葱白提取物联合针刺疗法治疗非酒精性脂肪性肝病（痰瘀互结型）的临床观察
发布时间：2018-08-06 12:14
【摘要】：目的： 观察运用葱白提取物联合针刺疗法在临床上治疗非酒精性脂肪性肝病（痰瘀互结型）的治疗效果，对中医内外合治法在治疗非酒精性脂肪性肝病中的临床疗效予以客观评价。 方法： 选取2012年3月至2012年8月期间在武汉市一医院消化内科门诊、脾胃外治中心、住院病房及医院体检中心就诊人群中符合病例标准的NAFLD痰瘀互结型患者共65例，随机分为两组，其中葱白提取物联合针刺疗法治疗组33例（治疗组），多烯磷脂酰胆碱对照组32例（对照组）。两组均在予以行为和生活方式干预、调整饮食、加强运动的基础上，对照组予以多烯磷脂酰胆碱胶囊（易善复）每次456mg口服，每日三次。治疗组予以葱白提取物（博心通软胶囊）每次800mg（2粒）口服，每日两次；同时予以针刺治疗，辨证选穴分组：第一组：丰隆、足三里、三阴交、中脘、阳陵泉、章门；第二组：膈俞、膻中、期门、肝俞、太冲、合谷；每次选取一组穴位，针刺得气后留针30min，期间行针1次，中-强度刺激；一天一次；同一组穴位连续针刺6天，休息1天后换用另一组穴位。两组均以12周为一个疗程。疗程结束后观察两组疗效情况，包括治疗前后及组间中医症状评分，超声检查分度积分，人体学指标（身高、体重、腰围、BMI）、肝功能（ALT、AST、GGT）、血脂（TC、TG、HDL-C、LDL-C）、动脉血压和空腹血糖，并进行统计学分析。 采用SPSS19.0软件进行数据管理和统计学分析。本研究均采用双侧检验，以P＜0.05为有显著性差异，以P＜0.01为有非常显著性差异的标准。计量资料用x±S表示，若服从正态分布（方差齐），组内采用配对比较t检验，组间采用两样本比较t检验；若不服从正态分布（方差不齐）则采用秩和检验；等级资料采用秩和检验；计数资料采用χ2检验。 结果： 1.按照总体疗效评定标准，治疗组总有效率为84.85%，对照组总有效率为78.13%，两组患者治疗后总体疗效比较有显著性差异（P＜0.05）， 具有统计学意义； 2.两组患者治疗前后人体学指标（体重、腰围及BMI）及血压血糖比较无显著性差异（P＞0.05）；两组患者其他指标治疗后与治疗前比较具有显著性差异（P＜0.05或P＜0.01）；两组患者治疗后相关结果比较，其中治疗组ALT、AST、TG与对照组比较，无显著性差异（P＞0.05）；而治疗组TC、HDL-C和LDL-C与对照组比较有显著性差异（P＜0.05）；对照组GGT与治疗组比较有显著性差异（P＜0.05）； 3.按照超声检查分度积分评定标准，，两组患者治疗后超声检查分度积分与治疗前比较均有显著性差异（P＜0.05），但两组患者治疗后超声检查分度积分比较无显著性差异（P＞0.05）； 4.按照中医症状积分评定标准，两组患者治疗后中医症状积分较治疗前有显著性差异（治疗组P＜0.01，对照组P＜0.05）；治疗后中医症状积分治疗组较对照组有显著性差异（P＜0.05）。 结论： 本研究显示两种治疗方法对NAFLD患者均有一定的治疗作用，但治疗组在改善患者临床症状及TC、HDL-C和LDL-C等方面明显优于对照组，对照组在改善患者GGT等方面有一定优势，在超声影像学等其他方面两组疗效相当；充分显示运用“通阳”理论，采用葱白提取物联合针刺疗法这一中医内外合治法治疗NAFLD（痰瘀互结型）在改善患者症状及提高其生活质量方面具有一定优势，值得进一步研究和推广。
[Abstract]:Objective:
To observe the effect of the treatment of nonalcoholic fatty liver disease (phlegm and blood stasis type) by the combination of scallion extract and acupuncture therapy, and to evaluate the clinical effect of internal and external combination therapy in the treatment of nonalcoholic fatty liver disease.
