复肝汤治疗脂肪肝40例

1998年9月-2003年2月,我们用自拟复肝汤治疗脂肪肝40例,收到较好疗效,现将结果报告如下。 1 资料与方法 1.1 一般资料 80例脂肪肝患者,均符合中华医学会肝脏病学分会于2002年10月修订的脂肪肝和酒精性肝病的诊断标准。其中男54例,女26例,年龄25～69岁,平均34岁,均因嗜酒、糖尿病、肥胖症等引起。其中有肥胖症42例,有饮酒史36例,糖尿病13例。表现症状为全身乏力、食欲不振、     

清肝降脂汤治疗非酒精性脂肪肝50例

[目的]观察清肝降脂汤治疗非酒精性脂肪肝（NASH）的临床疗效。[方法]75例患者随机分为治疗组50例（用清肝降脂汤治疗），对照组25例（用护肝片治疗），观察其治疗前后症状、肝功能、血脂等的变化。[结果]治疗组改善临床症状、肝功能、降血脂等均优于对照组，治疗组总有效率88．0％，对照组64．0％。两组比较差异有统计学意义（P〈0．05）。[结论]清肝降脂汤治疗NASH有明显效果。     

加味温胆汤治疗酒精性脂肪肝38例

1 临床资料 病历完整的38例酒精性脂肪肝患者,男34例,女4例,年龄27～62岁,平均43.1岁;饮酒史5～23年,平均日饮酒160～230ml;全部病例均有肝区疼痛,肝大肋下1.5～5cm,边缘钝,表面光滑,质软、有压痛,24例患者有乏力倦怠、纳呆、腹胀、恶心呕吐等消化道症状,30例患者舌暗红,苔腻、脉滑数或弦数。     

肝脂灵汤治疗脂肪肝126例

随着我国人民生活水平的提高,饮食结构的改变,高脂血症、肥胖症、脂肪肝的患病人数呈上升趋势,探讨有效的治疗方法成为临床研究的热门课题之一。2000年5月～2003年5月,我们采用自拟肝脂灵汤治疗126例脂肪肝患者取得较满意疗效,现报道如下。 1 对象与方法 1.1 诊断标准 ①患者有肝区不适、腹胀、纳差、乏力、口干、口苦、便秘等。②肝脏B超具备以下4项中的两项:肝内光点密集,回声强,肝肿大;肝肾回声差增大;深部回声衰减;肝内血管欠清晰。③肝功能异常。④血清胆固醇(TC)、甘油三酯(TG)升高。 1.2 临床资料 188例符合上述诊断标准的患者均为我科门     

降脂柔肝汤治疗脂肪肝68例

笔者从1999-2003年以来,在辨病和辨证相结合的基础上,应用降脂柔肝汤对68例脂肪肝患者进行临床治疗,并根据国外报道以熊去氧胆酸片作为对照观察,现报道如下。 1 临床资料 1.1 病例选择 所有病例均为门诊或住院患者,符合以下条件:①经B超检查确诊为脂肪肝,并伴有高血脂,即素食3天空腹抽血化验,血清总胆固醇(TC)≥5.7mmol/L,或甘油三酯(TG)≥1.71mmol/L;②伴有肝功能异常ALT>40U/L,或γ-GT>50U/L。凡妊娠或哺乳期妇女、急慢性病毒性肝炎、肝硬化、肝癌、酒精性药物性肝病患者均予剔除。 1.2 分组 随机分组,治疗组68例,其中男47例,女21例;年龄20～73岁,平均45.2岁。对照组34例,其中男23     

活血化痰护肝汤治疗酒精性脂肪肝50例

目的:观察活血化痰护肝汤治疗酒精性脂肪肝的临床疗效。方法:100例酒精性脂肪肝患者随机分为两组,观察组50例口服活血化痰护肝汤,150 ml/次,3次/d;对照组50例口服易善复(多烯磷脂酰胆碱)胶囊,228 mg/次,3次/d。两组患者均治疗3个疗程共12周,观察两组患者治疗前后的临床症状、血清甘油三酯、肝功能、肝脏影像学检查的变化。结果:观察组患者临床疗效总有效率显著高于对照组(82.0%vs 61.7%),两组间比较差异有显著性意义(P<0.05)。结论:活血化痰护肝汤治疗酒精性脂肪肝有较好的疗效,值得临床进一步研究应用。     

消脂汤治疗非酒精性脂肪肝30例

笔者采用自拟消脂汤治疗60例非酒精性脂肪肝患者取得较好的疗效,现报道如下。1资料与方法1.1一般资料60例患者均为我院肝病中心2004-2005年门诊及住院患者,诊断符合2002年10月南京会议制定的非酒精性肝病的诊断标准[1],随机分为治疗组和对照组各30例。其中治疗组男23例,女7例,平均年龄(45.88±9.46)岁,肝功能正常12例,异常18例;对照组男21例,女9例,平均年龄(44.6±9.41)岁,肝功能正常者10例,异常者20例。两组在年龄、身高及治疗前的体重等方面比较,差异无显著性意义(P>0.05),具有可比性。1.2观察指标及检测方法治疗前后观察下列指标:血常规…     

