泄浊解毒汤对非酒精性脂肪肝病及血清瘦素的临床观察

发布时间：2017-12-27 11:23

本文关键词：泄浊解毒汤对非酒精性脂肪肝病及血清瘦素的临床观察　出处：《河北医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景:非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是消化系统的常见疾病之一,其发病率呈逐年上升趋势,是常见的危害人类身体健康的严重隐患,并逐渐引起了人们的重视。现代医学治疗该病多是单靶点治疗,而祖国医学则从病人整体出发,或根据病人体质,或结合疾病发病原因和规律,把各相关因素综合分析,更符合NAFL的病因病机;在治疗上讲究的是辨证论治、整体观念,全面调节患者气血阴阳失衡,因而疗效确切,且毒副作用少,展现了中医药治疗非酒精性脂肪肝病的广阔前景。本课题旨在探讨泄浊解毒汤治疗非酒精性脂肪肝病临床疗效的观察及其对血清瘦素(Leptin,LP)的影响,为中医治疗非酒精性脂肪肝病提供临床及实验室依据。目的:本课题通过探讨泄浊解毒汤对非酒精性脂肪肝病及血清瘦素的临床疗效观察,为中医治疗NAFLD提供科学依据。方法:依据中华医学会肝脏病学分会制定的非酒精性脂肪性肝病诊疗指南(2010)诊断标准,收集2013.11-2014.12我院门诊及住院非酒精性脂肪性肝病患者80例。所有病例均无自身免疫性疾病、急性感染性疾病或肿瘤者。由研究生本人调查所有研究对象的一般情况:性别、年龄、既往史、体重、病史等。泄浊解毒汤治疗NAFLD前后彩超对比,血脂(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、极低密度脂蛋白),肝功能(谷丙转氨酶、谷草转氨酶、γ-谷氨酰转肽酶、碱性磷酸酶),体重指数(BMI),血清瘦素(LP)等指标。两组患者均给予健康生活方式指导,如根据肝功能情况适量进行有氧运动、禁酒、多食低脂及低碳水化合物饮食、多食果蔬、控制热量摄入,控制体重。治疗组-泄浊解毒汤(茯苓20g、柴胡12g、生山楂12g、虎杖12g、泽泻12g、茵陈20g、佩兰15g、酒大黄9g、瓜蒌12g、猪苓12g、蒲公英15g、青皮12g、陈皮12g、丹参20g),水煎煮2次,共取汁400ml,每天分早晚2次温服。对照组---阿托伐他汀钙片(20mg立普妥)口服,每天晚服1次。治疗时间:8周采用SPSS 17.0统计软件建立数据库。计量资料采用t检验,率或构成比比较采用2?检验。采用非条件Logistic回归分析,多元统计分析,P0.05为差异有统计学意义。结果1泄浊解毒汤对非酒精性脂肪肝病临床疗效优于阿托伐他汀钙组,差异有统计学意义(P0.05)。2泄浊解毒汤较对照组能明显降低血清瘦素水平(P0.05)。3泄浊解毒汤无副作用,阿托伐他汀钙组有副作用。结论1泄浊解毒汤对浊毒内蕴型非酒精性脂肪肝病有显著疗效,能有效缓解非酒精性脂肪肝病患者的临床症状。2泄浊解毒汤治疗非酒精性脂肪肝安全无毒副作用的中药复方制剂。3泄浊解毒汤对非酒精性脂肪肝病患者的血清瘦素有降低作用。
[Abstract]:Background: non-alcoholic fatty liver disease (NAFLD) is a common disease of the digestive system. Its incidence is increasing year by year. It is a serious hidden danger to human health, and has gradually attracted the attention of people. Modern medical treatment of this disease is the treatment of single target, and the traditional Chinese medicine from the point of view of the whole patient or patient, according to the constitution, or a combination of disease causes and rules, make a comprehensive analysis of all relevant factors, more in line with the pathogenesis of NAFL; pay attention to in the treatment of syndrome differentiation, the overall concept of comprehensive regulation the imbalance of yin and Yang Qi and blood, so the curative effect, and less side effects, showing a broad prospect of traditional Chinese medicine in the treatment of nonalcoholic fatty liver disease. The aim of this study is to investigate the clinical efficacy of Xie Zhuo Jiedu Decoction in the treatment of non-alcoholic fatty liver disease and its effect on serum Leptin (LP), so as to provide clinical and laboratory evidence for the treatment of non-alcoholic fatty liver disease by TCM. Objective: To observe the clinical efficacy of Zhuo Zhuo Jiedu Decoction on non-alcoholic fatty liver disease and serum leptin, and to provide a scientific basis for the treatment of NAFLD in traditional Chinese medicine. Methods: according to the diagnostic criteria of nonalcoholic fatty liver disease (2010) formulated by the Chinese Medical Association's liver disease branch (80), we collected 80 cases of non-alcoholic fatty liver disease in our hospital. All cases had no autoimmune disease, acute infectious disease or tumor. The general situation of all the subjects was investigated by the graduate student: sex, age, past history, weight, history and so on. Comparison of color Doppler ultrasound before and after discharge of Huazhuo Jiedu Decoction in the treatment of NAFLD, serum lipids (total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, low density lipoprotein), liver function (alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase), body mass index (BMI), serum leptin (LP) and other indicators. Two groups of patients were given healthy lifestyle guidance, such as aerobic exercise, temperance, eating low fat and low carbohydrate diet, eating more fruits and vegetables, controlling caloric intake and controlling body weight according to liver function. The treatment group - xiezhuojiedu Decoction (Poria 20g, bupleurum root 12g, hawthorn 12g, 12g, 12g, Alisma Polygonum Artemisia 20g, Perrin 15g, 9g, 12g, rhubarb, dandelion Trichosanthes Polyporus 12g 15g, green 12g, tangerine peel 12g, Salvia 20g), boiling water 2 times, take juice 400ml, every day sooner or later the 2 times. The control group - Atorvastatin Calcium Tablets (20mg Lipitor) orally, 1 times every night. Time of treatment: 8 weeks by using SPSS 17 statistical software to establish a database. T test was used for the measurement data, and the ratio or composition ratio was compared to 2? Test. Using non conditional Logistic regression analysis and multivariate statistical analysis, the difference of P0.05 was statistically significant. Results the clinical effect of 1 detoxification and detoxifying Decoction on nonalcoholic fatty liver disease was better than that of atorvastatin group (P0.05). Compared with the control group, the serum leptin level (P0.05) was significantly lower than that in the control group (P0.05). There is no side effect in 3 detoxification and detoxifying decoction, and the atorvastatin calcium group has side effects. Conclusion 1 detoxification and detoxifying decoction has significant effect on non alcoholic fatty liver disease with Turbid Toxin and can effectively relieve the clinical symptoms of nonalcoholic fatty liver disease. 2 the traditional Chinese medicine compound preparation for the treatment of non-alcoholic fatty liver and non-toxic side effects in the treatment of nonalcoholic fatty liver. The 3 detoxification and detoxifying decoction can reduce the serum leptin in patients with non-alcoholic fatty liver disease.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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