自拟降脂护肝方联合多烯磷脂酰胆碱治疗非酒精性脂肪肝的临床研究

发布时间：2019-05-03 20:38

【摘要】：目的:观察自拟降脂护肝方联合多烯磷脂酰胆碱对非酒精性脂肪肝的临床疗效及部分作用机制。方法:将本院收治的60例非酒精性脂肪肝患者根据入院顺序随机分为对照组(30例)和观察组(30例),对照组静脉注射多烯磷脂酰胆碱(易善复),5 m L/次,每日1次;观察组在对照组治疗方案基础上口服自拟降脂护肝方,每日1剂;两组均以12周为1个疗程,观察两组患者治疗前后肝脏彩超评分、血清丙氨酸氨基转移酶(ALT)、血清谷氨酸氨基转移酶(AST)、超氧化物歧化酶(SOD)、血浆中Bcl-2、Bax与Caspase-3蛋白水平等变化情况。结果:(1)两组治疗后肝脏彩超评分、血清SOD表达水平均较治疗前提高,与对照组比较,观察组提高的程度较为明显(P0.05);(2)两组治疗后血清ALT、AST表达水平均较治疗前降低,其中与对照组比较,治疗组患者血清ALT,AST水平差异无统计学意义(P0.05);(3)两组治疗后血浆中Bcl-2表达水平均较治疗前提高,与对照组比较,观察组提高的程度较为明显(P0.05);血浆中Bax、Caspase-3表达水平均较治疗前降低,其中与对照组比较,治疗组表达水平降低幅度大于对照组(P0.05)。结论:自拟降脂护肝方具有明显的保肝降酶疗效,还可以改善非酒精性脂肪肝的肝脏组织脂肪变性、炎症及纤维化的程度,这可能与调控肝细胞凋亡有关。
[Abstract]:Aim: to observe the clinical effect and some mechanism of self-made Jiangzhi Hugan recipe combined with polyene phosphatidylcholine on non-alcoholic fatty liver (NAFLD). Methods: 60 patients with nonalcoholic fatty liver were randomly divided into control group (n = 30) and observation group (n = 30) according to the order of admission. In the control group, polyen phosphatidylcholine was injected intravenously (5 mL / time, once a day), and the patients were divided into two groups: control group (n = 30) and observation group (n = 30). In the observation group, on the basis of the treatment plan of the control group, a self-made Jiangzhi Hugan recipe was given orally, one dose per day. The liver color Doppler score, serum alanine aminotransferase (ALT), serum glutamic aminotransferase (AST), superoxide dismutase (SOD),) plasma Bcl-2, were observed before and after treatment in the two groups (12 weeks as a course of treatment). The changes of protein levels of Bax and Caspase-3 were observed. Results: (1) after treatment, the liver color Doppler score and the expression of serum SOD in the two groups were higher than those before treatment, and the degree of improvement in the observation group was more obvious than that in the control group (P0.05). (2) after treatment, the expression of serum ALT,AST in the two groups was lower than that before treatment, and there was no significant difference in the level of serum ALT,AST between the two groups compared with the control group (P0.05). (3) the expression level of Bcl-2 in plasma of the two groups increased after treatment, compared with the control group, the degree of increase in the observation group was more obvious (P0.05). Compared with the control group, the expression of Bax,Caspase-3 in the treatment group was significantly lower than that in the control group (P0.05). Conclusion: the self-made Jiangzhi Hugan recipe has obvious protective effect on liver enzymes and can also improve the degree of hepatic steatosis, inflammation and fibrosis in non-alcoholic fatty liver, which may be related to the regulation of hepatocyte apoptosis.
【作者单位】：永康市第一人民医院感染性疾病科;广西中医药大学附属第一医院肝病科;
【分类号】：R575.5

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