消肝脂丸治疗酒精性脂肪肝的临床研究

目的:观察消肝脂丸治疗酒精性脂肪肝的疗效。方法:将130例酒精性脂肪肝患者随机分为2组。治疗组100例,给予口服消肝脂丸;对照组30例,服用非诺贝特治疗。比较2组疗效。结果:治疗组总有效率为92％,对照组总有效率为66.7％。2组总有效率比较有显著性差异(P<0.01)。结论:早期使用消肝脂丸对酒精性脂肪肝具有良好的治疗作用,安全有效。     

自拟祛脂汤治疗非酒精性脂肪肝50例

笔者自2007年1月-2010年1月采用自拟祛脂汤治疗50例非酒精性脂肪肝患者,取得明显疗效,现总结报道如下. 1 资料与方法 1.1 诊断标准 符合中华医学会肝病学会分会脂肪肝和酒精性肝病学组制订的<非酒精性脂肪性肝病诊断标准>[1].     

中医药治疗非酒精性脂肪肝的研究

非酒精性脂肪肝（NAFLD）是以无过量饮酒史（酒精摄入量〈20 g/d）以及肝细胞脂肪变性、气球样变、弥散性小叶轻度炎症和（或）肝中央静脉、肝窦周围胶原沉积等为临床病理特点的慢性肝脏疾病。近年来由于生活水平提高、饮食结构变化及预防保健措施相对滞后,非酒精性脂肪性肝病发病率上升,且发病年龄越来越小。笔者就中医药治疗NAFLD的现状做一回顾,以期探求中医药诊治该病的规律。为中医药防治NAFLD提供更加充分的理论和临床依据。     

Nonalcoholic Fatty Liver Disease Treated by Gastroplasty

Nonalcoholic steatohepatitis (NASH), which is the most severe histologic form of nonalcoholic fatty liver disease (NAFLD), is emerging as the most common clinically important form of liver disease in obese patients. The prevalence of NASH may increase with the rise in the rate of obesity and metabolic syndrome in affluent communities. The aim of this work is to describe clinical and histopathologic findings and correlate liver tissue damage to the length of duration of the obesity in the group of patients who underwent surgery as obesity treatment. Eighty-seven severely or morbidly obese patients underwent gastroplasty. Each patient was evaluated with complete clinical and laboratory medical assessment together with wedge liver biopsy taken from 59 unselected patients during the surgery. Patients were followed up for 41 months. Repeat liver biopsy was taken from 10 patients. Pathologic analysis recorded the presence and degree of steatosis, portal and lobular inflammation and fibrosis. Age, body mass index (BMI), and laboratory assessment correlated with pathologic data. Male patients showed more pronounced metabolic syndrome and fatty liver damage. Patients who become obese in childhood or as teenagers showed no differences in metabolic syndrome and NAFLD in mature age. There was statistically significant association between BMA, elevated transaminases, NAFLD, and fibrosis. Significant weight reduction was observed within first year after surgery, was slower in the second year, and stabilized within third year. Remarkable improvement followed in biological markers of metabolic syndrome. Ninety-six percent of initial liver biopsies had steatosis; 16% developed steatohepatitis and mild perivenular fibrosis. Significant improvement of the degenerative and inflammatory hepatic lesions in repeated biopsies and liver function readings was noted within 8 months after surgery. Obesity is a major and independent risk factor for the metabolic syndrome, NAFLD, NASH, and fibrosis. Surgical treatment improves metabolic abnormalities and hepatic lesions in long-term observations.     

补阳还五汤加减治疗脂肪肝59例临床疗效观察

目的 :观察补阳还五汤治疗脂肪肝的疗效 ,探索其抗肝纤维化的临床应用价值。方法 :脂肪肝 89例分为两组 ,治疗组 5 9例 ,服用补阳还五汤加减汤方 ;对照组 30例 ,服用丹参片和多烯康胶丸。观察临床疗效并检测治疗前后透明质酸、球蛋白、谷丙转氨酶和 B超的变化情况。结果 :治疗后两组生化指标均有所下降 ,差异有显著性意义 (P <0 .0 1) ;治疗组总有效率为 96 .4 % ,对照组 76 .7% ,两组比较差异有显著性意义 (P <0 .0 1)。结论 :补阳还五汤加减汤方能够显著改善脂肪肝的肝损伤 ,减轻、延缓肝纤维化趋势 ,无不良反应。     

抗结核组合药物致肝功能损害36例临床分析

目的:探讨抗结核组合药对HBV-M阳性肺结核患者肝功能的影响。方法:比较HBV-M阳性和HBV-M阴性结核患者组合药治疗后肝功能损害情况。结果:36例患者中HBV感染24例占24/36(66.67％)。明显高于一般人群HBV感染率;HBV-M阳性组同HBV-M阴性组比较,前者疲乏、肝功能损害明显,预后较差,P<0.05,但发生肝损害的时间较迟,HBV阳性组15例停用全部抗结核药物仍有7例病情继续加重。结论:MBV-M阳性的结核患者肝功能损害机制可能主要以HBV为主,化疗药物(如:利福平)可能起到打破免疫耐受作用。应合理应用利福平,长期监测肝功能,积极采取综合防范措施。     

