本文選題：非酒精性脂肪性肝病　切入點：痰瘀證　出處：《福建中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:以丹瓜方干預非酒精性脂肪性肝病痰瘀證患者,觀察其臨床療效,探討丹瓜方的作用機理與療效特點,以指導臨床應用。方法:對符合納入標準的128例非酒精性脂肪性肝病痰瘀證患者采用隨機對照試驗,分為對照組及試驗組,肝功或血脂異常者服用甘草酸二銨或氟伐他汀鈉,為對照組,試驗組在對照組的基礎上加服丹瓜方,均以4周為1療程,3療程連用,均配合飲食、運動治療,觀察比較兩組間肝功、血脂、肝彩超以及中醫(yī)癥候積分等方面干預前后的變化情況。結果:1.肝功:對照組肝功正常部分的ALT、GGT較12周前稍有升高(P0.05、P0.01),試驗組肝功正常部分的ALT、AST、GGT均有小幅度降低,GGT低于對照組且有統(tǒng)計學差異(P0.05),AST、ALT組間雖無統(tǒng)計學差異,但試驗組前后差值明顯大于對照組。12周后兩組肝功異常部分的指標均有下降,試驗組稍低于對照組,尤以GGT明顯(P0.01)。2.血脂:兩組血脂正常部分12周后TC、LDL-C組間雖無統(tǒng)計學差異,但試驗組前后是下降的趨勢,對照組卻是上升,TG試驗組明顯低于對照組(P0.01),對照組TC、TG12周后升高且有統(tǒng)計學差異(P0.05,P0.01);兩組血脂異常部分干預后均有所下降,試驗組稍低于對照組,TC、TG組間有統(tǒng)計學差異(P0.05)。3.彩超積分情況:12周后兩組超聲積分均有下降,試驗組明顯低于對照組(P0.01),積分分布上試驗組0分的有8例,對照組1例,7分的試驗組無,對照組較前增加1例,共2例。4.中醫(yī)證候積分情況:12周后兩組積分均有所下降,試驗組低于對照組,組間差異顯著(P0.01)。結論:1.丹瓜方能恢復NAFLD痰瘀證患者肝功,調節(jié)血脂,改善肝臟彩超情況及患者臨床癥狀及癥候,安全性好,無不良反應;2.肝功、血脂大致正常的NAFLD患者不予治療,指標短期內可能有升高的趨勢,而丹瓜方能有效遏制病情發(fā)展;3.丹瓜方可能是通過化痰祛瘀,消除氧化應激,減少脂肪異位積沉,來保護肝臟、降低血脂、改善癥狀而發(fā)揮防治NAFLD的療效。
[Abstract]:Objective: to observe the clinical effect of Dangua recipe in treating patients with phlegm and stasis syndrome of non-alcoholic fatty liver disease, and to explore the mechanism and characteristics of Dangua recipe. Methods: 128 cases of non-alcoholic fatty liver disease with phlegm stasis syndrome were randomly divided into control group and experimental group. Patients with abnormal liver function or blood lipid were treated with diammonium glycyrrhizinate or fluvastatin sodium. For the control group, the experimental group took Dangua recipe on the basis of the control group, all of them were treated with 4 weeks as a course of treatment and 3 courses of treatment, all of them were combined with diet and exercise therapy, and observed and compared the liver function and blood lipid between the two groups. Results: 1. Liver function: the alt GGT of the normal part of liver function in the control group was slightly higher than that of 12 weeks ago, and the GGT of the normal part of liver function in the experimental group was lower than that of the normal part of liver function. There was no statistical difference between the control group and the control group. But the difference between the experimental group and the control group was significantly higher than that in the control group after 12 weeks. The indexes of the abnormal part of liver function in the experimental group were lower than those in the control group, especially in the GGT group, especially in the control group (P 0.01). 2. Blood lipid: there was no statistical difference between the two groups after 12 weeks after the normal part of blood lipids in the two groups, and there was no significant difference between the two groups. However, there was a downward trend before and after treatment in the experimental group, but the TG test group in the control group was significantly lower than that in the control group (P 0.01), the TCU TG12 in the control group was higher than that in the control group after 12 weeks, and there was a statistical difference between the two groups. There was a statistical difference between the experimental group and the control group in TCTG. There was a significant difference between the two groups. After 12 weeks, the ultrasonic score of the two groups decreased, and that of the test group was significantly lower than that of the control group (P 0.01). The score distribution of the test group was 0 in 8 cases. There were 1 case in the control group, none in the test group with a score of 7, 1 case in the control group, and 2 cases in the control group. The score of TCM syndromes decreased in both groups after 12 weeks, and the score in the test group was lower than that in the control group. Conclusion: Dangua prescription can recover liver function of NAFLD patients with phlegm and stasis syndrome, regulate blood lipid, improve liver color ultrasound and clinical symptoms and symptoms of patients, have good safety and no adverse reactions. 2. Liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, liver function, If the patients with NAFLD with normal blood lipids are not treated, the indexes may increase in a short period of time, and Dangua prescription can effectively curb the development of the disease. 3. Dangua prescription may be used to eliminate oxidative stress and reduce the accumulation of fat ectopic by removing phlegm and removing blood stasis. To protect the liver, reduce blood lipids, improve symptoms and play a role in the prevention and treatment of NAFLD.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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