丹瓜方干预非酒精性脂肪性肝病的临床研究

发布时间：2018-03-09 04:38

本文选题：非酒精性脂肪性肝病　切入点：痰瘀证　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:以丹瓜方干预非酒精性脂肪性肝病痰瘀证患者,观察其临床疗效,探讨丹瓜方的作用机理与疗效特点,以指导临床应用。方法:对符合纳入标准的128例非酒精性脂肪性肝病痰瘀证患者采用随机对照试验,分为对照组及试验组,肝功或血脂异常者服用甘草酸二铵或氟伐他汀钠,为对照组,试验组在对照组的基础上加服丹瓜方,均以4周为1疗程,3疗程连用,均配合饮食、运动治疗,观察比较两组间肝功、血脂、肝彩超以及中医症候积分等方面干预前后的变化情况。结果:1.肝功:对照组肝功正常部分的ALT、GGT较12周前稍有升高(P0.05、P0.01),试验组肝功正常部分的ALT、AST、GGT均有小幅度降低,GGT低于对照组且有统计学差异(P0.05),AST、ALT组间虽无统计学差异,但试验组前后差值明显大于对照组。12周后两组肝功异常部分的指标均有下降,试验组稍低于对照组,尤以GGT明显(P0.01)。2.血脂:两组血脂正常部分12周后TC、LDL-C组间虽无统计学差异,但试验组前后是下降的趋势,对照组却是上升,TG试验组明显低于对照组(P0.01),对照组TC、TG12周后升高且有统计学差异(P0.05,P0.01);两组血脂异常部分干预后均有所下降,试验组稍低于对照组,TC、TG组间有统计学差异(P0.05)。3.彩超积分情况:12周后两组超声积分均有下降,试验组明显低于对照组(P0.01),积分分布上试验组0分的有8例,对照组1例,7分的试验组无,对照组较前增加1例,共2例。4.中医证候积分情况:12周后两组积分均有所下降,试验组低于对照组,组间差异显著(P0.01)。结论:1.丹瓜方能恢复NAFLD痰瘀证患者肝功,调节血脂,改善肝脏彩超情况及患者临床症状及症候,安全性好,无不良反应;2.肝功、血脂大致正常的NAFLD患者不予治疗,指标短期内可能有升高的趋势,而丹瓜方能有效遏制病情发展;3.丹瓜方可能是通过化痰祛瘀,消除氧化应激,减少脂肪异位积沉,来保护肝脏、降低血脂、改善症状而发挥防治NAFLD的疗效。
[Abstract]:Objective: to observe the clinical effect of Dangua recipe in treating patients with phlegm and stasis syndrome of non-alcoholic fatty liver disease, and to explore the mechanism and characteristics of Dangua recipe. Methods: 128 cases of non-alcoholic fatty liver disease with phlegm stasis syndrome were randomly divided into control group and experimental group. Patients with abnormal liver function or blood lipid were treated with diammonium glycyrrhizinate or fluvastatin sodium. For the control group, the experimental group took Dangua recipe on the basis of the control group, all of them were treated with 4 weeks as a course of treatment and 3 courses of treatment, all of them were combined with diet and exercise therapy, and observed and compared the liver function and blood lipid between the two groups. Results: 1. Liver function: the alt GGT of the normal part of liver function in the control group was slightly higher than that of 12 weeks ago, and the GGT of the normal part of liver function in the experimental group was lower than that of the normal part of liver function. There was no statistical difference between the control group and the control group. But the difference between the experimental group and the control group was significantly higher than that in the control group after 12 weeks. The indexes of the abnormal part of liver function in the experimental group were lower than those in the control group, especially in the GGT group, especially in the control group (P 0.01). 2. Blood lipid: there was no statistical difference between the two groups after 12 weeks after the normal part of blood lipids in the two groups, and there was no significant difference between the two groups. However, there was a downward trend before and after treatment in the experimental group, but the TG test group in the control group was significantly lower than that in the control group (P 0.01), the TCU TG12 in the control group was higher than that in the control group after 12 weeks, and there was a statistical difference between the two groups. There was a statistical difference between the experimental group and the control group in TCTG. There was a significant difference between the two groups. After 12 weeks, the ultrasonic score of the two groups decreased, and that of the test group was significantly lower than that of the control group (P 0.01). The score distribution of the test group was 0 in 8 cases. There were 1 case in the control group, none in the test group with a score of 7, 1 case in the control group, and 2 cases in the control group. The score of TCM syndromes decreased in both groups after 12 weeks, and the score in the test group was lower than that in the control group. Conclusion: Dangua prescription can recover liver function of NAFLD patients with phlegm and stasis syndrome, regulate blood lipid, improve liver color ultrasound and clinical symptoms and symptoms of patients, have good safety and no adverse reactions. 2. Liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, If the patients with NAFLD with normal blood lipids are not treated, the indexes may increase in a short period of time, and Dangua prescription can effectively curb the development of the disease. 3. Dangua prescription may be used to eliminate oxidative stress and reduce the accumulation of fat ectopic by removing phlegm and removing blood stasis. To protect the liver, reduce blood lipids, improve symptoms and play a role in the prevention and treatment of NAFLD.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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