痰濕方聯(lián)合健康管理治療非酒精性脂肪性肝炎的臨床觀察
發(fā)布時間：2018-08-04 18:59
【摘要】：目的觀察痰濕方聯(lián)合健康管理治療非酒精性脂肪性肝炎(痰濕內(nèi)阻證)的臨床治療效果及評價其應(yīng)用安全性。方法將2014年11月至2016年11月期間于湖北省中醫(yī)院光谷院區(qū)肝病科門診就診的90例非酒精性脂肪性肝炎患者(痰濕內(nèi)阻證)隨機分為3組,其中西藥組30例患者予口服多烯磷脂酰膽堿膠囊,2顆/次,3次/日治療,并進(jìn)行口頭健康宣教;中藥組30例患者予口服中藥散裝配方顆粒痰濕方1劑/日治療,并進(jìn)行口頭健康宣教;聯(lián)合組30例患者予口服中藥散裝配方顆粒痰濕方1劑/日治療,及基于“肝好”APP實施的個體化飲食、運動方案。總療程3個月,觀察治療前后3組患者臨床證候積分變化,檢測腰臀比(WHR)、體重指數(shù)(BMI)、實施脂肪衰減參數(shù)(FAI)、肝功能(ALT、AST、GGT)、血脂(TC、TG、HDL-C、LDL-C)及超聲影像學(xué)變化情況,并于治療過程中第0、1、2、3個月對中藥組及聯(lián)合組進(jìn)行生命體征及心電圖、腎功能、血常規(guī)、尿常規(guī)、糞常規(guī)檢查,通過SPSS17.0軟件系統(tǒng)對上述所得數(shù)據(jù)進(jìn)行分析,比較3組臨床療效并評價痰濕方安全性。結(jié)果(1)治療前,90例非酒精性脂肪性肝炎患者,各項觀測指標(biāo)比較,差異皆沒有統(tǒng)計學(xué)意義(P0.05),具有可比性。(2)療程結(jié)束后,組內(nèi)比較結(jié)果如下1.西藥組ALT、AST、GGT、證候積分與治療前相比降低,差異有統(tǒng)計學(xué)意義(P0.05);其他觀測指標(biāo)與治療前相比,差異皆沒有統(tǒng)計學(xué)意義(P0.05)。2.中藥組ALT、AST、GGT、TG、LDL-C、FAI、證候積分與治療前相比皆降低,差異皆有統(tǒng)計學(xué)意義(P0.05);HDL-C較治療前升高,差異具有統(tǒng)計學(xué)意義(p0.05);余觀測指標(biāo)較治療前差異無統(tǒng)計學(xué)意義(p0.05)。3.聯(lián)合組alt、ast、ggt、tc、tg、ldl-c、fai、whr、bmi與治療前相比降低,差異有統(tǒng)計學(xué)意義(p0.05);hdl-c較治療前升高,差異有統(tǒng)計學(xué)意義(p0.05),b超分度較治療前降低,差異有統(tǒng)計學(xué)意義(p0.05)。(3)療程結(jié)束后,組間比較結(jié)果如下1.總有效率比較西藥組總有效率為40.0%,中藥組為46.7%,聯(lián)合組為83.3%。中藥組總體療效優(yōu)于西藥組,但差異無統(tǒng)計學(xué)意義(p0.05);聯(lián)合組總體療效優(yōu)于中藥組、西藥組,差異具有統(tǒng)計學(xué)意義(p0.05)。2.肥胖指標(biāo)及fai比較中藥組bmi、whr與西藥組比較,差異無統(tǒng)計學(xué)意義(p0.05);中藥組fai較西藥組降低,差異具有統(tǒng)計學(xué)意義(p0.05);聯(lián)合組bmi、whr、fai與中藥組、西藥組比較明顯降低,差異均具有統(tǒng)計學(xué)意義(p0.05)。3.肝功能指標(biāo)比較中藥組alt、ast、ggt與西藥組比較均降低,差異有統(tǒng)計學(xué)意義(p0.05);聯(lián)合組alt、ast、ggt與中藥組相比,差異無統(tǒng)計學(xué)意義(p0.05)。4.血脂指標(biāo)比較中藥組tg、ldl-c與西藥組相比降低,差異有統(tǒng)計學(xué)意義(p0.05);中藥組hdl-c較西藥組升高,差異有統(tǒng)計學(xué)意義(p0.05);聯(lián)合組tg、tc、ldl-c與中藥組相比降低,差異有統(tǒng)計學(xué)意義(p0.05);聯(lián)合組hdl-c較中藥組升高,差異有統(tǒng)計學(xué)意義(p0.05)。5.b超分度比較中藥組b超分度與西藥組比較,差異無統(tǒng)計學(xué)意義(p0.05);聯(lián)合組與中藥組、西藥組比較b超分度降低,差異均具有統(tǒng)計學(xué)意義(p0.05)。聯(lián)合組及中藥組的中醫(yī)證候積分與西藥組比較均明顯降低,差異均具有統(tǒng)計學(xué)意義(P0.05);聯(lián)合組證候積分與中藥組比較降低,差異無統(tǒng)計學(xué)意義(P0.05)。6.中醫(yī)證候積分比較(4)安全性評價中藥組及聯(lián)合組患者第0、1、2、3個月生命體征穩(wěn)定,心電圖、腎功能、血常規(guī)、尿常規(guī)、糞常規(guī)等檢查均未發(fā)現(xiàn)明顯異常。結(jié)論1.痰濕方聯(lián)合基于“肝好”APP實施的健康管理,治療非酒精性脂肪性肝炎的總體療效明顯優(yōu)于痰濕方組及多烯磷脂酰膽堿膠囊組,其作用體現(xiàn)在改善患者的臨床癥狀、腰臀比、體重指數(shù)、脂肪衰減參數(shù)、肝功能指標(biāo)、血脂指標(biāo)及肝臟超聲影像學(xué)表現(xiàn)方面;優(yōu)勢體現(xiàn)在改善腰臀比、體重指數(shù)、脂肪衰減參數(shù)、血脂指標(biāo)(TC)、肝臟超聲影像學(xué)表現(xiàn)等方面,對非酒精性脂肪性肝炎有較好治療作用。2.單用痰濕方能夠很好地改善患者的臨床癥狀、肝功能指標(biāo)、血脂指標(biāo)(TG、LDL-C、HDL-C)及降低脂肪衰減參數(shù)。3.療程中,未發(fā)現(xiàn)與痰濕方明顯相關(guān)不良反應(yīng),痰濕方用于治療非酒精性脂肪性肝炎安全性良好。
[Abstract]:Objective To observe the clinical effect of phlegm dampness prescription combined with health management in the treatment of nonalcoholic steatohepatitis (phlegm dampness syndrome) and evaluate its application safety. Methods 90 patients with non-alcoholic steatohepatitis (phlegm dampness syndrome) were randomly selected from November 2014 to November 2016 in the clinic of Optics Valley Hospital of Hubei Provincial Traditional Chinese Medical Hospital. The western medicine group was divided into 3 groups, of which 30 patients in the western medicine group were given oral Polyene Phosphatidylcholine Capsules, 2 / times, 3 times / day, and oral health education. 