健脾理气化湿方配方颗粒治疗脾虚湿热型非酒精性脂肪性肝炎患者疗效及对FFA,HOMA-IR,APRI的影响

发布时间：2018-10-19 12:00

【摘要】：目的:观察健脾理气化湿配方颗粒治疗脾虚湿热型非酒精性脂肪性肝炎(NASH)患者的疗效,及对患者游离脂肪酸(FFA),胰岛素抵抗指数(HOMA-IR)和天门冬氨酸氨基转移酶/血小板指数(APRI)的影响。方法:根据标准募集96例符合纳入标准的脾虚湿热型NASH患者,采用随机数字表将患者按1∶1比例分配至对照组和治疗组,每组48例。在运动和饮食调整基础上,对照组予安慰剂颗粒剂,治疗组予健脾理气化湿方颗粒剂口服,疗程共24周。分别于治疗前后进行相关检查,评估疗效并观察FFA,HOMA-IR和APRI的变化。结果:治疗组临床总有效率为82.5%,对照组为52.5%,治疗组高于对照组(P0.01)。两组患者治疗后FFA水平均较治疗前明显下降(P0.05,P0.01),治疗组下降更为显著(P0.01);两组治疗后HOMA-IR均较治疗前显著下降(P0.01),治疗组下降更为显著(P0.01)。与治疗前比较,对照组治疗后APRI略有下降,差异无统计学意义;治疗组APRI显著下降(P0.01),且显著低于对照组(P0.01)。结论:健脾理气化湿方对脾虚湿热型NASH患者具有较好疗效,能够显著降低FFA水平,改善胰岛素抵抗和肝纤维化。
[Abstract]:Objective: to observe the curative effect of Jianpi liqi wet formula granule on (NASH) patients with spleen deficiency damp-heat type non-alcoholic fatty hepatitis. And its effects on free fatty acid (FFA), insulin resistance index (HOMA-IR) and aspartate aminotransferase / platelet index (APRI). Methods: according to the standard, 96 NASH patients with spleen deficiency and damp-heat type were recruited according to the standard. The patients were randomly assigned to the control group and the treatment group according to the 1:1 scale, 48 cases in each group. On the basis of exercise and diet adjustment, the control group was given placebo granule, and the treatment group was given Jianpi Li Qi Shen Fang granule orally for 24 weeks. The effect was evaluated and the changes of FFA,HOMA-IR and APRI were observed before and after treatment. Results: the total effective rate was 82.5 in the treatment group and 52.5 in the control group, which was higher in the treatment group than in the control group (P0.01). The levels of FFA in both groups were significantly lower than those before treatment (P0.05, P0.01), and the levels of HOMA-IR in treatment group were significantly lower than those before treatment (P0.01), and the decrease in treatment group was more significant (P0.01). Compared with before treatment, the APRI of the control group decreased slightly after treatment, the difference was not statistically significant; the APRI of the treatment group decreased significantly (P0.01), and significantly lower than that of the control group (P0.01). Conclusion: Jianpi liqi-dampness prescription has better curative effect on NASH patients with spleen deficiency and damp-heat type, can significantly reduce the level of FFA, improve insulin resistance and liver fibrosis.
【作者单位】：上海浦东新区传染病医院;上海中医药大学附属曙光医院;
【基金】：上海市浦东新区科技发展基金项目(PKJ2014-Y37) 上海市浦东新区卫生系统领先人才培养项目(PWRL2016-01) 上海市中医药领军人才建设项目(ZY3-RCPY-1-1001) 上海市名中医工作室项目(ZYSNXD-CC-MZY003)
【分类号】：R259

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