發(fā)布時(shí)間：2018-01-12 16:39

  本文關(guān)鍵詞：健脾疏肝降脂方治療非酒精性脂肪肝（肝郁脾虛證）的臨床研究　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 健脾疏肝降脂方 非酒精性脂肪性肝病 血脂康膠囊 臨床療效

【摘要】：目的:探討健脾疏肝降脂方對非酒精性脂肪肝(肝郁脾虛證)患者臨床癥狀、體征的作用及對患者血脂的影響,以期為臨床治療NAFLD提供有效方劑。方法:采用SPSS17.0軟件,由計(jì)算機(jī)產(chǎn)生隨機(jī)數(shù)字,入選患者102人按就診順序1:1隨機(jī)分配入治療組和對照組。兩組均給予一般基礎(chǔ)治療,即低糖、低脂平衡膳食,減少蔗糖、反式脂肪酸、飽和脂肪酸的攝入,增加膳食纖維的攝入,中等量有氧運(yùn)動(dòng)。對照組在一般治療基礎(chǔ)上加用血脂康膠囊,治療組在一般治療基礎(chǔ)上加用健脾疏肝降脂方,療程8周。觀察指標(biāo)與療效性指標(biāo)分別予治療前后各監(jiān)測一次。結(jié)果:(1)兩組患者一般情況分析:經(jīng)獨(dú)立樣本t檢驗(yàn)和卡方檢驗(yàn),兩組在年齡、性別分布上無統(tǒng)計(jì)學(xué)差異(P0.05)。(2)綜合療效:按照綜合療效評定標(biāo)準(zhǔn),試驗(yàn)組總有效率78.4%;對照組總有效率54.9%。經(jīng)Ridit分析,兩組具有統(tǒng)計(jì)學(xué)差異(P0.05)。(3)中醫(yī)證候療效:按照中醫(yī)證候療效評定標(biāo)準(zhǔn),試驗(yàn)組總有效率為84.3%;對照組總有效率為58.8%。經(jīng)Ridit分析,兩組相比有統(tǒng)計(jì)學(xué)差異(P0.05)。(4)中醫(yī)證候總積分:按照臨床癥狀體征療效的判定標(biāo)準(zhǔn),治療前兩組在中醫(yī)證候總積分上,無統(tǒng)計(jì)學(xué)差異(P0.05);治療后兩組在中醫(yī)證候總積分上,具有統(tǒng)計(jì)學(xué)差異(P0.05)。(5)治療前后兩組中醫(yī)各證候積分:按照癥狀和體征分級量化表評定標(biāo)準(zhǔn),治療前,兩組在癥狀、體征等方面均無統(tǒng)計(jì)學(xué)差異(P0.05);治療后,與對照組相比,試驗(yàn)組在抑郁煩悶、脅肋脹滿或疼痛、腹痛欲瀉、大便稀溏方面具有統(tǒng)計(jì)學(xué)差異(P0.05),在腹脹、食欲不振、噯氣、舌質(zhì)、舌苔、脈象方面無統(tǒng)計(jì)學(xué)差異(P0.05)。組內(nèi)相比較,對照組與試驗(yàn)組患者在治療前后的脈象方面無統(tǒng)計(jì)學(xué)差異(P0.05),在其它癥狀、體征方面具有統(tǒng)計(jì)學(xué)差異(P0.05)。(6)血脂四項(xiàng)指標(biāo)療效:組間相比較,試驗(yàn)組與對照組在治療前的HDL-C、CHOL、TG、LDL-C實(shí)驗(yàn)室指標(biāo)方面無統(tǒng)計(jì)學(xué)差異(P0.05)。試驗(yàn)組與對照組在治療后的HDL-C指標(biāo)上無統(tǒng)計(jì)學(xué)差異(P0.05),在LDL-C、TG方面具有統(tǒng)計(jì)學(xué)差異(P0.05),在CHOL方面具有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。組內(nèi)相比較,試驗(yàn)組與對照組在治療前后的HDL-C、CHOL、TG、LDL-C方面具有統(tǒng)計(jì)學(xué)差異(P0.05)。(7)影像學(xué)療效:按照彩超療效評價(jià)標(biāo)準(zhǔn),試驗(yàn)組總有效率為80.4%;對照組總有效率為56.9%。經(jīng)Ridit分析,兩組具有統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:通過以上統(tǒng)計(jì)學(xué)分析,可以得出結(jié)論,健脾疏肝降脂方不僅可以顯著改善非酒精性脂肪性肝病患者的癥狀、體征,而且可以改善患者甘油三酯、總膽固醇、高密度脂蛋白、低密度脂蛋白等臨床指標(biāo),是治療NAFLD的有效方藥。
[Abstract]:Objective: To investigate the effect of Jianpi Shugan Jiangzhi Decoction on nonalcoholic fatty liver (liver stagnation and spleen deficiency syndrome) clinical symptoms, signs and the effects on blood lipid, in order to provide an effective prescription for the treatment of NAFLD. Methods: using SPSS17.0 software, generate random numbers by a computer, 102 patients were randomly assigned 1:1 in the treatment group and control group. Two groups were given basic treatment, low sugar, low-fat diet balance, reducing sugar, trans fatty acid intake of saturated fatty acids, increasing dietary fiber intake, moderate aerobic exercise. The control group on the basis of general treatment with Xuezhikang Capsule treatment. On the basis of the general treatment group with Jianpi Shugan Jiangzhi Decoction, 8 weeks treatment. Observation index and efficacy index before and after treatment to the monitoring time. Results: (1) of the two groups of patients with general condition: the independent sample t test and chi square Test, the two groups in age, there was no significant difference in