三子养亲汤加味结肠水疗治疗痰湿内阻型非酒精性脂肪性肝病的临床疗效

目的:探讨三子养亲汤加味结肠水疗治疗痰湿内阻型非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:选取痰湿内阻型NAFLD患者100例,经随机数字表法分为治疗组和对照组,各50例。两组患者均予口服水飞蓟宾胶囊与甘草酸二胺胶囊为基础治疗,治疗组则在基础治疗上加用三子养亲汤加味结肠水疗,对照组则加用生理盐水结肠水疗,疗程均为7 d。记录两组患者治疗前后主要中医证候评分、肝脏酶学指标[丙氨酸氨基转氨酶(ALT),天冬氨酸氨基转氨酶(AST),γ-谷氨酸转肽酶(GGT)],血脂指标[胆固醇(TCH),甘油三酯(TG)],炎症因子指标[白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α)],Fibro Scan测量值[肝脏硬度值(LSM),受控衰减参数(CAP)],尿酸及体质量的变化,并观察不良反应,评价患者的用药安全性。结果:与本组治疗前比较,两组患者治疗后中医证候评分,肝脏酶学指标,血脂指标,炎症因子指标,Fibro Scan CAP,尿酸,体质量均明显降低(P<0.05,P<0.01)。治疗后两组在肝脏酶学指标,TCH,IL-6,LSM较对照组未见统计学差异,治疗后治疗组中医证候评分,UA,TNF-α,Fibro Scan CAP较对照组明显降低(P<0.05)。结论:三子养亲汤加味结肠水疗,不仅能明显改善痰湿内阻型NAFLD的临床症状,而且还可显著降低TG,UA,TNF-α,Fibro Scan CAP及体质量,可在短期取得内取得一定的临床疗效。

Clinical Efficacy of Modified Sanzi Yangqintang and Colon Hydrotherapy on Treatment of Non-alcoholic Fatty Liver Disease with Phlegm-dampness

Objective:To explore the clinical efficacy of modified Sanzi Yangqintang combined with colon hydrotherapy in the treatment of non-alcoholic fatty liver disease(NAFLD)with phlegm-dampness.Method:Totally 100 patients with NAFLD were selected and randomly divided into treatment group(50 cases)and control group(50 cases).Both groups were orally given silybin and glycyrrhizic acid diamine capsules.The treatment group was also added with modified Sanzi Yangqintang and colon hydrotherapy.The treatment lasted for7 days.The control group was also added with saline colon hydrotherapy.Main traditional Chinese medicine(TCM)syndrome scores and liver function indexes before and after treatment[alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamate transpeptidase(GGT)],blood lipid routine[cholesterol(TCH),triglyceride(TG)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],FibroScan measurement[liver stiffness measurement(LSM),controlled attenuation parameters(CAP)],uric acid and body weight changes were observed.Adverse reactions were observed,and the patient’s medication safety was evaluated.Result:TCM syndrome score,liver enzyme index,blood lipid index,inflammatory factor index,FibroScan CAP,uric acid and body weight of the two groups were significantly reduced than those before treatment(P<0.05,P<0.01).There was no significant difference in liver enzymes,TCH,IL-6 and LSM between treatment group and control group.And TCM syndrome scores,UA,TNF-α,FibroScan CAP decreased were significantly different from control group(P<0.05).Conclusion:Modified Sanzi Yangqintang combined with colon hydrotherapy can not only alleviate NAFLD with phlegm-dampness symptoms,but also significantly reduce triglyceride,tumor necrosis factor and FibroScan CAP and body mass,with certain clinical efficacy in a short term.