30 patients in the Chinese medicine group were given oral traditional Chinese medicine granule Phlegm Recipe 1 / day treatment and oral health education, and 30 patients in the combined group were given oral traditional Chinese medicine granule phlegm dampness recipe 1 doses orally. Daily treatment, and the individualized diet based on "liver good" APP, a total course of exercise. The total course of treatment was 3 months. The changes of clinical syndrome scores in 3 groups of patients were observed before and after treatment. The waist to hip ratio (WHR), body mass index (BMI), fat attenuation parameter (FAI), liver function (ALT, AST, GGT), blood lipid (TC, TG, HDL-C, LDL-C), and ultrasonic imaging changes, and the treatment of ultrasound imaging, were treated and treated. In the course of the treatment, the life signs and electrocardiogram, renal function, blood routine, urine routine and fecal routine examination were performed on the Chinese medicine group and the combined group during the 0,1,2,3 month. The above data were analyzed by the SPSS17.0 software system, and the 3 groups of clinical effects were compared and the safety of the phlegm dampness was evaluated. Before the treatment, 90 cases of non alcoholic steatohepatitis were treated. The differences were not statistically significant (P0.05). (2) after the end of the course, the results were as follows: ALT, AST, GGT, compared with before treatment, and the difference was statistically significant (P0.05). The difference was not statistically significant (P0.05).2. traditional Chinese medicine compared with before treatment (P0.05). Group ALT, AST, GGT, TG, LDL-C, FAI, the syndrome scores were all lower than those before treatment, and the difference was statistically significant (P0.05); HDL-C was higher than before the treatment (P0.05), and there was no significant difference between the Yu Guance index and before the treatment (P0.05). There was statistical significance (P0.05); the difference was statistically significant (P0.05) compared with before treatment (P0.05), and the difference was statistically significant (P0.05). (3) after the end of the course, the total effective rate between the group and the western medicine group was 40%, the traditional Chinese medicine group was 46.7%, and the combined group was better than the 83.3%. group after the end of the treatment. Western medicine group, but the difference was not statistically significant (P0.05), the overall effect of the combined group was better than the traditional Chinese medicine group, the western medicine group, the difference had statistical significance (P0.05).2. obesity index and Fai compared with the Chinese medicine group BMI, WHR and Western medicine group, the difference was not statistically significant (P0.05); traditional Chinese medicine group Fai compared with western medicine