泄?jié)峤舛緶珜Ψ蔷凭灾靖尾〖把迨菟氐呐R床觀察
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本文關(guān)鍵詞：泄?jié)峤舛緶珜Ψ蔷凭灾靖尾〖把迨菟氐呐R床觀察 出處：《河北醫(yī)科大學(xué)》2016年碩士論文 論文類型：學(xué)位論文
更多相關(guān)文章： 泄?jié)峤舛緶?/b> 非酒精性脂肪肝病 血清瘦素 臨床研究 療效
【摘要】：背景:非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是消化系統(tǒng)的常見疾病之一,其發(fā)病率呈逐年上升趨勢,是常見的危害人類身體健康的嚴(yán)重隱患,并逐漸引起了人們的重視。現(xiàn)代醫(yī)學(xué)治療該病多是單靶點治療,而祖國醫(yī)學(xué)則從病人整體出發(fā),或根據(jù)病人體質(zhì),或結(jié)合疾病發(fā)病原因和規(guī)律,把各相關(guān)因素綜合分析,更符合NAFL的病因病機;在治療上講究的是辨證論治、整體觀念,全面調(diào)節(jié)患者氣血陰陽失衡,因而療效確切,且毒副作用少,展現(xiàn)了中醫(yī)藥治療非酒精性脂肪肝病的廣闊前景。本課題旨在探討泄?jié)峤舛緶委煼蔷凭灾靖尾∨R床療效的觀察及其對血清瘦素(Leptin,LP)的影響,為中醫(yī)治療非酒精性脂肪肝病提供臨床及實驗室依據(jù)。目的:本課題通過探討泄?jié)峤舛緶珜Ψ蔷凭灾靖尾〖把迨菟氐呐R床療效觀察,為中醫(yī)治療NAFLD提供科學(xué)依據(jù)。方法:依據(jù)中華醫(yī)學(xué)會肝臟病學(xué)分會制定的非酒精性脂肪性肝病診療指南(2010)診斷標(biāo)準(zhǔn),收集2013.11-2014.12我院門診及住院非酒精性脂肪性肝病患者80例。所有病例均無自身免疫性疾病、急性感染性疾病或腫瘤者。由研究生本人調(diào)查所有研究對象的一般情況:性別、年齡、既往史、體重、病史等。泄?jié)峤舛緶委烴AFLD前后彩超對比,血脂(總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、極低密度脂蛋白),肝功能(谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶、γ-谷氨酰轉(zhuǎn)肽酶、堿性磷酸酶),體重指數(shù)(BMI),血清瘦素(LP)等指標(biāo)。兩組患者均給予健康生活方式指導(dǎo),如根據(jù)肝功能情況適量進(jìn)行有氧運動、禁酒、多食低脂及低碳水化合物飲食、多食果蔬、控制熱量攝入,控制體重。治療組-泄?jié)峤舛緶?茯苓20g、柴胡12g、生山楂12g、虎杖12g、澤瀉12g、茵陳20g、佩蘭15g、酒大黃9g、瓜蔞12g、豬苓12g、蒲公英15g、青皮12g、陳皮12g、丹參20g),水煎煮2次,共取汁400ml,每天分早晚2次溫服。對照組---阿托伐他汀鈣片(20mg立普妥)口服,每天晚服1次。治療時間:8周采用SPSS 17.0統(tǒng)計軟件建立數(shù)據(jù)庫。計量資料采用t檢驗,率或構(gòu)成比比較采用2?檢驗。采用非條件Logistic回歸分析,多元統(tǒng)計分析,P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果1泄?jié)峤舛緶珜Ψ蔷凭灾靖尾∨R床療效優(yōu)于阿托伐他汀鈣組,差異有統(tǒng)計學(xué)意義(P0.05)。2泄?jié)峤舛緶^對照組能明顯降低血清瘦素水平(P0.05)。3泄?jié)峤舛緶珶o副作用,阿托伐他汀鈣組有副作用。結(jié)論1泄?jié)峤舛緶珜岫緝?nèi)蘊型非酒精性脂肪肝病有顯著療效,能有效緩解非酒精性脂肪肝病患者的臨床癥狀。2泄?jié)峤舛緶委煼蔷凭灾靖伟踩珶o毒副作用的中藥復(fù)方制劑。3泄?jié)峤舛緶珜Ψ蔷凭灾靖尾』颊叩难迨菟赜薪档妥饔谩?br/>[Abstract]:Background: non-alcoholic fatty liver disease (NAFLD) is a common disease of the digestive system. Its incidence is increasing year by year. It is a serious hidden danger to human health, and has gradually attracted the attention of people. Modern medical treatment of this disease is the treatment of single target, and the traditional Chinese medicine from the point of view of the whole patient or patient, according to the constitution, or a combination of disease causes and rules, make a comprehensive analysis of all relevant factors, more in line with the pathogenesis of NAFL; pay attention to in the treatment of syndrome differentiation, the overall concept of comprehensive regulation the imbalance of yin and Yang Qi and blood, so the curative effect, and less side effects, showing a broad prospect of traditional Chinese medicine in the treatment of nonalcoholic fatty liver disease. The aim of this study is to investigate the clinical efficacy of Xie Zhuo Jiedu Decoction in the treatment of non-alcoholic fatty liver disease and its effect on serum Leptin (LP), so as to provide clinical and laboratory evidence for the treatment of non-alcoholic fatty liver disease by TCM. Objective: To observe the clinical efficacy of Zhuo Zhuo Jiedu