DOI:10.13481/j.1671-587x.2012.01.009 142 38 1 2012 1 ( ) JournalofJilinUniversity(MedicineEdition) Vol.38 No.1 Jan.2012 [ ] 1671-587Ⅹ(2012)01-0142-05 1 1 2 3 1 1 1 (1., 445000;2., 445000; 3., 445000) [ ] : (NASH) NASH 172, 50 56 66, 3 1 : 66, 50, 12, 4 75.8%, 93.9%; 56, 38, 15, 3, 67.9%, 94.6%; 50, 26, 17, 7 52.0% 86.0% (P<0.01); (P<0.05); (P>0.05) 3 ALT AST GGT (P< 0.01); ALT AST GGT (P<0.05 P<0.01); ALT AST GGT (P>0.05) 3 TG TC (P<0.01) TG TC (P<0.05 P<0.01) TC TG (P>0.05) 3, (P<0.01), : ;, [ ] ; [ ] R575.1 [ ] B EvaluationoncurativeeffectofSelf-prepared SofteningLiverandEliminatingFatDecoction intreatmentofnon-alcoholicsteatohepatitis YANG Qiang 1,XIE Hui-chen 1,PAN Qing-hua 2,LIU Xiao-qin 3,XUJian-hua 1, ZHAO Xiao-qin 1,JIANGJin-lin 1 (1.DepartmentofTraditionalChineseMedicine,AfiliatedHospital,HubeiUniversityforNationalities, Enshi445000,China;2.DepartmentofDigestiveMedicine,CentralHospital,EnshiAutonomousPrefecture, Enshi445000,China;3.DepartmentofPreventiveMedicine,CenterforDiseaseControland PreventionofEnshi,EnshiAutonomousPrefecture,Enshi445000,China) Abstract:Objective ToobservetheclinicaleficacyofSelf-preparedSofteningLiverandEliminatingFatDecoction [ ] 2011-06-29 [ ] (B20092905) [ ] (1979-), [ ] (Tel:0718-8301389,E-mail:yq20010602@tom.com)
,. 143 intreatmentofnon-alcoholicsteatohepatitis (NASH).Methods 172 patients with NASH,accordingtothe wilingnessofpatients,weredividedintowesternmedicinetreatmentgroup (n=50),chinesemedicinetreatment group (n=56),andcombinedtreatmentgroup with Chineseand western medicine (n=66).thepatientsin Westernmedicinetreatmentgroupweretreatedwithoralwesternmedicineforprotectingtheliver,reducingenzyme andloweringbloodlipids,intraditionalchinesemedicinegroupwithself-preparedsofteningliverandeliminating FatDecoction,incombinedtreatmentgroupwithwesternmedicinecombinedwithChinesemedicine,andlastedfor 3months.Theliverfunction,serumlipids,liverimagewereobserved.Results Incombinedtreatmentgroup, 50cases werecured,12cases wereefective,4cases wereinefective,thecurerate was75.8%,thetotal efectiveratewas93.9%;inchinese medicinetreatmentgroup,38caseswerecured,15cases wereefective, 3caseswereinefective,thecureratewas67.9%,thetotalefectiveratewas94.6%;inwesternmedicinegroup, 26cases werecured,17cases wereefective,7cases wereinefective,thecurerate was52.0%,thetotal efectiveratewas86.0%.inchinesemedicinetreatmentgroupandcombinedtreatmentgroupthecureratesand thetotalefectiveratesweresignificantlyhigherthanthoseinwesternmedicinegroup (P<0.05orP<0.01);the curerateincombinedtreatmentgroupwashigherthanthatinchinesemedicinetreatmentgroup (P<0.05);the diferenceinefectiveratebetweencombinedtreatmentgroupand Chinesetreatmentgroup had nosignificant diference(p> 0.05).Theserum ALT,AST,andGGTlevelsaftertreatmentinthreegroupswerelowerthan beforetreatment(p<0.01);thealt,ast,andggtlevelsinchinesemedicinegroupandcombinedtreatment groupwerelowerthanthoseinwesternmedicinegroup (P<0.05orP<0.01);theALT,AST,andGGTlevels aftertreatmentincombinedtreatmentgroupandchinesemedicinegrouphadnosignificantdiference(p> 0.05). Theserum TGandTCaftertreatmentinthreegroupsweredecreasedcomparedwithbeforetreatment,therewere significantdiferences (P <0.01);the TG and TClevelsin Chinese medicinetreatmentgroupandcombined treatmentgroupwerelowerthanthoseinwesternmedicinegroup(p<0.05orp<0.01);therewerenosignificant diferenceinthetgandtclevelsbetweenchinesemedicinetreatmentgroupandcombinedtreatmentgroup (P> 0.05).Inthecourseoftreatment,someshort-term gastrointestinalsideefectsoccurredin western medicine group,butchinese medicinetreatmentgroupandcombinedtreatmentgrouphadnoobviousadversereactions. Conclusion Self-preparedSofteningLiverandEliminatingFatDecoctionhastheexactefectonNASHandhasno