蔥白提取物聯(lián)合針刺療法治療非酒精性脂肪性肝病（痰瘀互結(jié)型）的臨床觀察
發(fā)布時間：2018-08-06 12:14
【摘要】：目的： 觀察運(yùn)用蔥白提取物聯(lián)合針刺療法在臨床上治療非酒精性脂肪性肝病（痰瘀互結(jié)型）的治療效果，對中醫(yī)內(nèi)外合治法在治療非酒精性脂肪性肝病中的臨床療效予以客觀評價。 方法： 選取2012年3月至2012年8月期間在武漢市一醫(yī)院消化內(nèi)科門診、脾胃外治中心、住院病房及醫(yī)院體檢中心就診人群中符合病例標(biāo)準(zhǔn)的NAFLD痰瘀互結(jié)型患者共65例，隨機(jī)分為兩組，其中蔥白提取物聯(lián)合針刺療法治療組33例（治療組），多烯磷脂酰膽堿對照組32例（對照組）。兩組均在予以行為和生活方式干預(yù)、調(diào)整飲食、加強(qiáng)運(yùn)動的基礎(chǔ)上，對照組予以多烯磷脂酰膽堿膠囊（易善復(fù)）每次456mg口服，每日三次。治療組予以蔥白提取物（博心通軟膠囊）每次800mg（2粒）口服，每日兩次；同時予以針刺治療，辨證選穴分組：第一組：豐隆、足三里、三陰交、中脘、陽陵泉、章門；第二組：膈俞、膻中、期門、肝俞、太沖、合谷；每次選取一組穴位，針刺得氣后留針30min，期間行針1次，中-強(qiáng)度刺激；一天一次；同一組穴位連續(xù)針刺6天，休息1天后換用另一組穴位。兩組均以12周為一個療程。療程結(jié)束后觀察兩組療效情況，包括治療前后及組間中醫(yī)癥狀評分，超聲檢查分度積分，人體學(xué)指標(biāo)（身高、體重、腰圍、BMI）、肝功能（ALT、AST、GGT）、血脂（TC、TG、HDL-C、LDL-C）、動脈血壓和空腹血糖，并進(jìn)行統(tǒng)計(jì)學(xué)分析。 采用SPSS19.0軟件進(jìn)行數(shù)據(jù)管理和統(tǒng)計(jì)學(xué)分析。本研究均采用雙側(cè)檢驗(yàn)，以P＜0.05為有顯著性差異，以P＜0.01為有非常顯著性差異的標(biāo)準(zhǔn)。計(jì)量資料用x±S表示，若服從正態(tài)分布（方差齊），組內(nèi)采用配對比較t檢驗(yàn)，組間采用兩樣本比較t檢驗(yàn)；若不服從正態(tài)分布（方差不齊）則采用秩和檢驗(yàn)；等級資料采用秩和檢驗(yàn)；計(jì)數(shù)資料采用χ2檢驗(yàn)。 結(jié)果： 1.按照總體療效評定標(biāo)準(zhǔn)，治療組總有效率為84.85%，對照組總有效率為78.13%，兩組患者治療后總體療效比較有顯著性差異（P＜0.05）， 具有統(tǒng)計(jì)學(xué)意義； 2.兩組患者治療前后人體學(xué)指標(biāo)（體重、腰圍及BMI）及血壓血糖比較無顯著性差異（P＞0.05）；兩組患者其他指標(biāo)治療后與治療前比較具有顯著性差異（P＜0.05或P＜0.01）；兩組患者治療后相關(guān)結(jié)果比較，其中治療組ALT、AST、TG與對照組比較，無顯著性差異（P＞0.05）；而治療組TC、HDL-C和LDL-C與對照組比較有顯著性差異（P＜0.05）；對照組GGT與治療組比較有顯著性差異（P＜0.05）； 3.按照超聲檢查分度積分評定標(biāo)準(zhǔn)，，兩組患者治療后超聲檢查分度積分與治療前比較均有顯著性差異（P＜0.05），但兩組患者治療后超聲檢查分度積分比較無顯著性差異（P＞0.05）； 4.按照中醫(yī)癥狀積分評定標(biāo)準(zhǔn)，兩組患者治療后中醫(yī)癥狀積分較治療前有顯著性差異（治療組P＜0.01，對照組P＜0.05）；治療后中醫(yī)癥狀積分治療組較對照組有顯著性差異（P＜0.05）。 結(jié)論： 本研究顯示兩種治療方法對NAFLD患者均有一定的治療作用，但治療組在改善患者臨床癥狀及TC、HDL-C和LDL-C等方面明顯優(yōu)于對照組，對照組在改善患者GGT等方面有一定優(yōu)勢，在超聲影像學(xué)等其他方面兩組療效相當(dāng)；充分顯示運(yùn)用“通陽”理論，采用蔥白提取物聯(lián)合針刺療法這一中醫(yī)內(nèi)外合治法治療NAFLD（痰瘀互結(jié)型）在改善患者癥狀及提高其生活質(zhì)量方面具有一定優(yōu)勢，值得進(jìn)一步研究和推廣。
[Abstract]:Objective:
To observe the effect of the treatment of nonalcoholic fatty liver disease (phlegm and blood stasis type) by the combination of scallion extract and acupuncture therapy, and to evaluate the clinical effect of internal and external combination therapy in the treatment of nonalcoholic fatty liver disease.
