肝脂溶颗粒治疗非酒精性脂肪性肝炎（痰湿郁热证）的研究进展及临床观察

【作者】 霍丹丹；

【导师】 刘铁军；

【作者基本信息】 长春中医药大学 ， 中医内科学， 2007， 硕士

【摘要】 目的：观察肝脂溶颗粒治疗非酒精性脂肪性肝炎(NASH)痰湿郁热证的临床疗效和不良反应，客观评价其治疗非酒精性脂肪性肝炎的有效性及安全性，探索一种经济安全、疗效可靠、适宜推广的治疗非酒精性脂肪性肝炎的有效方剂。方法：选取符合条件的门诊患者60例，按随机抽签分组原则分为治疗组30例和对照组30例。治疗组给予肝脂溶颗粒(长春中医学院附属医院制剂室，批准文号：长中医字(96)1367号，100g／袋)，每日三次，每次10g服，三个月为一疗程。对照药为东保肝泰(批准文号：吉卫药准字1996年第430110号)，每日三次，每次3片，三个月为一疗程。结果：1、治疗组总有效率为90.0％，对照组总有效率为76.7％，治疗组总体疗效与对照组相比存在显著性差异(P＜0.05)，表明在治疗非酒精性脂肪性肝炎上，肝脂溶颗粒治疗组优于东保肝泰片对照组。2、两组治疗前后主要临床症侯总积分比较均有差异(P＜0.05)，两组间有显著性差异(P＜0.01)，表明两组均能有效改善临床症状和体征，且治疗组在改变倦怠困重、恶心暖气、烦躁易怒等症侯方面优于对照组。3、两组在减轻体重方面治疗前后比较均有显著性差异(P＜0.05)，两组间比较无显著性差异(P＞0.05)，说明两组在减轻体重方面作用相仿。4、两组均能改善肝功能(ALT，AST，γ-GGT，AKP)及血脂(TC，TG)水平(P＜0.05)，且治疗组于对照组组间比较亦存在差异(P＜0.05)，说明治疗组在降低血脂方面优于对照组。5、两组在改善B超程度积分治疗前后比存在差异(P＜0.05)，两组间比较(P＜0.05)，说明两组都能改善患者肝脏病变在B超下的严重程度，且治疗组优于对照组。结论：经过三个月的疗程治疗观察：肝脂溶颗粒治疗非酒精性脂肪性肝炎的临床疗效优于东保肝泰，且肝脂溶颗粒在降低患者症侯积分、降低TG值及减轻患者B超脂肪沉积程度优于东保肝泰。肝脂溶颗粒适用于非酒精性脂肪性肝炎痰湿郁热症的患者，既能祛脂，又可保护肝功能，降低转氨酶，是一种有效安全的治疗非酒精性脂肪性肝炎的中药制剂。更多还原

【Abstract】 Objective:To observet the linical effect and blight of The Traditional Chineseherb Medicine gan zhi rong particles (GZRP) to non-alcoholic steatohepatitis (NASH), which are belong to tan shi yu re by TCM Bianzheng. To evaluate objectively the validity and security of GZRP in treating NASH, inquiry into its function mechanism, guide its in the clinical application.Methods:The qualified test-acceptors were divided randomly into two groups:the treatment group and the control group. There were 30 Outpatients in each group without significance in sex, age, symptoms pattern between two groups (P>0.05). The treatment group took The Traditional Chinese herb Medicine GZRP(Changchun, China Medical College Hospital Preparation Room, ratified the text: Chinese characters long (96) 1367, coating bag), three time a day. The control group took Dong Bao Gan Tai(DBGT ratified Symbol: Gil-American in 1996, No. 430110.) 3 pains three times a day. The treatment is for three-month.Results:1、The total efficient of the treatment group is 90.0%, of the control group is 76.7%. The total treatment effect of treatment group and is Superior the control group (P<0.05). This indicating the treatment of GZRP is Superior the treatment of DBGT2、After three months treatment, both groups can improve significantly the total integral calculus of symptoms and advertises (P<0.01).And the treated group is significantly better than the control one (P<0.01).3、Both groups can reduce the weight (P<0.05).There is no significant difference on the two groups (P>0.05)4、Both groups can reduce significantly serum transaminase (AST, AST, GGT) and blood lipid (TC,TG)(P<0.05).There is no significant difference on improving liver function, reducing serum total cholesterol (TC) (P<0. 05).But has significant difference on reducing serum triglyceride (TG)( P<0.05 ).5、On lightening the degree of pathological changes of liver reflecting by B type ultrasonic, both groups have significant difference (P<0.05). Compared with the control group, the treated group has a better result (P<0.05).Conclusions:By three months treatment,the clinical effect of GZRP is alitter superior to DBGT, but in improving the total integral calculus of symptoms and advertises, reducing serum triglyceride (TG), reducing weight and lighting the degree of pathological changes of liver reflecting by B type ultrasonic, GZRP is much better than DBGT. Therefore, GZRP is adapt to non-alcoholic steatohepatitis (NASH), which are belong to tan shi yu re by TCM Bianzheng. It can either reduce blood lipid or protect the liver function and reduce serum transaminsase. It has been certified a safe and effective prescription of Chinese herbal medicine by clinic experiment. It deserves the clinical expansion更多还原