group, the difference was statistically significant (P0.05); joint group BMI, BMI, WHR, FAI and traditional Chinese medicine group, the western medicine group was significantly lower, the difference was statistically significant (P0.05).3. liver function indexes compared with the Chinese medicine group alt, AST, GGT and Western medicine group were lower, the difference was statistically significant (P0.05), the group alt, AST, GGT compared with the traditional Chinese medicine group, there was no statistical significance (P0.05) compared with the Chinese medicine group Compared with the western medicine group, the difference was statistically significant (P0.05); the HDL-C in the Chinese medicine group was higher than the western medicine group, the difference was statistically significant (P0.05); the combination group TG, TC, LDL-C and the traditional Chinese medicine group were lower, the difference was statistically significant (P0.05); the joint group HDL-C was higher than the traditional Chinese medicine group, the difference was statistically significant (P0.05).5. B Ultrasound fraction compared with the Chinese medicine group B Ultrasound score. Compared with the western medicine group, the difference was not statistically significant (P0.05). Compared with the traditional Chinese medicine group and the western medicine group, the difference of B Ultrasound scores was statistically significant (P0.05). The TCM syndrome scores of the combined group and the Chinese medicine group were significantly lower than those in the western medicine group (P0.05); the syndrome scores of the combined group and the Chinese medicine group were compared. The difference was not statistically significant (P0.05).6. TCM syndrome score comparison (4) safety evaluation of the safety evaluation of the Chinese medicine group and the combined group of patients for 0,1,2,3 months of life signs stability, electrocardiogram, renal function, blood routine, urine routine, fecal routine examination have not found obvious abnormalities. Conclusion the 1. phlegm wet prescription based on "liver good" APP implementation of health management, treatment The overall effect of non-alcoholic steatohepatitis was obviously better than that of the phlegm and Polyene Phosphatidylcholine Capsules group. The effect was manifested in improving the patient's clinical symptoms, waist to hip ratio, body mass index, fat attenuation parameters, liver function index, blood lipid index and liver ultrasound imaging. The advantage is to improve the waist to hip ratio and body mass index. Fat attenuation parameters, blood lipid index (TC), liver ultrasound imaging and other aspects, it has a good therapeutic effect on non-alcoholic steatohepatitis,.2. can improve the clinical symptoms, liver function index, blood lipid index (TG, LDL-C, HDL-C) and decrease the adipose attenuation parameters in.3. course, and not found with phlegm dampness prescription. The side effects of phlegm dampness decoction are effective in the treatment of nonalcoholic steatohepatitis.