Method:
From March 2012 to August 2012, 65 cases of NAFLD phlegm and blood stasis syndrome in the outpatient of a hospital in a hospital in Wuhan, the external treatment center of the spleen and the stomach, the hospitalized ward and the hospital check-up center, were randomly divided into two groups, including 33 cases (treatment group) and polyene phosphatidyl group in the group of scallion extract combined with acupuncture treatment group. 32 cases (control group) were treated with choline control group. On the basis of the intervention of behavior and lifestyle, diet adjustment and exercise, the control group was given Polyene Phosphatidylcholine Capsules (Yi Shanfu) every time 456mg oral, three times a day. The treatment group was given the onion extract (Bo Xin Tong soft capsule) for oral 800mg (2 grains) each time, two times a day. The first group: Fenglong, Zusanli, Sanyinjiao, Zhong Wan, Yang Ling spring, Zhang gate in the first group: second groups: phrenic Shu, Shan Zhong, Lianshu, Tai Chung, Hegu; each select a group of acupoints, the needle after the gas is 30min, 1 times the needle, medium intensity stimulation; once a day, the same group of acupuncture points for 6 days, rest. 1 days after another group of acupoints, the two groups were treated with 12 weeks as a course of treatment. After the end of the course, the two groups of curative effects were observed, including the symptom score of the Chinese medicine before and after the treatment, the score score of ultrasonic examination, the index of human body (height, weight, waist circumference, BMI), the liver function (ALT, AST, GGT), the blood lipid (TC, TG, HDL-C, LDL-C), arterial blood pressure and fasting blood glucose, and the arterial blood pressure and fasting blood glucose. Statistical analysis.
SPSS19.0 software was used for data management and statistical analysis. The results were both bilateral and P < 0.05, with P < 0.01 as the standard of very significant difference. The measurement data were expressed in X + S, if the normal distribution (Fang Chaqi) was subordinate to the normal distribution (Fang Chaqi), the paired comparison t test was used in the group, and two samples were compared with the t test among the groups. Rank sum test was used if normal distribution was not obeyed.Rank sum test was used for grade data and_2test was used for count data.
Result:
1. according to the overall evaluation standard of curative effect, the total effective rate of the treatment group was 84.85%, the total effective rate of the control group was 78.13%. The total curative effect of the two groups was significantly different (P < 0.05), and the total effective rate of the control group was significantly different (P < 0.05).
It has statistical significance.
2. there was no significant difference in the anthropometric indexes (weight, waist circumference and BMI) and blood pressure before and after treatment in the two groups (P > 0.05). The other indexes in the two groups were significantly different from those before treatment (P < 0.05 or P < 0.01). The two groups were compared with the treatment group, including ALT, AST, and TG in the treatment group, and there was no comparison between the control group and the control group. The difference was significant (P > 0.05), while the TC, HDL-C and LDL-C in the treatment group were significantly different from those in the control group (P < 0.05), and there was a significant difference between the control group and the treatment group (P < 0.05).
3. according to the evaluation criteria of ultrasonic examination scores, there were significant differences between the two groups after treatment (P < 0.05), but there was no significant difference between the two groups after treatment (P > 0.05).
4. according to the evaluation standard of TCM symptom score, there was significant difference between the two groups after treatment (P < 0.01 in the treatment group and P < 0.05 in the control group), and there was significant difference between the treatment group and the control group after treatment (P < 0.05).
