从痰论治非酒精性脂肪性肝炎痰瘀证对纤溶状态的影响

作者	单位
陈黎	广西中医学院附属瑞康医院肝胆科南宁530001
蒋阳昆	广西中医学院附属瑞康医院肝胆科南宁530001
蔡晏波	广西中医学院附属瑞康医院肝胆科南宁530001

摘要点击次数: 1235

全文下载次数: 1

中文摘要:

目的观察从痰论治非酒精性脂肪性肝炎(Non-alcoholic steatohepatitis,NASH)痰瘀证的临床疗效。方法62例NASH痰瘀证患者随机分为两组,治疗组34例,给予化痰利湿、舒肝利胆、活血化瘀中药(组成:青黛10g明矾3g草决明15g生山楂15g醋柴胡10g郁金10g丹参12g泽兰12g六一散15g)每日1剂,水煎分两次口服;对照组28例,予熊去氧胆酸片口服,每次150mg,每日3次。两组共治疗12周,并分别于治疗前后评价肝功能(ALT、AST、ALP)、胰岛素抵抗指标(HOMA-IR、Ins)、组织纤溶酶原激活物(t-PA)、1型纤溶酶原激活物抑制物(PAI-1)及主要症状、体征改善情况。结果(1)治疗组治疗后ALT、AST、HOMA-IR、t-PA、PAI-1及主要症状均较治疗前改善(P<0.05或P<0.01);(2)与对照组治疗后比较,ALP、HOMA-IR、t-PA、PAI-1差异有显著性(P<0.05或P<0.01);(3)熊去氧胆酸片对肝功能指标的改善以谷丙转氨酶、t-PA显著(P<0.01),HOMA-IR、Ins、PAI-1及症状亦有所改善。结论从痰论治NASH痰瘀证能有效改善肝功能及纤溶状态,且优于熊去氧胆酸片。

英文摘要:

ObjectiveTo observe the effect of resolving phlegm method(RPM)on fibrinolytic status in non-alcoholic steatohepatitis(NASH)patients of phlegm blood-stasis(PBS)syndrome type.Methods Sixty-two patients were randomly assigned to 2 groups,namely the treated group(n=34)treated with Chinese herbs for resolving phlegm and dampness,smoothing liver and gallbladder,promoting blood circulation and removing blood stasis(composition:Indigo Naturalis 10 g,Alumen 3 g,Semen Cassiae 15 g,Fructus Crataegi 15 g,vinegar prepared Radix Bupleuri 10 g,Radix Curcumae 10 g,Radix Salviae Miltiorrhizae 12 g,Herba Lycopi 12 g,talc 12 g and Radix Glycyrrhizae 2 g),one dose twice per day orally,and the control group(n=28)with ursodeoxycholic acid tablet(UAT)150 mg three times per day.The treatment course for both groups was 12 weeks.Liver function(ALT,AST,ALP),insulin resistance(IR)index represented by homeostasis model-IR(HOMA-IR)and insulin(Ins),levels of tissue plasminogen activator(t-PA)and plasminogen activator inhibitor-1(PAI-1),as well as main symptoms and physical signs were assessed before and after treatment.Results(1)Compared with those before treatment,levels of ALT,AST,HOMA-IR,t-PA,PAI-1 and main symptoms were all improved in the treated group(P<0.05 or P<0.01);(2)There was significant difference in ALP,HOMA-IR,t-PA and PAI-1 between the treated group and the control group(P< 0.05 or P< 0.01);(3)The improvement in liver function related indexes in the control group was mainly the level of ALT,t-PA(P<0.01),and also shown on HOMA-IR,Ins and PAI-1.Conclusion RPM could effectively improve liver function and fibrinolytic status.Its effect was better than that of UAT.

关闭