健脾活血方治疗脂肪肝的临床疗效观察

目的观察健脾活血方治疗脂肪肝的临床疗效。方法运用健脾活血方治疗脂肪肝患者52例(治疗组),并与对照组(东宝肝泰片治疗)24例作对照,通过治疗前后临床症状和体征的观察,血丙氨酸转氨酶、门冬氨酸转氨酶、甘油三酯、胆固醇检测和B超检查,分析健脾活血方的临床疗效。结果健脾活血方能显著改善患者的脂肪肝B超影像,减轻和缓解临床症状,改善和恢复肝功能,降低腰臀比值和血甘油三酯、胆固醇含量,其总有效率为73.08%,显著优于对照组50.00%(P＜0.05)。结论健脾活血方是治疗脂肪肝的有效方剂。     

Effect of Fenofibrate on Fatty Liver in Rats Treated With Alcohol

Background: Although fatty liver and hyperlipemia are common in chronic alcoholics, there is no practical approach to prevent alcoholic fatty liver. Recently, it has been reported that fibrates bind to peroxisome proliferator-activated receptor-α and induce β-oxidation enzymes of fatty acid in mitochondria. In this study, we investigated the effect of fenofibrate, one of the fibrates, on fatty liver in rats induced by chronic alcohol feeding. Furthermore, we studied the effect of fenofibrate on hyperlipemia in patients with alcoholic fatty liver.
Methods: Male Wistar rats were treated with liquid diet that contained ethanol (36% of total calories) or an isocaloric carbohydrate instead of ethanol for 4 weeks. Fenofibrate was administered orally with the liquid diets for 4 weeks at a concentration of either 0, 5, or 30 mg/kg body weight/day. As a pilot study, eight patients with alcoholic fatty liver were treated with 200 mg/day of fenofibrate for 4 weeks.
Results: After fenofibrate administration, fatty degeneration of liver was not observed in three of the five rats treated with 5 mg and in all rats treated with 30 mg of fenofibrate. Hepatic triglyceride content was decreased significantly in rats treated with 30 mg of fenofibrate compared with the rats not treated with fenofibrate. Serum triglyceride and total cholesterol levels also were decreased after treatment with fenofibrate. In eight alcoholic patients treated with 200 mg of fenofibrate for 4 weeks, serum triglyceride level decreased significantly compared with the levels before treatment. All patients continued alcohol consumption during fenofibrate administration.
Conclusion: The results of the present investigation suggest that fenofibrate may be useful to prevent alcoholic fatty liver. Further studies with larger numbers of patients are necessary to obtain definitive results.     

消瘤汤治疗肝癌45例

1 临床资料 以国际抗癌联盟1987年TNM分类法定为Ⅳ期肝癌者作为病例入选对象,包括门诊及住院病人。其中男48例,女12例;17～30岁5例,30～50岁21例,50岁以上24例,全部病人均经过肝脏B超,CT检查证实,肿块在2～4cm~2者34例,4～6cm~2者20例,6cm~2以上者6例,伴脏器转移者8例。60例患者中有一部分曾在外院作过手术治疗或化疗,或在本院作全身化疗及“介入”治疗。采用双盲对照法将60例患者分为治疗     

参莲胶囊配合介入疗法治疗继发性肝癌的临床观察

以肝动脉插管化疗、栓塞治疗69例具有血瘀证症状的继发性肝癌患者．其中32例（治疗组）加服参莲胶囊1个疗程以上。结果治疗组肝区疼痛、腹胀、烦躁、苔黄根腻等血瘀证症状改善，与对照组比较均P＜0．05；治疗组生活质量提高，用Karuafsky计分制统计．80～70分的明显较多（P＜0．05）；介入治疗后的毒副反应和并发症与对照组比较也有所减轻。因此参莲胶囊配合介入疗法不失为治疗具有血瘀证症状的继发性肝癌的有效方法，同时对控制原发性癌灶也有良好的作用。     

健脾活血方治疗脂肪肝的临床研究

目的：观察健脾活血方治疗脂肪肝的临床疗效。方法：用健脾活血方法脂肪肝４０例,疗程３个月。结果：患者乏力、肝区不适或疼痛等症状消失或缓解;肝脏在Ｂ超下的形态和实质明显改善（其中６例恢复正常、２６例显著好转）;ＢＭＩ值、血清胆固醇含量较治疗前显著降低（Ｐ〈０．０５）、ＡＣＲ复常率为７７．７８％;血清ＡＬＴ、ＡＳＴ、ＧＧＴ的复常率分别为４８．１５％、４２．１１％和３３．３３％。总有效率８０％。结论：健脾