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目的观察健脾磨积汤联合西药治疗非酒精性脂肪性肝病的临床疗效。方法将60例非酒精性脂肪性肝病患者随机分为对照组和治疗组,每组30例。对照组予多烯磷脂酰胆碱胶囊,治疗组在此基础上加用健脾磨积汤。两组疗程均为3个月,观察比较肝功能、血脂相关指标、内毒素及相关炎症因子(TNF-α、IL-6和IL-8)水平、中医证候积分的变化情况。结果 1治疗前后组内比较,治疗组ALT、GGT、TG水平差异有统计学意义(P<0.05),对照组ALT、TG水平差异有统计学意义(P<0.05);组间治疗后比较,ALT、TG水平差异有统计学意义(P<0.05)。2治疗前后组内比较,治疗组内毒素、TNF-α、IL-6及IL-8水平差异有统计学意义(P<0.05),对照组仅内毒素水平差异有统计学意义(P<0.05);组间治疗后比较,内毒素、TNF-α、IL-6及IL-8水平差异有统计学意义,治疗组改善程度明显优于对照组(P<0.05)。3治疗前后组内比较,治疗组胃脘胀满、胁肋疼痛、纳呆少食、倦怠乏力积分差异有统计学意义(P<0.05),对照组胃脘胀满及纳呆少食积分差异有统计学意义(P<0.05);组间治疗后比较,胃脘胀满、胁肋疼痛、纳呆少食、倦怠乏力积分差异有统计学意义,治疗组各症状积分的改善均优于对照组(P<0.05)。结论健脾磨积汤联合西药治疗非酒精性脂肪性肝病,可显著缓解临床症状,改善肝功能、降低血脂水平,其机制可能与减轻内毒素肠渗漏的“二次打击”有关。
Objective To observe the clinical effects of Jianpi mill soup combined with Western medicine in the treatment of non-alcoholic fatty liver disease. Methods Sixty non-alcoholic fatty liver disease patients were randomly divided into control group and treatment group, 30 cases in each group. The control group to polyene phosphatidylcholine capsules, the treatment group on the basis of Jianpi Rongji Tang. The two courses of treatment were 3 months. The changes of liver function, serum lipids, endotoxin and related inflammatory cytokines (TNF-α, IL-6 and IL-8) and TCM syndrome scores were observed and compared. Results 1 After treatment, the levels of ALT, GGT and TG in the treatment group were significantly different (P <0.05), while the levels of ALT and TG in the control group were statistically significant (P <0.05). After treatment, ALT, TG levels were significantly different (P <0.05). The level of endotoxin, TNF-α, IL-6 and IL-8 in the treatment group had significant difference before and after treatment (P <0.05), but the endotoxin level in the control group was statistically significant (P <0.05 ). After treatment, the levels of endotoxin, TNF-α, IL-6 and IL-8 in the two groups were significantly different from those in the control group (P <0.05). 3 before and after treatment group comparison, the treatment group stomach fullness, flank pain, adolescents eat less, lassitude fatigue score difference was statistically significant (P <0.05), the control group stomach fullness and adolescent eating integral difference statistics (P <0.05). After treatment, there were significant differences between the treatment group and the control group (P> 0.05). There was significant difference between the treatment group and the control group (P> 0.05) <0.05). Conclusion Jianpi mill soup combined with Western medicine in the treatment of nonalcoholic fatty liver disease can significantly relieve clinical symptoms, improve liver function, lower blood lipid levels, the mechanism may be related to relieve intestinal leakage of endotoxin “second strike ”.