自拟脂炎平颗粒治疗非酒精性脂肪性肝炎45例临床观察

雷欣博鹏 李旭英 代轶楠 黄学军 董伟 高芬 雷陵

【摘 要】 目的：观察自拟脂炎平颗粒治疗非酒精性脂肪性肝炎的临床疗效。方法：选择非酒精性脂肪性肝炎患者100例为研究对象，随机分为对照组与观察組各50例。对照组予益肝灵分散片口服;观察组服用自拟脂炎平颗粒，均治疗3个月为1个疗程。观察治疗后肝功能、血脂、影像学变化及中医证候疗效情况。结果：在改善肝功能、影像学及降低血脂方面，观察组明显优于对照组（P<0.05）。观察组中医证候有效率为93.33%，优于对照组的77.27%，两组比较差异有统计学意义（P<0.05）。两组未出现明显不良反应。结论：自拟脂炎平颗粒治疗非酒精性脂肪性肝炎疗效显著。

【关键词】 脂肪性肝炎;非酒精性;脂炎平颗粒;自拟方;中医药疗法

【中图分类号】R575.1   【文献标志码】 A    【文章编号】1007-8517（2021）05-0084-04

Clinical Observation of Self-made Zhiyanping Granule in the Treatment of 45 Cases of Non-alcoholic Steatohepatitis

LEI Xinbopeng1 LI Xuying2 DAI Yinan3 HUANG Xuejun3 DONG Wei3 GAO Fen3 LEI Ling3*

1.Department of Clinical Laboratory， Wuhan Puren Hospital， Wuhan  430081，China;

2. Department of Traditional Chinese Medicine， Shiyan Taihe Hospital， Shiyan  442000，China;

3. Key Specialty of Liver Diseases， Shiyan Hospital of Traditional Chinese Medicine， Shiyan 442012，China

Abstract：Objective Observe the clinical efficacy of self-made Zhiyanping granules in the treatment of non-alcoholic steatohepatitis. Methods Select 100 patients with non-alcoholic steatohepatitis as observation and treatment subjects， randomly divide 50 patients into the control group and 50 into the observation group. Patients in the control group will take Yiganling dispersible tablets orally. Patients in the observation group will take self-made Zhiyanping granules orally （it consists of 12 ingredients， namely rhizoma cyperi， rhizome chuanxiong， snakegourd fruit， atractylodes macrocephala koidz， rhizoma， white peony root， hawthorn， semen cassiae， coptidis rhizoma， gardenia jasminoides and dahurian patrinia herb. The drug manufacturing room of Shiyan Hospital of Traditional Chinese Medicine is responsible for processing them into granule. Each bag is 20 g.）. Patients in each group are treated for one treatment course （3 months）. Observe the changes of liver function， blood lipid， imaging and the effect of TCM syndromes after the treatment. Results In terms of improving liver function， imaging and reducing blood lipid， the observation group was significantly better than the control group （P<0.05）. The effective rate of TCM syndromes of the control group and the observation group reached 77.27% and 93.33% respectively， with statistically significant difference between the two groups the observation group was higher than the control group（P<0.05）. No obvious adverse reactions occurred. Conclusion The self-made Zhiyanping granule is effective.

Keywords：Steatohepatitis;Non-alcoholic; Zhiyanping Granules;Self-made Formula; TCM Therapy

非酒精性脂肪性肝炎（Non-alcoholic ateatohepatitis，NASH）系非酒精性脂肪性肝病（Nonalcoholic Fatty Liver Disease， NAFLD）的严重类型，5%以上的肝细胞脂肪变合并小叶内炎症和肝细胞气球样变性。不合并肝纤维化或仅有轻度肝纤维化（F0-1）为早期NASH;合并显著肝纤维化或间隔纤维化（F2-3）为纤维化性NASH;合并肝硬化（F4）为NASH肝硬化[1]。该病是临床常见的肝脏疾病，近年来，NASH的发病率呈不断增长趋势，其在世界范围内的患病率约为6%～33%，国内患病率高达15%～20%[2]。在饮食结构紊乱及生活习惯改变等因素作用下，NASH发生的人群不再只是中老年人，青少年甚至儿童的患病率也在升高。故对于NASH的诊治及研究成为一项重大课题[3]。自拟脂炎平颗粒是十堰市中医医院采用鄂西北武当山地区道地中草药為主要成分研制的一种中药制剂。该制剂具有疏肝清热、健脾祛湿、化痰通络功效。经多年临床观察，对治疗非酒精性脂肪性肝炎有满意效果。……