化痰柔肝方聯(lián)合瑞舒伐他汀治療非酒精性脂肪性肝炎的研究
發(fā)布時(shí)間：2019-04-10 21:15
【摘要】：目的:觀察化痰柔肝方聯(lián)合瑞舒伐他汀鈣片聯(lián)合治療非酒精性脂肪性肝炎的臨床效果和不良反應(yīng),客觀、綜合評價(jià)該治療方法的有效性及安全性,為臨床提供一種有證可循且具確切療效的治療方法。方法:將2015年05月1日至2016年06月30日我院門診及住院收治的、符合納入標(biāo)準(zhǔn)的、確診NASH并使用化痰柔肝方、瑞舒伐他汀鈣片治療的80例病人,按就診順序編號并按隨機(jī)數(shù)字表隨機(jī)分2組,治療組及對照組各40例。兩組均配合運(yùn)動及飲食療法;對照組給予口服瑞舒伐他汀鈣片,5mg/次,每日1次,溫水吞服;治療組在對照組的基礎(chǔ)上加口服化痰柔肝方,1袋/次,每日3次,溫水吞服。兩組均治療12周。于初診首日及治療結(jié)束后各觀察記錄一次肝功能(谷丙轉(zhuǎn)氨酶ALT、谷草轉(zhuǎn)氨酶AST、谷氨酰轉(zhuǎn)肽酶GGT)、血脂(總膽固醇TC、甘油三酯TG)、肝臟超聲、體重指數(shù)、中醫(yī)證候、不良反應(yīng)等。將收集到的數(shù)據(jù)通過SPSS21.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)治療組總有效率90.00%,對照組總有效率為72.50%,兩組對比存在統(tǒng)計(jì)學(xué)意義差異(P=0.0140.05),表明在治療非酒精性脂肪性肝炎療效上,化痰柔肝方聯(lián)合瑞舒伐他汀鈣片治療組優(yōu)于瑞舒伐他汀鈣片對照組。(2)在肝功能改善情況方面,兩組治療后ALT、AST、GGT均明顯下降,經(jīng)對比,兩組的差異存在統(tǒng)計(jì)學(xué)意義(P0.05),表明治療組更能改善非酒精性脂肪性肝炎患者的肝功能。(3)在血脂改善情況方面,兩組治療后TC、TG均有所下降,但治療組優(yōu)于對照組(P0.05),說明治療組對降低非酒精性脂肪性肝炎患者的血脂水平更有效。(4)在肝臟超聲改善情況方面,兩組治療后超聲下脂肪肝的表現(xiàn)均有所減輕,以治療組更為明顯(P0.01),因此,化痰柔肝方聯(lián)合瑞舒伐他汀鈣片對于改善NASH的肝臟超聲表現(xiàn)具有良好的效果。(5)體重指數(shù)下降情況方面,兩組均能降低體重指數(shù),但治療組治療結(jié)束后能使患者體重指數(shù)平均下降0.5個(gè)指數(shù)以上,顯示出良好的效果。(6)中醫(yī)證候改善情況方面,針對中醫(yī)痰濕內(nèi)阻型的相關(guān)證候,將其分為四大主癥、三大次癥以及舌脈,治療結(jié)束后,兩組均出現(xiàn)證候消失的病例,其中治療組明顯多于對照組(P0.05),同時(shí)治療組無論主癥、次癥或舌脈均有大幅度的改善,總療效高達(dá)95.00%,說明治療組能明顯改善證候,甚至治愈中醫(yī)相關(guān)證候。(7)在安全性方面,整個(gè)治療過程中治療組出現(xiàn)1例不良反應(yīng),對照組出現(xiàn)3例不良反應(yīng),兩藥均安全可靠。結(jié)論:(1)化痰柔肝方是治療非酒精性脂肪性肝炎的有效藥物,該藥治療組臨床總有效率90%,明顯優(yōu)于瑞伐他汀鈣片對照組。(2)化痰柔肝方具有較好的改善肝功能、降低血脂水平、減輕超聲脂肪肝表現(xiàn)、降低體重指數(shù)等方面的作用。(3)化痰柔肝方能很好的改善體態(tài)肥胖、周身困重、右脅脹悶、食少納呆、倦怠無力、頭暈惡心、腹脹便溏等中醫(yī)痰濕內(nèi)阻證相關(guān)癥狀。(4)在治療過程中治療組僅出現(xiàn)1例較輕微的不良反應(yīng),說明本藥安全可靠。
[Abstract]:Objective: to observe the clinical effect and adverse reaction of Huatanluogan recipe combined with Ruishuvastatin calcium tablet in the treatment of non-alcoholic steatohepatitis, and to evaluate the efficacy and safety of this method. To provide a clinical treatment that can be documented and has a definite curative effect. Methods: from May 1, 2015 to June 30, 2016, 80 patients with NASH were diagnosed and treated with Risuvastatin calcium tablet. The patients were randomly divided into two groups: treatment group (n = 40) and control group (n = 40). The two groups were treated with exercise and diet therapy, the control group was given Rishuvastatin calcium tablets, 5mg/ once a day, and warm water swallowing, while the treatment group was treated with Huatanluogan decoction on the basis of the control group, one bag per day, three times a day, and warm water swallowing. Both groups were treated for 12 weeks. On the first day of diagnosis and after treatment, the liver function (alanine aminotransferase ALT, aspartate aminotransferase AST, glutamyl transpeptidase GGT), lipid (total cholesterol TC, triglyceride TG), liver ultrasound, body mass index, TCM syndrome) was observed and recorded. Adverse reactions, etc. The collected data were analyzed by SPSS21.0 statistical software. Results: (1) the total effective rate of the treatment group was 90.00%, that of the control group was 72.50%, there was significant difference between the two groups (P < 0.0140.05), which indicated that the therapeutic effect of non-alcoholic steatohepatitis was better than that of the control group. (2) in the improvement of liver function, the ALT,AST,GGT of the two groups decreased significantly after treatment, and compared with that of the control group, and the treatment group of Huatanruogan decoction combined with Ruishuvastatin calcium tablet was better than the control group. (2) in the improvement of liver function, both groups decreased significantly after treatment. The difference between the two groups was statistically significant (P0.05), indicating that the treatment group could improve the liver function of the