【作者】 葛庆红；

【导师】 马健；

【作者基本信息】 黑龙江中医药大学 ， 中西医结合临床， 2009， 硕士

【摘要】 目的:通过临床病例收集,观察疏肝健脾清热利湿法治疗非酒精性脂肪性肝炎肝郁脾虚瘀血湿热内阻型的临床疗效,分析中药对NASH患者肝功(ALT、AST、γ-GT)的改善效果,从而为治疗NASH提供新的思路及治疗方法。方法:1、选取2007年5月-2008年5月黑龙江中医药大学附属第一医院门诊及住院80例NASH患者,按中医辨证属于肝郁脾虚瘀血湿热内阻型,西医符合NASH的诊断标准。采用去组随机化法分为治疗组40例,对照组40例,两组在性别、年龄、病程、受试时症状等方面比较均无显著性差异(P＞0.05),具有可比性;2、治疗组:以中医理论为指导,根据疏肝健脾清热利湿法选药组方进行治疗;对照组选用东宝肝泰药进行治疗:3、观察两组在治疗前后肝功(ALT、AST、γ-GT)的变化情况,并做统计学分析,比较两者的疗效。结果:治疗结束后,两组肝功均有恢复,治疗组有效率为89.47%,对照组有效率为79.49%,两组差异无统计学意义(P＞0.05).两组肝功各项指标ALT、AST、γ-GT均有下降,治疗组治疗后ALT 47.11±17.27,对照组治疗后ALT 66.51±18.31,两组有显著差异(P＜0.05);治疗组治疗后AST 40.76±15.60,对照组治疗后AST 58.10±14.94,两组有显著差异(P＜0.05);治疗组治疗后GGT 56.10±14.45,对照组治疗后γ-GT 42.57±5.71,两组有显著差异(P＜0.05)。试验期间无不良事件与不良反应发生。结论:疏肝健脾清热利湿法治疗非酒精性脂肪性肝炎可以改善患者肝功指标中的ALT、AST、γ-GT,且疗效优于东宝肝泰组,安全性良好。更多还原

【Abstract】 Title:A Clinical Study on the Treatment of Liver Depression Spleen Deficiency And Blood Stasis Damp-heat Stagnation Syndrome type of non-alcoholic steatohepatitis in the liver function with Shuganjianpi Qingrelishi method.Objective:Through collecting clinical cases,to investigate Shuganjianpi Qingrelishi method of the treatment of NASH clinical efficacy and to analyze the effect of Chinese medicine on the treatment of NASH in the liver function(ALT、AST、γ-GT),thus to provide new ideas and treatment methods for the treatment of NASH.Methods:1、To seclect 80 cases patients with Non-alcoholic steatohepatitis diseases who from May 2007 to May 2008 in the number one hospital of Heilongjiang Province Chinese medicine university inpatient and outpatient.The patients with NASH as the Chinese medicine theory is liver depression spleen deficiency and blood stasis damp-heat stagnation syndrome,and conforming to western medicine diagnose criterion.The patients were randomly divided into treatment group 40 cases,the control group 40 cases.Patients in the two group by gender,age,duration,symptoms tested at compared.There was no significant difference(P＞0.05),and comparabil-ity.2、The treatment group take the Chinese medicine theory as the instruction,and based on the principle of Shuganjianpi Qingrelishi method.The control group adoption Dongbao Gantai tablet treatment 3、In the course of treatment,the items that we had observed with all patients were glutamic pyruvic transaminase(ALT),glutamic oxaloacetic transaminase(AST),γglutamyltransferase(γ-GT),and do statical analysis, and compare the results.Result:The total effective rate of improvement the function of liver of Chinese medicine in the treatment group is 89.47%after treatment,while it is 79.49%in the control group,the difference between the two groups is not significant,but there was significant difference in the level of ALT, AST,andγ-GT.between the two group,the level of ALT trial group is 47.11±17.27,while the conrtol group is 66.51±18.31(P＞0.05);the level of AST trial group is 40.76±15.60,while the conrtol group is 58.10±14.94 (P＞0.05);the level of GGT trial group is 38.084-14.99,while the conrtol group is 56.10±14.54(P＞0.05).During the period of the clinical study has not adverse events and adverse reaction occured.Conclusion:the Treatment of non-alcoholic steatohepatitis with Shuganjianpi Qingrelishi Method could improve the function of liverALT、AST,γ-GT,the effect is superior to the conrtol group.The clinical study is good safety.更多还原