Method:
From March 2012 to August 2012, 65 cases of NAFLD phlegm and blood stasis syndrome in the outpatient of a hospital in a hospital in Wuhan, the external treatment center of the spleen and the stomach, the hospitalized ward and the hospital check-up center, were randomly divided into two groups, including 33 cases (treatment group) and polyene phosphatidyl group in the group of scallion extract combined with acupuncture treatment group. 32 cases (control group) were treated with choline control group. On the basis of the intervention of behavior and lifestyle, diet adjustment and exercise, the control group was given Polyene Phosphatidylcholine Capsules (Yi Shanfu) every time 456mg oral, three times a day. The treatment group was given the onion extract (Bo Xin Tong soft capsule) for oral 800mg (2 grains) each time, two times a day. The first group: Fenglong, Zusanli, Sanyinjiao, Zhong Wan, Yang Ling spring, Zhang gate in the first group: second groups: phrenic Shu, Shan Zhong, Lianshu, Tai Chung, Hegu; each select a group of acupoints, the needle after the gas is 30min, 1 times the needle, medium intensity stimulation; once a day, the same group of acupuncture points for 6 days, rest. 1 days after another group of acupoints, the two groups were treated with 12 weeks as a course of treatment. After the end of the course, the two groups of curative effects were observed, including the symptom score of the Chinese medicine before and after the treatment, the score score of ultrasonic examination, the index of human body (height, weight, waist circumference, BMI), the liver function (ALT, AST, GGT), the blood lipid (TC, TG, HDL-C, LDL-C), arterial blood pressure and fasting blood glucose, and the arterial blood pressure and fasting blood glucose. Statistical analysis.
SPSS19.0 software was used for data management and statistical analysis. The results were both bilateral and P < 0.05, with P < 0.01 as the standard of very significant difference. The measurement data were expressed in X + S, if the normal distribution (Fang Chaqi) was subordinate to the normal distribution (Fang Chaqi), the paired comparison t test was used in the group, and two samples were compared with the t test among the groups. Rank sum test was used if normal distribution was not obeyed.Rank sum test was used for grade data and_2test was used for count data.
Result:
1. according to the overall evaluation standard of curative effect, the total effective rate of the treatment group was 84.85%, the total effective rate of the control group was 78.13%. The total curative effect of the two groups was significantly different (P < 0.05), and the total effective rate of the control group was significantly different (P < 0.05).
It has statistical significance.
2. there was no significant difference in the anthropometric indexes (weight, waist circumference and BMI) and blood pressure before and after treatment in the two groups (P > 0.05). The other indexes in the two groups were significantly different from those before treatment (P < 0.05 or P < 0.01). The two groups were compared with the treatment group, including ALT, AST, and TG in the treatment group, and there was no comparison between the control group and the control group. The difference was significant (P > 0.05), while the TC, HDL-C and LDL-C in the treatment group were significantly different from those in the control group (P < 0.05), and there was a significant difference between the control group and the treatment group (P < 0.05).
3. according to the evaluation criteria of ultrasonic examination scores, there were significant differences between the two groups after treatment (P < 0.05), but there was no significant difference between the two groups after treatment (P > 0.05).
4. according to the evaluation standard of TCM symptom score, there was significant difference between the two groups after treatment (P < 0.01 in the treatment group and P < 0.05 in the control group), and there was significant difference between the treatment group and the control group after treatment (P < 0.05).
Conclusion:
This study shows that two treatment methods have some therapeutic effect on NAFLD patients, but the treatment group is obviously superior to the control group in improving the clinical symptoms and TC, HDL-C and LDL-C. The control group has some advantages in improving the patient's GGT and other aspects, and the curative effect is equivalent in the other sides of the other sides of the ultrasound imaging and other sides; fully display the use of "Tong Yang". In theory, the combination of scallion extract and acupuncture therapy in the treatment of NAFLD (phlegm and blood stasis type) has some advantages in improving the patient's symptoms and improving the quality of life. It is worth further research and promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R259;R246.1
本文编号：2167697
[Abstract]:Objective:
To observe the effect of the treatment of nonalcoholic fatty liver disease (phlegm and blood stasis type) by the combination of scallion extract and acupuncture therapy, and to evaluate the clinical effect of internal and external combination therapy in the treatment of nonalcoholic fatty liver disease.
