会肝病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南[J].中华肝脏病杂志,2010,18(3):163.
[6]唐金模,梁惠卿,王宏国,等.皂术茵陈方治疗非酒精性脂肪性肝炎的临床疗效及对游离脂肪酸和TNF-α的影响[J].中国中西医结合杂志,2016,36(5):544-548.
[7]Younossi Z M,Guyatt G,Kiwi M,et al.Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease[J].Gut,1999,45(2):295-300.
[8]Schulz KH,Kroencke S,Ewer SH.The factorial structure of the Chronic Liver Disease Questionnaire(CLDQ)[J].Qual Life Res,2008,17(4):575-584.
[9]中国中西医结合学会消化系统疾病专业委员会.非酒精性脂肪性肝病的中西医结合诊疗共识意见[J].中国中西医结合杂志,2011,32(2):155-188.
[10]La Brecque DR,Abbas Z,Anania F,et al.World Gastroenterology Organisation Global Guidelines:Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis[J].J Clin Gastoenterol,2014,48(6):467-473.
[11]Alt Y,Grimm A,Schlegel L,et al.The impact of liver cell injury on health related quality of life in patients with chronic liver disease[J].PLo S One,2016,11(3):e0151200.
[12]Ratziu V,Goodman Z,Sanyal A.Current efforts and trends in the treatment of NASH[J].J Hepatol,2015,62(1):S65-S75.
[13]Ratziu V,Harrison SA,Francque S,et al.Elafibranor,an Agonist of the Peroxisome Proliferator-Activated Receptor-αand-δ,Induces Resolution of Nonalcoholic Steatohepatitis Without Fibrosis Worsening e[J].Gastroenterology,2016,150(5):1147-1159.
[14]Sanyal AJ,Chalasani N,Kowdley KV,et al.Pioglitazone,vitamin E,or placebo for nonalcoholic steatohepatitise[J].N Engl J Med,2010,362(18):1675-1685.
[15]Pai V,Paneerselvam A,Mukhopadhyay S,et al.A Multicenter,Prospective,Randomized,Double-blind Study to Evaluate the Safety and Efficacy of Saroglitazar 2 and 4 mg Compared to Pioglitazone 45 mg in Diabetic Dyslipidemia(PRESS V)[J].Journal of Diabetes Science&Technology,2014,8(1):132-141.
[16]Neuschwander-Tetri BA,Loomba R,Sanyal AJ,et al.Farnesoid X nuclear receptor ligand obeticholic acid for noncirrhotic,non-alcoholic steatohepatitis(FLINT):A multicentre,randomised,placebo-controlled trial[J].Lancet,2015,385(9972):956-965.
[17]Nash Biotechs.NGM282(EB/OL).Available from:URL:http://www.nashbiotechs.com/drugs_en/NGM282.php.
[18]Safadi R,Konikoff FM,Mahamid M,et al.The fatty acidbile acid conjugate Aramchol reduces liver fat content in patients with nonalcoholic fatty liver disease[J].Clinical Gastroenterology and Hepatology,2014,12:2085-2091.
[19]Dongiovanni P,Petta S,Mannisto V,et al.Statin use and non-alcoholic steatohepatitis in at risk individuals[J].Journal of Hepatology,2015,63(3):705-712.
[20]冷雪君,颜学兵.非酒精性脂肪性肝炎的药物治疗进展[J].世界华人消化杂志,2017,25(18):1645-1654.
[21]康年松,韩旭丰,陈笑腾,等.马伟明辨治功能性消化不良重叠肠易激综合征经验[J].浙江中医杂志,2014,49(7):473-474.