patients with non-alcoholic steatohepatitis. (3) in the improvement of blood lipid, the TC,TG of the two groups decreased after treatment. However, the treatment group was better than the control group (P0.05), indicating that the treatment group was more effective in reducing the level of blood lipid in patients with non-alcoholic steatohepatitis. (4) in the improvement of liver ultrasound, After treatment, the performance of fatty liver was alleviated in both groups, especially in the treatment group (P0.01). Huatanluogan recipe combined with Risuvastatin calcium tablet has a good effect on improving the ultrasonic performance of liver in NASH. (5) in the aspect of body mass index decrease, both groups can reduce body mass index. But the treatment group can reduce the average body mass index more than 0.5 indexes after treatment, showing a good effect. (6) in the improvement of TCM syndrome, according to the related syndrome of phlegm-dampness internal obstruction in TCM, it can be divided into four main symptoms. After treatment, the syndrome disappeared in both groups, and the treatment group was significantly more than the control group (P0.05). At the same time, no matter the main symptoms, secondary symptoms or tongue veins in the treatment group, there was a significant improvement in the treatment group, both in the treatment group and in the control group (P0.05). The total curative effect was as high as 95.0%, indicating that the treatment group could significantly improve the syndrome and even cure the TCM-related syndrome. (7) in the safety aspect, 1 case of adverse reaction appeared in the treatment group and 3 cases of adverse reaction in the control group. Both drugs are safe and reliable. Conclusion: (1) Huatan Ruogan recipe is an effective drug for the treatment of non-alcoholic steatohepatitis, the total clinical effective rate of the treatment group is 90%, which is obviously better than that of the control group. (2) Huatanluogan recipe has a good improvement on liver function. (3) Huatan soft liver recipe can improve body mass obesity, body mass loss, right flutter distension, lack of appetite, fatigue, dizziness, nausea, and so on. (3) Huatan soft liver recipe can improve body mass obesity, body mass loss, right flank distension, lack of appetite, tiredness, dizziness, nausea, and so on. The symptoms related to phlegm-dampness internal obstruction of traditional Chinese medicine such as loose stool and abdominal distension. (4) in the treatment group, only one case of mild adverse reaction occurred in the treatment group, which indicated that the drug was safe and reliable.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R575
，
本文編號：2456135
[Abstract]:Objective: to observe the clinical effect and adverse reaction of Huatanluogan recipe combined with Ruishuvastatin calcium tablet in the treatment of non-alcoholic steatohepatitis, and to evaluate the efficacy and safety of this method. To provide a clinical treatment that can be documented and has a definite curative effect. Methods: from May 1, 2015 to June 30, 2016, 80 patients with NASH were diagnosed and treated with Risuvastatin calcium tablet. The patients were randomly divided into two groups: treatment group (n = 40) and control group (n = 40). The two groups were treated with exercise and diet therapy, the control group was given Rishuvastatin calcium tablets, 5mg/ once a day, and warm water swallowing, while the treatment group was treated with Huatanluogan decoction on the basis of the control group, one bag per day, three times a day, and warm water swallowing. Both groups were treated for 12 weeks. On the first day of diagnosis and after treatment, the liver function (alanine aminotransferase ALT, aspartate aminotransferase AST, glutamyl transpeptidase GGT), lipid (total