adversereactions;self-preparedsofteningliverandeliminatingfatdecoctioncombinedwithwesternmedicinecan significantlyimprovetheclinicalcurerateof NASH,andreducethegastrointestinaltractreactioncaused by westernmedicine. Keywords:non-alcoholicsteatohepatitis;Self-prepared Softening Liverand Eliminating FatDecoction;eficacy evaluation (non-alcoholic [2], steatohepatitis,nash) NASH,,, (non- NASH,, alcoholicfatyliverdisease,nafld) 1,NASH :NAFLD 1.1 2007 2010, 20% ~33%, 172 10%~30% NASH NASH 10 3 50, 32, 15% ~25%, 18 ; (42.5±13.1) ; 3 ~13, <24 14, 24~60 21, 30% ~40% [1], >60 15 (3.2±2.7) NASH NASH 56, 36, 20 ; (41.6±, 13.3) ; 4 ~12, <24
144 ( ) 38 1 2012 1 14, 24~60 25, >60 17, 20mg,1 / ; (3.3±2.4) 66,,0.1g,3 / ) : 42, 24 ; (40.4±13.8) ; 3 ~13, <24 18,24~ 60 27, >60 21, 20g 10g 30g 30g (3.5±3.0) 3 30g 20g, 1 1, (P> 3 ) : 0.05) 1.2 [3] 1.4 :, [4] 1 ALT (AST) <140g <70g; 2 CT ; : ;3 ALT AST GGT TC TG CT ;4 ( CT 1 (ALT) 2, ); : ALT AST 4, GGT TC TG, CT (GGT) (TG) ;5 ( CT <1 ) ;6 : [5], 1.5 SPSS13.0, ALT AST GGT TC TG x±s t [5] 1.3 3 2 1 :, ;2 : 2.1, ;3 (P<0.01); 3 (P<0.01); 3 1,1 :,2 /,3 / ; ( TC (P>0.05) 1 ( 15g 15g 10g 30g 30 g 30 g 10 g GGT (TC) TG, (P<0.05); 1 3 Tab.1 Comparisonofcomprehensiveefectofpatientsbetweenthreegroups [n( η /%)] Group n Cure Efective Invalid Totalefective Westernmedicine 50 26(52.0) 17(34.0) 7(14.0) 43(86.0) Chinesemedicine 56 38(67.9)* 15(26.8) 3(5.4) 53(94.6)* Combinedmedicine 66 50(75.8) 12(18.2) 4(6.1) 62(93.9)* * P<0.01comparedwithwesternmedicinegroup; P<0.05comparedwithChinesemedicinegroup. 2.2 3 ALT AST GGT ALT AST GGT, (P>0.05) 2 (P<0.01);
,. 145 2 3 Tab.2 Comparisonofliverfunctionofpatientsbeforeandaftertreatmentbetweenthreegroups [x±s,λb/(u L -1 )] Group n ALT AST GGT Before After Before After Before After Westernmedicine 50 94.36±14.20 52.48±30.15 62.50±18.05 42.54±18.17 83.42±27.35 51.38±24.20 Chinesemedicine 56 94.29±13.87 41.75±14.06 ** 64.68±17.97 30.71±11.67 ** 81.43±25.91 41.29±21.64 * Combinedmedicine 66 94.15±13.44 40.88±14.02 ** 64.53±17.69 34.88±12.55 ** 81.12±25.27 39.98±20.51 ** * P<0.05,** P<0.01comparedwithwesternmedicinegroup. 2.3 3 (P>0.05) 3 TC TG, 2.4 3 (P<0.01); TC TG (P<0.01) 4 3 3 Tab.3 Comparisonofbloodlipidsofpatientsbeforeandaftertreatmentbetweenthreegroups [x±s,cb/(mmol L -1 )] Group n TC TG Before After Before After Westernmedicine 50 6.23±2.22 3.78±0.79 4.36±2.21 2.51±1.24 Chinesemedicine 56 6.11±2.17 3.36±0.74 ** 4.43±2.18 2.02±0.95 * Combinedmedicine 66 6.01±2.16 3.21±0.80 ** 4.42±2.08 1.97±0.80 ** * P<0.05,** P<0.01comparedwithwesternmedicinegroup. 4 3 Tab.4 Comparisonofradiographicchangesofpatientsaftertreatmentbetweenthreegroups [n( η /%)] Group n Cure Efective Invalid Totalefective Westrenmedicine 50 28(56.0) 9(18.0) 13(26.0) 37(74.0) Chinesemedicine 56 43(76.8)* 11(19.6) 2(3.6) 54(96.4) Combinedmedicine 66 52(78.8)* 12(15.2) 2(4.5) 64(97.0) * P<0.01comparedwithwesternmedicinegroup. 2.5 6 : -OH 3 NASH, [6-7], [8] : ;,,, ; [9],,, ; HSC
146 ( ) 38 1 2012 1 [10-11] 11 (2):71., [12] TGFβ1 [6] [13] [14] [15-16] : NASH ALT AST B 2 GGT TC TG 58-59. [10] [J]. NASH,, [ ] [1] AnguloP. GI epidemiology: nonalcoholic faty liver disease[j].alimentpharmacolther,2007,25 (8):883-889. [15]. [2],,. [J]. [J].,2005,,2009,11 (6):133-135. [3]. [M]. :,2005:493- [J].,2003, [5]. [J].,2006, 14 (3):161-163.. - [J].,2002,11 (3):183. [7]. [J].,2010,6 (12):161-162. [8]. [M]. :,2005:56-58. [9]. [J].,2006,22 (3): 494.,2009,3 (7):189-190. [4]..,2004,2 (2):145-146. [11]. [J]., 2010,4 (15):230-231. [12],. [J].,2007,18 (24):1093-1094. [13]. [J].,2010,31 (3):215-216. [14],,. [J].,2008,27 (1):67-68. 22 (6):454-455. [16]. [J]. 1 1 ( 130021),,39, 1, 9d, 2010 11 8 1 CT CT 3 + 6, (PR) 4 CT + 1 9d, 40Gy/20f 20Gy/10f + 2 2 :1 2 40Gy/20f 20Gy/10f + 6 PR, 1