Decoction on non-alcoholic fatty liver disease and serum leptin, and to provide a scientific basis for the treatment of NAFLD in traditional Chinese medicine. Methods: according to the diagnostic criteria of nonalcoholic fatty liver disease (2010) formulated by the Chinese Medical Association's liver disease branch (80), we collected 80 cases of non-alcoholic fatty liver disease in our hospital. All cases had no autoimmune disease, acute infectious disease or tumor. The general situation of all the subjects was investigated by the graduate student: sex, age, past history, weight, history and so on. Comparison of color Doppler ultrasound before and after discharge of Huazhuo Jiedu Decoction in the treatment of NAFLD, serum lipids (total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, low density lipoprotein), liver function (alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase), body mass index (BMI), serum leptin (LP) and other indicators. Two groups of patients were given healthy lifestyle guidance, such as aerobic exercise, temperance, eating low fat and low carbohydrate diet, eating more fruits and vegetables, controlling caloric intake and controlling body weight according to liver function. The treatment group - xiezhuojiedu Decoction (Poria 20g, bupleurum root 12g, hawthorn 12g, 12g, 12g, Alisma Polygonum Artemisia 20g, Perrin 15g, 9g, 12g, rhubarb, dandelion Trichosanthes Polyporus 12g 15g, green 12g, tangerine peel 12g, Salvia 20g), boiling water 2 times, take juice 400ml, every day sooner or later the 2 times. The control group - Atorvastatin Calcium Tablets (20mg Lipitor) orally, 1 times every night. Time of treatment: 8 weeks by using SPSS 17 statistical software to establish a database. T test was used for the measurement data, and the ratio or composition ratio was compared to 2? Test. Using non conditional Logistic regression analysis and multivariate statistical analysis, the difference of P0.05 was statistically significant. Results the clinical effect of 1 detoxification and detoxifying Decoction on nonalcoholic fatty liver disease was better than that of atorvastatin group (P0.05). Compared with the control group, the serum leptin level (P0.05) was significantly lower than that in the control group (P0.05). There is no side effect in 3 detoxification and detoxifying decoction, and the atorvastatin calcium group has side effects. Conclusion 1 detoxification and detoxifying decoction has significant effect on non alcoholic fatty liver disease with Turbid Toxin and can effectively relieve the clinical symptoms of nonalcoholic fatty liver disease. 2 the traditional Chinese medicine compound preparation for the treatment of non-alcoholic fatty liver and non-toxic side effects in the treatment of nonalcoholic fatty liver. The 3 detoxification and detoxifying decoction can reduce the serum leptin in patients with non-alcoholic fatty liver disease.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
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