缪氏资生丸汤剂对脾虚湿阻型非酒精性脂肪性肝病患者血清甘油三酯的影响

发布时间：2018-02-28 21:22

本文关键词： 非酒精性脂肪肝病脾虚湿阻型资生丸汤剂临床疗效　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的：本研究旨在探讨资生丸汤剂健脾助运化湿法治疗脾虚湿阻型非酒精性脂肪肝病(NAFLD)的临床疗效,重点观察资生丸汤剂对该类人群血清甘油三酯的影响,同时验证NAFLD脾虚湿阻的中医病机认识,为临床上探索新的有效的中医治疗NAFLD手段打下基础。研究方法：将符合标准的30例患者随机分为治疗组和对照组各15例。两组患者均采用相同的基础疗法(①每天至少持续半小时的中等强度的有氧运动,不宜高强度的大量运动。②调整饮食结构,均衡营养,限制高热量、高脂肪食物的过度摄入。③适度并且持续、渐进的控制体重,以减轻基础体重的5%10%作为前3月的减重目标,使得每周体重下降不宜超过1.6kg),并在治疗期间禁止服用其他任何降脂药物；治疗组在基础治疗的同时予以资生丸汤剂,200ml/次,每日2次,总疗程12个周,结束后观测两组患者治疗前后血脂、肝功能、中医证候积分及单项临床症状积分等相关指标并予以比较分析。研究结果：①治疗组和对照组的总有效率分别为86.7%和60.0%,两组之间的差异具有显著性(P0.05),治疗组效果优于对照组。②治疗后两组中医证候积分较治疗前均有降低,差异显著(P0.05),治疗组和对照组的中医证候改善总有效率分别为93.3%和66.7%,治疗组效果优于对照组,两组之间的差异具有显著性(P0.05)。③单项症状方面,两组症状积分治疗后均有降低,且治疗组在改善患者胁肋部不适、头身困重、神疲乏力、食少纳呆等方面疗效更为显著,组内治疗前后比较及治疗后组间比较的差异均有统计学意义(P0.05)。④两组治疗后肝功能(ALI、AST)较治疗前均降低,治疗组总有效率84.62%,优于对照组总有效率61.54%,组内治疗前后比较及治疗后组间比较的差异均有统计学意义(P0.05)。⑤两组治疗后血脂(TG、TC、LDL-C)较治疗前均降低,HDL-C较治疗前有所升高：治疗组和对照组的总有效率分别为86.67%和60.00%,组内治疗前后比较及治疗后组间比较的差异均有统计学意义(P0.05)。⑥用药安全性方面,两组间差异无统计学意义(P0.05),说明本课题中药是安全的。结论：1.资生丸汤剂对于脾虚湿阻型N4FLD并存的SHTG具有良好的临床疗效。可以有效缓解头身困重、胁部不适、纳差、腹胀、头晕、大便溏薄等不适,同时可以降血脂、保护肝功能：但在改善神疲乏力、形体肥胖方面,疗效与对照组相当。2.资生丸汤剂临床用药安全,无明显的毒副作用,病程中可以长期服用。3.资生丸是一个适应现代疾病谱良好的方子,临床上具有重要的应用价值。
[Abstract]:Objective: to investigate the clinical effect of Zisheng Pill decoction on treating non-alcoholic fatty liver disease with spleen deficiency and dampness obstruction, and to observe the effect of Zisheng Pill decoction on serum triglyceride in this group of people. At the same time verify the NAFLD spleen deficiency dampness obstruction of TCM pathogenesis, Methods: 30 patients who met the standard were randomly divided into treatment group (n = 15) and control group (n = 15). Both groups were treated with the same basic therapy every day. At least half an hour of moderate aerobic exercise, It is not suitable for heavy exercise of high intensity to adjust the diet structure, to balance nutrition, to limit the excessive intake of high-calorie and high-fat foods, to control the weight moderately and continuously, and to reduce the basic weight by 5% as the weight loss target of March. The weight loss should not exceed 1.6 kg per week and no other lipid-lowering drugs should be taken during the treatment. The treatment group was treated with 200 ml of Zisheng Pill decoction twice a day for a total of 12 weeks. Blood lipid and liver function were observed before and after treatment. The results showed that the total effective rates of the treatment group and the control group were 86.7% and 60.00.The difference between the two groups was significant (P 0.05), and the effect of the treatment group was better than that of the control group. The scores of TCM syndromes in the two groups were lower than those before treatment after treatment in the control group (.2). The total effective rate of TCM syndrome improvement in treatment group and control group was 93.3% and 66.7, respectively. The effect of treatment group was better than that of control group. The treatment group was more effective in improving the discomforts of the hypochondria, the head and body, the fatigue of the mind, the low intake of food, and so on. Before and after treatment, the difference between the two groups was statistically significant. The liver function of the two groups after treatment was lower than that before and after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. The total effective rate of the treatment group was 84.62%, which was better than the total effective rate of the control group (61.54). The differences between the two groups before and after treatment were statistically significant. The total effective rates of the treatment group and the control group were 86.67% and 60.00.The differences between the two groups before and after treatment were statistically significant. There was no significant difference between the two groups (P 0.05), which indicated that this subject was safe. Conclusion: Zisheng Pill decoction has good clinical effect on SHTG with spleen deficiency and dampness obstruction type N4FLD. It can effectively relieve head and body distress, hypochondria discomfort, anorexia and abdominal distension. Dizziness, loose stools and other discomfort can also reduce blood lipid, protect liver function: but in improving fatigue, body obesity, the curative effect is equivalent to the control group. 2. Zisheng Pill decoction is safe in clinical use and has no obvious toxic side effects. Zisheng pills can be taken for a long time during the course of the disease. Zisheng Pill is a good prescription for modern disease spectrum and has important clinical application value.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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