健脾疏肝降脂方治疗非酒精性脂肪肝（肝郁脾虚证）的临床研究

发布时间：2018-01-12 16:39

本文关键词：健脾疏肝降脂方治疗非酒精性脂肪肝（肝郁脾虚证）的临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨健脾疏肝降脂方对非酒精性脂肪肝(肝郁脾虚证)患者临床症状、体征的作用及对患者血脂的影响,以期为临床治疗NAFLD提供有效方剂。方法:采用SPSS17.0软件,由计算机产生随机数字,入选患者102人按就诊顺序1:1随机分配入治疗组和对照组。两组均给予一般基础治疗,即低糖、低脂平衡膳食,减少蔗糖、反式脂肪酸、饱和脂肪酸的摄入,增加膳食纤维的摄入,中等量有氧运动。对照组在一般治疗基础上加用血脂康胶囊,治疗组在一般治疗基础上加用健脾疏肝降脂方,疗程8周。观察指标与疗效性指标分别予治疗前后各监测一次。结果:(1)两组患者一般情况分析:经独立样本t检验和卡方检验,两组在年龄、性别分布上无统计学差异(P0.05)。(2)综合疗效:按照综合疗效评定标准,试验组总有效率78.4%;对照组总有效率54.9%。经Ridit分析,两组具有统计学差异(P0.05)。(3)中医证候疗效:按照中医证候疗效评定标准,试验组总有效率为84.3%;对照组总有效率为58.8%。经Ridit分析,两组相比有统计学差异(P0.05)。(4)中医证候总积分:按照临床症状体征疗效的判定标准,治疗前两组在中医证候总积分上,无统计学差异(P0.05);治疗后两组在中医证候总积分上,具有统计学差异(P0.05)。(5)治疗前后两组中医各证候积分:按照症状和体征分级量化表评定标准,治疗前,两组在症状、体征等方面均无统计学差异(P0.05);治疗后,与对照组相比,试验组在抑郁烦闷、胁肋胀满或疼痛、腹痛欲泻、大便稀溏方面具有统计学差异(P0.05),在腹胀、食欲不振、嗳气、舌质、舌苔、脉象方面无统计学差异(P0.05)。组内相比较,对照组与试验组患者在治疗前后的脉象方面无统计学差异(P0.05),在其它症状、体征方面具有统计学差异(P0.05)。(6)血脂四项指标疗效:组间相比较,试验组与对照组在治疗前的HDL-C、CHOL、TG、LDL-C实验室指标方面无统计学差异(P0.05)。试验组与对照组在治疗后的HDL-C指标上无统计学差异(P0.05),在LDL-C、TG方面具有统计学差异(P0.05),在CHOL方面具有显著统计学差异(P0.01)。组内相比较,试验组与对照组在治疗前后的HDL-C、CHOL、TG、LDL-C方面具有统计学差异(P0.05)。(7)影像学疗效:按照彩超疗效评价标准,试验组总有效率为80.4%;对照组总有效率为56.9%。经Ridit分析,两组具有统计学差异(P0.05)。结论:通过以上统计学分析,可以得出结论,健脾疏肝降脂方不仅可以显著改善非酒精性脂肪性肝病患者的症状、体征,而且可以改善患者甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白等临床指标,是治疗NAFLD的有效方药。
[Abstract]:Objective: To investigate the effect of Jianpi Shugan Jiangzhi Decoction on nonalcoholic fatty liver (liver stagnation and spleen deficiency syndrome) clinical symptoms, signs and the effects on blood lipid, in order to provide an effective prescription for the treatment of NAFLD. Methods: using SPSS17.0 software, generate random numbers by a computer, 102 patients were randomly assigned 1:1 in the treatment group and control group. Two groups were given basic treatment, low sugar, low-fat diet balance, reducing sugar, trans fatty acid intake of saturated fatty acids, increasing dietary fiber intake, moderate aerobic exercise. The control group on the basis of general treatment with Xuezhikang Capsule treatment. On the basis of the general treatment group with Jianpi Shugan Jiangzhi Decoction, 8 weeks treatment. Observation index and efficacy index before and after treatment to the monitoring time. Results: (1) of the two groups of patients with general condition: the independent sample t test and chi square Test, the two groups in age, there was no significant difference in gender distribution (P0.05). (2) the comprehensive curative effect: according to the comprehensive evaluation standard of test group, the total efficiency of 78.4%; control group, the total efficiency of 54.9%. by Ridit analysis, the two groups were statistically different (P0.05). (3): according to TCM syndrome curative effect the standard of TCM syndrome curative effect, the total effective rate of experimental group was 84.3%; the control group the total efficiency of 58.8%. by Ridit analysis, two groups were significantly different (P0.05). (4) the total score of TCM syndrome: according to the criteria of clinical symptoms and signs of efficacy of the two groups before treatment in TCM syndrome integral, no significant difference (P0.05); the two groups after treatment in TCM syndrome total score, with statistical difference (P0.05). (5) before and after treatment of the two groups of TCM syndrome integral: according to the symptoms and signs of quantitative table classification evaluation standard, before treatment, the two groups in symptoms, there were no statistically signs etc. The difference (P0.05); after treatment, compared with control group, experimental group in depression depressed, rib swelling or pain, abdominal pain for diarrhea, loose stool has significant difference (P0.05), the loss of appetite, abdominal distension, belching, tongue, tongue, pulse was no difference (P0.05) in the group. Compared to the control group and the experimental group of patients before and after treatment, there was no significant difference of the pulse (P0.05), with statistical difference in other symptoms, signs (P0.05). (6) the four lipid indicators: effect of group comparison, the experimental group and the control group before treatment, HDL-C, CHOL, TG. There was no significant difference in LDL-C laboratory index (P0.05). No significant difference between the experimental group and the control group after treatment HDL-C index (P0.05), in LDL-C, with statistical difference TG (P0.05), the difference was statistically significant in CHOL group (P0.01). In comparison, the experimental group and the control group in the cure Before and after the treatment of HDL-C, CHOL, TG, with statistical difference (P0.05). LDL-C (7): Color Doppler imaging efficacy evaluation in accordance with the standard of curative effect, the total efficiency of the test group was 80.4%; the control group the total efficiency of 56.9%. by Ridit analysis, the two groups were statistically different (P0.05). Conclusion: through the above the statistical analysis, it can be concluded that Jianpi Shugan Jiangzhi Decoction can significantly improve patients with nonalcoholic fatty liver disease symptoms, signs, but also can improve the patients with triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein and other clinical indicators, is a effective prescription for the treatment of NAFLD.

【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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