cholesterol TC, triglyceride TG), liver ultrasound, body mass index, TCM syndrome) was observed and recorded. Adverse reactions, etc. The collected data were analyzed by SPSS21.0 statistical software. Results: (1) the total effective rate of the treatment group was 90.00%, that of the control group was 72.50%, there was significant difference between the two groups (P < 0.0140.05), which indicated that the therapeutic effect of non-alcoholic steatohepatitis was better than that of the control group. (2) in the improvement of liver function, the ALT,AST,GGT of the two groups decreased significantly after treatment, and compared with that of the control group, and the treatment group of Huatanruogan decoction combined with Ruishuvastatin calcium tablet was better than the control group. (2) in the improvement of liver function, both groups decreased significantly after treatment. The difference between the two groups was statistically significant (P0.05), indicating that the treatment group could improve the liver function of the patients with non-alcoholic steatohepatitis. (3) in the improvement of blood lipid, the TC,TG of the two groups decreased after treatment. However, the treatment group was better than the control group (P0.05), indicating that the treatment group was more effective in reducing the level of blood lipid in patients with non-alcoholic steatohepatitis. (4) in the improvement of liver ultrasound, After treatment, the performance of fatty liver was alleviated in both groups, especially in the treatment group (P0.01). Huatanluogan recipe combined with Risuvastatin calcium tablet has a good effect on improving the ultrasonic performance of liver in NASH. (5) in the aspect of body mass index decrease, both groups can reduce body mass index. But the treatment group can reduce the average body mass index more than 0.5 indexes after treatment, showing a good effect. (6) in the improvement of TCM syndrome, according to the related syndrome of phlegm-dampness internal obstruction in TCM, it can be divided into four main symptoms. After treatment, the syndrome disappeared in both groups, and the treatment group was significantly more than the control group (P0.05). At the same time, no matter the main symptoms, secondary symptoms or tongue veins in the treatment group, there was a significant improvement in the treatment group, both in the treatment group and in the control group (P0.05). The total curative effect was as high as 95.0%, indicating that the treatment group could significantly improve the syndrome and even cure the TCM-related syndrome. (7) in the safety aspect, 1 case of adverse reaction appeared in the treatment group and 3 cases of adverse reaction in the control group. Both drugs are safe and reliable. Conclusion: (1) Huatan Ruogan recipe is an effective drug for the treatment of non-alcoholic steatohepatitis, the total clinical effective rate of the treatment group is 90%, which is obviously better than that of the control group. (2) Huatanluogan recipe has a good improvement on liver function. (3) Huatan soft liver recipe can improve body mass obesity, body mass loss, right flutter distension, lack of appetite, fatigue, dizziness, nausea, and so on. (3) Huatan soft liver recipe can improve body mass obesity, body mass loss, right flank distension, lack of appetite, tiredness, dizziness, nausea, and so on. The symptoms related to phlegm-dampness internal obstruction of traditional Chinese medicine such as loose stool and abdominal distension. (4) in the treatment group, only one case of mild adverse reaction occurred in the treatment group, which indicated that the drug was safe and reliable.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R575
，
本文編號：2456135
本文鏈接：http://sikaile.net/yixuelunwen/xiaohjib/2456135.html
最近更新
教材專著
