健脾导滞汤治疗脾虚气滞型非酒精性脂肪肝

目的观察健脾导滞汤治疗脾虚气滞型非酒精性脂肪肝(非酒精性脂肪性肝病)的临床疗效。方法将108例临床确诊为非酒精性脂肪性肝病的患者随机分为治疗组和对照组,各54例,治疗组采用健脾导滞汤加减(砂仁、干姜、炙甘草、山楂等,1剂/d)治疗,对照组采用脂必妥片(脂必妥片3片/次,2次/d)治疗,疗程均为3个月。对比观察2组治疗的综合疗效和治疗前后中医症状积分、体质量指数、血脂指标、肝功能指标、肝脾影像指标变化。结果治疗组治疗后总有效率为96.30%,对照组为75.93%,2组比较,差异有统计学意义(P<0.05);2组患者治疗后中医症状积分、体质量指数、血脂指标(TC、TG)、肝功能指标(AST、ALT)及肝脾影像指标(肝脾CT比值)均较治疗前明显改善,差异有统计学意义(P<0.05或P<0.01);治疗组治疗后中医症状积分、TC及肝/脾CT比值改善明显优于对照组,差异有统计学意义(P<0.05)。结论健脾导滞汤治疗脾虚气滞型非酒精性脂肪肝可有效恢复患者肝功能、降低血脂,减轻脂肪肝病情程度,延缓病情发展。

Jianpi Daozhi Decoction in treating nonalcoholic fatty liver disease with spleen asthenia and Qi stagnation

Objective To observe the clinical effect of Jianpi Daozhi Decoction in treating nonalcoholic fatty liver disease on Spleen asthenia and Qi Stagnation. Methods Adopting randomized controlled method, the 108 patients who diagnosed asNAFLD were assigned to the treatment group （ n = 54） and the control group （ n = 54）. The treatment group was treated by Jianpi Daozhi Decoction （villous amomum, dried ginger, prepared licorice and hawthorn etc., 1 dose/d） and control group was treated by ZhiBiTuo tablet （3/times, 2/d） for three months period of treatment. To compare the two groups＇ comprehen- sive therapeutic effect, TCM Symptom scores, BMI, serum lipid, liver function index and images of liver and spleen index changes before and after treatment. Results The total efficiency of treated group was 96.30%, while the control group was 75.93 % ; Difference between the two groups has statistical significance （ P 〈 0.05 ）. Compared with before treatment, the two groups＇ TCM symptom scores, BMI, serum lipid （TC,TG）, liver function index （AST, ALT） and images of liver and spleen index （CT） both improve obviously after treatment, the difference has statistical significance （ P 〈 0.05 or P 〈 0.01） .After treatment, the treated group improve more obviously than the control group in TCM symptom scores, tiC, and liver/spleen （CT） （ P 〈 0.05）. Conclusion In treatment of nonalcoholic fatty liver disease on Spleen asthenia and Qi Stag- nation, Jianpi Daozhi Decoctions could obtain a better effect by restoring liver function effectively, lowering blood lipid, re- ducing the degree of fatty liver disease, to delay the development of disease, and it deserved a further research and expand.