Method:
From March 2012 to August 2012, 65 cases of NAFLD phlegm and blood stasis syndrome in the outpatient of a hospital in a hospital in Wuhan, the external treatment center of the spleen and the stomach, the hospitalized ward and the hospital check-up center, were randomly divided into two groups, including 33 cases (treatment group) and polyene phosphatidyl group in the group of scallion extract combined with acupuncture treatment group. 32 cases (control group) were treated with choline control group. On the basis of the intervention of behavior and lifestyle, diet adjustment and exercise, the control group was given Polyene Phosphatidylcholine Capsules (Yi Shanfu) every time 456mg oral, three times a day. The treatment group was given the onion extract (Bo Xin Tong soft capsule) for oral 800mg (2 grains) each time, two times a day. The first group: Fenglong, Zusanli, Sanyinjiao, Zhong Wan, Yang Ling spring, Zhang gate in the first group: second groups: phrenic Shu, Shan Zhong, Lianshu, Tai Chung, Hegu; each select a group of acupoints, the needle after the gas is 30min, 1 times the needle, medium intensity stimulation; once a day, the same group of acupuncture points for 6 days, rest. 1 days after another group of acupoints, the two groups were treated with 12 weeks as a course of treatment. After the end of the course, the two groups of curative effects were observed, including the symptom score of the Chinese medicine before and after the treatment, the score score of ultrasonic examination, the index of human body (height, weight, waist circumference, BMI), the liver function (ALT, AST, GGT), the blood lipid (TC, TG, HDL-C, LDL-C), arterial blood pressure and fasting blood glucose, and the arterial blood pressure and fasting blood glucose. Statistical analysis.
SPSS19.0 software was used for data management and statistical analysis. The results were both bilateral and P < 0.05, with P < 0.01 as the standard of very significant difference. The measurement data were expressed in X + S, if the normal distribution (Fang Chaqi) was subordinate to the normal distribution (Fang Chaqi), the paired comparison t test was used in the group, and two samples were compared with the t test among the groups. Rank sum test was used if normal distribution was not obeyed.Rank sum test was used for grade data and_2test was used for count data.
Result:
1. according to the overall evaluation standard of curative effect, the total effective rate of the treatment group was 84.85%, the total effective rate of the control group was 78.13%. The total curative effect of the two groups was significantly different (P < 0.05), and the total effective rate of the control group was significantly different (P < 0.05).
It has statistical significance.
2. there was no significant difference in the anthropometric indexes (weight, waist circumference and BMI) and blood pressure before and after treatment in the two groups (P > 0.05). The other indexes in the two groups were significantly different from those before treatment (P < 0.05 or P < 0.01). The two groups were compared with the treatment group, including ALT, AST, and TG in the treatment group, and there was no comparison between the control group and the control group. The difference was significant (P > 0.05), while the TC, HDL-C and LDL-C in the treatment group were significantly different from those in the control group (P < 0.05), and there was a significant difference between the control group and the treatment group (P < 0.05).
3. according to the evaluation criteria of ultrasonic examination scores, there were significant differences between the two groups after treatment (P < 0.05), but there was no significant difference between the two groups after treatment (P > 0.05).
4. according to the evaluation standard of TCM symptom score, there was significant difference between the two groups after treatment (P < 0.01 in the treatment group and P < 0.05 in the control group), and there was significant difference between the treatment group and the control group after treatment (P < 0.05).
Conclusion:
This study shows that two treatment methods have some therapeutic effect on NAFLD patients, but the treatment group is obviously superior to the control group in improving the clinical symptoms and TC, HDL-C and LDL-C. The control group has some advantages in improving the patient's GGT and other aspects, and the curative effect is equivalent in the other sides of the other sides of the ultrasound imaging and other sides; fully display the use of "Tong Yang". In theory, the combination of scallion extract and acupuncture therapy in the treatment of NAFLD (phlegm and blood stasis type) has some advantages in improving the patient's symptoms and improving the quality of life. It is worth further research and promotion.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R259;R246.1
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