降脂清肝汤加味治疗肝胆湿热型脂肪肝对脂代谢、肝功能及氧化应激反应的影响

目的探究降脂清肝汤加味治疗肝胆湿热型脂肪肝病人的疗效及对脂代谢、肝功能及氧化应激水平的影响。方法选取 2019年 7月至 2021年 9月南阳市中医院收治的肝胆湿热型脂肪肝病人 110例，采用随机数字表法分为对照组与观察组，各 55例。对照组给予阿托伐他汀钙片；观察组在此基础上给予降脂清肝汤加味治疗。比较两组临床疗效，中医证候积分、脂代谢、肝功能及氧化应激指标，并记录治疗期间两组不良反应发生率。结果治疗后，两组中医证候积分、血清三酰甘油( TG)、总胆固醇( TC)、低密度脂蛋白胆固醇( LDL-C)、谷草转氨酶( AST)、谷丙转氨酶( ALT)、丙二醛( MDA)水平均显著低于治疗前(P<0.05)，观察组［(7.25±1.16)分、(2.14±0.42)mmol/L、(5.05±0.78)mmol/L、(2.25±0.35)mmol/L、(27.91±2.52)U/L、(27.13±2.21) U/L、(7.75±0.89)μmol/L］显著低于对照组［(9.86±1.29)分、(2.59±0.54)mmol/L、(5.49±0.65)mmol/L、(2.79±0.42)mmol/L、(33.43±3.50)U/L、(31.28±2.34)U/L、(9.21±1.03)μmol/L］(P<0.05)；高密度脂蛋白胆固醇( HDL-C)、谷胱甘肽过氧化物酶( GSH-PX)、氧化物歧化酶( SOD)水平较治疗前显著升高( P<0.05)观察组［(1.47±0.48)mmol/L、(135.82±7.91)U/L、(38.43±3.81)U/L］较对超照组［( 1.32±0.28)mmol/L、(121.43±7.52)U/L、(33.51±4.10，)U/L］显著升高( P<0.05)。观察组临床疗效 90.91%(50/55)较对照组74.55%(41/55)更优( P<0.05)，两组不良反应发生率差异无统计学意义( P>0.05)。结论降脂清肝汤加味治疗肝胆湿热型脂肪肝可有效改善病人脂代谢、肝功能和氧化应激反应，疗效显著且安全性良好。

Effects of lipid-lowering liver decoction on lipid metabolism, liver function and oxidative stress in the treatment of hepatobiliary moist and hot fatty liver

Objective To explore the efficacy of lipid-lowering liver decoction and flavor treatment on patients with hepatobiliarymoist and hot fatty liver and the effects on serum lipid metabolism indexes, liver function indexes and oxidative stress indexes.Meth- ods A total of 110 patients with hepatobiliary moist fever fatty liver received and treated by Nanyang Traditional Chinese MedicineHospital from July 2019 to September 2021 were randomly divided into control group and observation group, with 55 cases each. Thecontrol group was treated with atorvastatin calcium tablets, the observation group was given lipid-lowering liver decoction and flavortreatment on the basis of the control group.The clinical efficacy of the two groups, TCM syndrome scores, lipid metabolism, liver func-tion and oxidative stress indexes before and after treatment were compared, and the incidence of adverse reactions between the twogroups during treatment was recorded.Results After treatment, the levels of medical syndrome score, serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) in the two groups were significantly lower than those before treatment (P<0.05), and the observation group[(7.25±1.16) scores, (2.14±0.42) mmol/L, (5.05±0.78) mmol/L, (2.25±0.35) mmol/L, (27.91±2.52) U/L, (27.13±2.21) U/L, (7.75±0.89)μmol/L] were significantly lower than that in the control group [(9.86±1.29) scores, (2.59±0.54) mmol/L, (5.49±0.65) mmol/L, (2.79±0.42) mmol/L, (33.43±3.50) U/L, (31.28±2.34) U/L, (9.21±1.03) μmol/L] (P<0.05), high-density lipoprotein cholesterol (HDL-C), gluta- thione peroxidase (GSH-PX), The level of superoxide dismutase (SOD) was significantly higher than that before treatment (P<0.05), andthe observation group [(1.47±0.48) mmol/L, (135.82±7.91) U/L, (38.43±3.81) U/L] were significantly higher than that in the controlgroup [(1.32±0.28) mmol/L, (121.43±7.52) U/L, (33.51±4.10) U/L] (P<0.05). The observation group had better clinical efficacy 90.91% (50/55)than that in the control group 74.55% (41/55) (P<0.05), and there was no significant difference in the incidence of adverse reac- tions between the two groups (P>0.05).Conclusion The treatment of hepatobiliary moist and hot fatty liver with lipid-lowering decoc-tion can effectively improve the lipid metabolism, liver function and oxidative stress response of patients, with significant efficacy andgood safety.