消脂利肝方治疗非酒精性脂肪肝病疗效及对TNF-琢、HOMA-IR的影响

目的：观察消脂利肝方治疗非酒精性脂肪肝（NAFLD）临床疗效和对肿瘤坏死因子α（TNF-α）、胰岛素抵抗的影响。方法72例NAFLD患者随机分为治疗组和对照组各36例，两组均给予健康教育和生活方式指导，对照组给予易善复治疗，治疗组予消脂利肝方联合易善复治疗，疗程8周。治疗前后均检测ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、游离脂肪酸（FFA）、TNF-α、空腹胰岛素（FINS），计算胰岛素抵抗指数（HOMA-IR），肝脏超声检查，评定临床疗效和各观察指标。结果治疗组有效率86.11豫，对照组为63.89豫，两组比较差异有统计学意义（P约0.05）；两组治疗后ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、FFA、TNF-α、HOMA-IR均较治疗前改善（P约0.05）；治疗组治疗后ALT、AST、TC、TG、FFA、TNF-α、HOMA-IR较对照组改善明显（P约0.05）。结论消脂利肝方联合易善复治疗NAFLD较单用易善复疗效明显，其机制可能与降低TNF-α和HOMA-IR水平有关。

Efficacy of Xiaozhi Ligan Decoction in Treatment of Nonalcoholic Fatty Liver Disease and its effect on TNF-α and HOMA-IR in Patients

Objective To investigate the therapeutic effect of Xiaozhi Ligan decoction on nonalcoholic fatty liver disease（NAFLD） and its effect on tumor necrosis factor-α（TNF-α） and insulin resistance. Methods Seventy-two NAFLD patients were randomly divided into treatment group （n=36） and control group （n=36）. Patients in two groups were given health education and living style guidance. Control group received essentiale for treatment of NAFLD, while treatment group was given essentiale plus Xiaozhi Ligan decoction, both for 8 weeks. The level of ALT, AST, TBIL, TC, TG, HDL-C, LDL-C, free fatty acid（FFA）, TNF-α, fasting insulin（FINS） was measured and HOMA-IR was calculated before and after treatment. Ultrasound was performed to evaluate liver function. Results The effective rate of treatment group was 86.11% and that of control group was 63.89%, with a significant differ-ence between them （P〈0.05）. The parameters including ALT, AST, TBIL, TC, TG, HDL-C, LDL-C, FFA, TNF-α, HOMA-IR were all improved after treatment in both groups（P〈0.05）; the level of ALT, AST, TC, TG, FFA, TNF-α, HOMA-IR in treatment group was lower than that in control group after treatment （P〈0.05）. Conclusion Xi-aozhi Ligan decoction combined with essentiale has more satisfactory effect against NAFLD compared with simple essentiale, which may be related to down-regulating TNF-α and HOMA-IR.