【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】：2017
【分類號】：R259
本文編號：2164816
[Abstract]:Objective To observe the clinical effect of phlegm dampness prescription combined with health management in the treatment of nonalcoholic steatohepatitis (phlegm dampness syndrome) and evaluate its application safety. Methods 90 patients with non-alcoholic steatohepatitis (phlegm dampness syndrome) were randomly selected from November 2014 to November 2016 in the clinic of Optics Valley Hospital of Hubei Provincial Traditional Chinese Medical Hospital. The western medicine group was divided into 3 groups, of which 30 patients in the western medicine group were given oral Polyene Phosphatidylcholine Capsules, 2 / times, 3 times / day, and oral health education. 30 patients in the Chinese medicine group were given oral traditional Chinese medicine granule Phlegm Recipe 1 / day treatment and oral health education, and 30 patients in the combined group were given oral traditional Chinese medicine granule phlegm dampness recipe 1 doses orally. Daily treatment, and the individualized diet based on "liver good" APP, a total course of exercise. The total course of treatment was 3 months. The changes of clinical syndrome scores in 3 groups of patients were observed before and after treatment. The waist to hip ratio (WHR), body mass index (BMI), fat attenuation parameter (FAI), liver function (ALT, AST, GGT), blood lipid (TC, TG, HDL-C, LDL-C), and ultrasonic imaging changes, and the treatment of ultrasound imaging, were treated and treated. In the course of the treatment, the life signs and electrocardiogram, renal function, blood routine, urine routine and fecal routine examination were performed on the Chinese medicine group and the combined group during the 0,1,2,3 month. The above data were analyzed by the SPSS17.0 software system, and the 3 groups of clinical effects were compared and the safety of the phlegm dampness was evaluated. Before the treatment, 90 cases of non alcoholic steatohepatitis were treated. The differences were not statistically significant (P0.05). (2) after the end of the course, the results were as follows: ALT, AST, GGT, compared with before treatment, and the difference was statistically significant (P0.05). The difference was not statistically significant (P0.05).2. traditional Chinese medicine compared with before treatment (P0.05). Group ALT, AST, GGT, TG, LDL-C, FAI, the syndrome scores were all lower than those before treatment, and the difference was statistically significant (P0.05); HDL-C was higher than before the treatment (P0.05), and there was no significant difference between the Yu Guance index and before the treatment (P0.05). There was statistical significance (P0.05); the difference was statistically significant (P0.05) compared with before treatment (P0.05), and the difference was statistically significant (P0.05). (3) after the end of the course, the total effective rate between the group and the western medicine group was 40%, the traditional Chinese medicine group was 46.7%, and the combined group was better than the 83.3%. group after the end of the treatment. Western medicine group, but the difference was not statistically significant (P0.05), the overall effect of the combined group was better than the traditional Chinese medicine group, the western medicine group, the difference had statistical significance (P0.05).2. obesity index and Fai compared with the Chinese medicine group BMI, WHR and Western medicine group, the difference was not statistically significant (P0.05); traditional Chinese medicine group Fai compared with western medicine group, the difference was statistically significant (P0.05); joint group BMI, BMI, WHR, FAI and traditional Chinese medicine group, the western medicine group was significantly lower, the difference was statistically significant (P0.05).3. liver function indexes compared with the Chinese medicine group alt, AST, GGT and Western medicine group were lower, the difference was statistically significant (P0.05), the group alt, AST, GGT compared with the traditional Chinese medicine group, there was no statistical significance (P0.05) compared with the Chinese medicine group Compared with the western medicine group, the difference was statistically significant (P0.05); the HDL-C in the Chinese medicine group was higher than the western medicine group, the difference was statistically significant (P0.05); the combination group TG, TC, LDL-C and the traditional Chinese medicine group were lower, the difference was statistically significant (P0.05); the joint group HDL-C was higher than the traditional Chinese medicine group, the difference was statistically significant (P0.05).5. B Ultrasound fraction compared with the Chinese medicine group B Ultrasound score. Compared with the western medicine group, the difference was not statistically significant (P0.05). Compared with the traditional Chinese medicine group and the western medicine group, the difference of B Ultrasound scores was statistically significant (P0.05). The TCM syndrome scores of the combined group and the Chinese medicine group were significantly lower than those in the western medicine group (P0.05); the syndrome scores of the combined group and the Chinese medicine group were compared. The difference was not statistically significant (P0.05).6. TCM syndrome score comparison (4) safety evaluation of the safety evaluation of the Chinese medicine group and the combined group of patients for 0,1,2,3 months of life signs stability, electrocardiogram, renal function, blood routine, urine routine, fecal routine examination have not found obvious abnormalities. Conclusion the 1. phlegm wet prescription based on "liver good" APP implementation of health management, treatment The overall effect of non-alcoholic steatohepatitis was obviously better than that of the phlegm and Polyene Phosphatidylcholine Capsules group. The effect was manifested in improving the patient's clinical symptoms, waist to hip ratio, body mass index, fat attenuation parameters, liver function index, blood lipid index and liver ultrasound imaging. The advantage is to improve the waist to hip ratio and body mass index. Fat attenuation parameters, blood lipid index (TC), liver ultrasound imaging and other aspects, it has a good therapeutic effect on non-alcoholic steatohepatitis,.2. can improve the clinical symptoms, liver function index, blood lipid index (TG, LDL-C, HDL-C) and decrease the adipose attenuation parameters in.3. course, and not found with phlegm dampness prescription. The side effects of phlegm dampness decoction are effective in the treatment of nonalcoholic steatohepatitis.
【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】：2017
【分類號】：R259
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