gender distribution (P0.05). (2) the comprehensive curative effect: according to the comprehensive evaluation standard of test group, the total efficiency of 78.4%; control group, the total efficiency of 54.9%. by Ridit analysis, the two groups were statistically different (P0.05). (3): according to TCM syndrome curative effect the standard of TCM syndrome curative effect, the total effective rate of experimental group was 84.3%; the control group the total efficiency of 58.8%. by Ridit analysis, two groups were significantly different (P0.05). (4) the total score of TCM syndrome: according to the criteria of clinical symptoms and signs of efficacy of the two groups before treatment in TCM syndrome integral, no significant difference (P0.05); the two groups after treatment in TCM syndrome total score, with statistical difference (P0.05). (5) before and after treatment of the two groups of TCM syndrome integral: according to the symptoms and signs of quantitative table classification evaluation standard, before treatment, the two groups in symptoms, there were no statistically signs etc. The difference (P0.05); after treatment, compared with control group, experimental group in depression depressed, rib swelling or pain, abdominal pain for diarrhea, loose stool has significant difference (P0.05), the loss of appetite, abdominal distension, belching, tongue, tongue, pulse was no difference (P0.05) in the group. Compared to the control group and the experimental group of patients before and after treatment, there was no significant difference of the pulse (P0.05), with statistical difference in other symptoms, signs (P0.05). (6) the four lipid indicators: effect of group comparison, the experimental group and the control group before treatment, HDL-C, CHOL, TG. There was no significant difference in LDL-C laboratory index (P0.05). No significant difference between the experimental group and the control group after treatment HDL-C index (P0.05), in LDL-C, with statistical difference TG (P0.05), the difference was statistically significant in CHOL group (P0.01). In comparison, the experimental group and the control group in the cure Before and after the treatment of HDL-C, CHOL, TG, with statistical difference (P0.05). LDL-C (7): Color Doppler imaging efficacy evaluation in accordance with the standard of curative effect, the total efficiency of the test group was 80.4%; the control group the total efficiency of 56.9%. by Ridit analysis, the two groups were statistically different (P0.05). Conclusion: through the above the statistical analysis, it can be concluded that Jianpi Shugan Jiangzhi Decoction can significantly improve patients with nonalcoholic fatty liver disease symptoms, signs, but also can improve the patients with triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein and other clinical indicators, is a effective prescription for the treatment of NAFLD.

【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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