清热化湿消瘀法防治非酒精性脂肪性肝炎的实验研究

目的：探讨清热化湿消瘀法防治非酒精性脂肪性肝炎（NASH）的作用及机制。方法：采用高脂饮食复制大鼠NASH模型。实验分正常对照组、空白模型组、降脂益肝汤防治组、东宝肝泰组进行干预,测定各组血清甘油三酯（TG）、总胆固醇（TCH）、低密度脂蛋白（LDL）和丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）超氧化物歧化酶（SOD）活性、丙二醛（MDA）、游离脂肪酸（FFA）含量,评估肝组织病理脂肪变性和炎症活动程度等变化。结果：与空白模型组相比,降脂益肝汤防治组血清TG、TCH、LDL、ALT、AST明显降低（P〈0.01）,作用均优于东宝肝泰组（P〈0.05）,降脂益肝汤防治组脂肪变性和炎症活动程度明显改善（P〈0.01）,其炎症活动程度较东宝肝泰组明显减轻（P〈0.05）。肝中SOD活性显著升高（P〈0.01）、MDA含量显著降低（P〈0.01）;血清TNF-α含量显著减少（P〈0.01）,显著降低血清FFA含量（P〈0.01）。明显优于东宝肝泰对照组（P〈0.01或P〈0.05）。结论：降脂益肝汤有明显防治NASH作用,作用机制与其能减少脂类淤积、缓解氧化应激、氧化抗氧化平衡失调、抑制致炎细胞因子的表达有关。

Experimental Study on Clearing Away Heat and Eliminating Dampness and Stasis Therapy Treating Nonalcoholic Steatohepatitis in Rats

Objective： To study the effect and mechanism of clearing away heat and eliminating dampness and stasis therapy on treating nonalcoholic steatohepatitis（NASH）.Methods： Rats were randomly divided into 4 groups,namely normal control group,blank model group,Lipid-reducing and liver-benefiting recipe groups and Compound Methionine and Choline Tablet control group.To adopt the high fat diet to replicate NASH model of rats.The changes of serum triglyceride（TG）,total cholesterol（TCH）,low density lipoprotein（LDL）,aminotransferase（ALT）,aspartate aminotransferase（AST）,content of free fatty acids（FFA）and tumor necrosis factorα（TNF-α）were observed.the activity of superoxide dismutase（SOD）,content of malondialdehyde（MDA） of liver tissues were observed.The degrees of hepatocyte fatty degeneration,hepatitis activity were detected.Results： Compared with that of the blank model group,the content of serum TG TCH LDL ALT AST of Lipid-reducing and liver-benefiting recipe groups decreased significantly（P0.01）.The effects have an advantage to that of Compound Methionine and Choline Tablet control group（P0.05）.The degrees of hepatocyte fatty degeneration and hepatitis activity were less pronounced in the animals treated with Lipid-reducing and liver-benefiting recipe（P0.01）.and the degree of the inflammation activity was more lessen than Compound Methionine and Choline Tablet control group（P0.05）.Compared with that of the blank model group,Lipid-reducing and liver-benefiting recipe could raise the SOD activity and degrade the MDA of liver tissue,degrade serum FFA and TNF-αcontent（P0.01）,the effect of Lipid-reducing and liver-benefiting recipe surpass to that of Compound Methionine and Choline Tablet（P0.01 or P0.05）.Conclusion： Lipid-reducing and liver-benefiting recipe has the function of treating NASH.The mechanism is related to resisting the lipid peroxidation and restraining proinflammatory cytokine.