Conclusion:
This study shows that two treatment methods have some therapeutic effect on NAFLD patients, but the treatment group is obviously superior to the control group in improving the clinical symptoms and TC, HDL-C and LDL-C. The control group has some advantages in improving the patient's GGT and other aspects, and the curative effect is equivalent in the other sides of the other sides of the ultrasound imaging and other sides; fully display the use of "Tong Yang". In theory, the combination of scallion extract and acupuncture therapy in the treatment of NAFLD (phlegm and blood stasis type) has some advantages in improving the patient's symptoms and improving the quality of life. It is worth further research and promotion.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R259;R246.1
本文編號：2167697
[Abstract]:Objective:
To observe the effect of the treatment of nonalcoholic fatty liver disease (phlegm and blood stasis type) by the combination of scallion extract and acupuncture therapy, and to evaluate the clinical effect of internal and external combination therapy in the treatment of nonalcoholic fatty liver disease.
Method:
From March 2012 to August 2012, 65 cases of NAFLD phlegm and blood stasis syndrome in the outpatient of a hospital in a hospital in Wuhan, the external treatment center of the spleen and the stomach, the hospitalized ward and the hospital check-up center, were randomly divided into two groups, including 33 cases (treatment group) and polyene phosphatidyl group in the group of scallion extract combined with acupuncture treatment group. 32 cases (control group) were treated with choline control group. On the basis of the intervention of behavior and lifestyle, diet adjustment and exercise, the control group was given Polyene Phosphatidylcholine Capsules (Yi Shanfu) every time 456mg oral, three times a day. The treatment group was given the onion extract (Bo Xin Tong soft capsule) for oral 800mg (2 grains) each time, two times a day. The first group: Fenglong, Zusanli, Sanyinjiao, Zhong Wan, Yang Ling spring, Zhang gate in the first group: second groups: phrenic Shu, Shan Zhong, Lianshu, Tai Chung, Hegu; each select a group of acupoints, the needle after the gas is 30min, 1 times the needle, medium intensity stimulation; once a day, the same group of acupuncture points for 6 days, rest. 1 days after another group of acupoints, the two groups were treated with 12 weeks as a course of treatment. After the end of the course, the two groups of curative effects were observed, including the symptom score of the Chinese medicine before and after the treatment, the score score of ultrasonic examination, the index of human body (height, weight, waist circumference, BMI), the liver function (ALT, AST, GGT), the blood lipid (TC, TG, HDL-C, LDL-C), arterial blood pressure and fasting blood glucose, and the arterial blood pressure and fasting blood glucose. Statistical analysis.
SPSS19.0 software was used for data management and statistical analysis. The results were both bilateral and P < 0.05, with P < 0.01 as the standard of very significant difference. The measurement data were expressed in X + S, if the normal distribution (Fang Chaqi) was subordinate to the normal distribution (Fang Chaqi), the paired comparison t test was used in the group, and two samples were compared with the t test among the groups. Rank sum test was used if normal distribution was not obeyed.Rank sum test was used for grade data and_2test was used for count data.
Result:
1. according to the overall evaluation standard of curative effect, the total effective rate of the treatment group was 84.85%, the total effective rate of the control group was 78.13%. The total curative effect of the two groups was significantly different (P < 0.05), and the total effective rate of the control group was significantly different (P < 0.05).
It has statistical significance.
2. there was no significant difference in the anthropometric indexes (weight, waist circumference and BMI) and blood pressure before and after treatment in the two groups (P > 0.05). The other indexes in the two groups were significantly different from those before treatment (P < 0.05 or P < 0.01). The two groups were compared with the treatment group, including ALT, AST, and TG in the treatment group, and there was no comparison between the control group and the control group. The difference was significant (P > 0.05), while the TC, HDL-C and LDL-C in the treatment group were significantly different from those in the control group (P < 0.05), and there was a significant difference between the control group and the treatment group (P < 0.05).
3. according to the evaluation criteria of ultrasonic examination scores, there were significant differences between the two groups after treatment (P < 0.05), but there was no significant difference between the two groups after treatment (P > 0.05).
4. according to the evaluation standard of TCM symptom score, there was significant difference between the two groups after treatment (P < 0.01 in the treatment group and P < 0.05 in the control group), and there was significant difference between the treatment group and the control group after treatment (P < 0.05).
Conclusion:
This study shows that two treatment methods have some therapeutic effect on NAFLD patients, but the treatment group is obviously superior to the control group in improving the clinical symptoms and TC, HDL-C and LDL-C. The control group has some advantages in improving the patient's GGT and other aspects, and the curative effect is equivalent in the other sides of the other sides of the ultrasound imaging and other sides; fully display the use of "Tong Yang". In theory, the combination of scallion extract and acupuncture therapy in the treatment of NAFLD (phlegm and blood stasis type) has some advantages in improving the patient's symptoms and improving the quality of life. It is worth further research and promotion.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R259;R246.1
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