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目的:观察健脾祛湿方联合生活方式调整干预脾虚湿阻型非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:将120例脾虚湿阻型NAFLD患者随机分为治疗组和对照组各60例,对照组给予基础运动和生活指导等生活方式调整,治疗组在生活方式调整基础上给予健脾祛湿方。2组均以3月为1疗程,3月后比较2组的治疗效果,观察治疗前后中医证候积分、肝功能指标和血脂指标、肝脏B超结果等变化。结果:治疗后,总有效率治疗组93.33%,对照组61.67%,2组比较,差异有统计学意义(P<0.01)。2组胁痛、体倦乏力、脘闷腹胀、食少纳呆积分均较治疗前下降,差异均有统计学意义(P<0.01,P<0.05);治疗组以上4项积分均低于对照组,差异均有统计学意义(P<0.05)。2组总胆固醇(TC)、甘油三酯(TG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均较治疗前下降,差异均有统计学意义(P<0.01,P<0.05);治疗组TC、TG、ALT、AST水平均低于对照组,差异均有统计学意义(P<0.05)。2组超声结果均较治疗前改善,差异均有统计学意义(P<0.05);2组超声结果比较,差异有统计学意义(P<0.05)。结论:采用健脾祛湿方联合生活方式调整干预脾虚湿阻型NAFLD患者能够缓解脂肪肝的各种症状,减轻脂肪肝的病变程度,具有较好的临床疗效。
Objective: To observe the clinical effect of Jianpi Qushi Decoction combined with lifestyle adjustment intervention on non-alcoholic fatty liver disease (NAFLD) with spleen deficiency syndrome. Methods: 120 cases of NAFLD patients with spleen dampness type were randomly divided into treatment group and control group, 60 cases in each group. The control group was given lifestyle adjustments such as basic exercise and life guidance. The treatment group was given Jianpi Qushi Decoction . Both groups were treated with 1 course of treatment in March. After 3 months, the therapeutic effect was compared between the two groups. The TCM syndrome score, liver function index, blood lipid index and liver ultrasonography were observed before and after treatment. Results: After treatment, the total effective rate was 93.33% in the treatment group and 61.67% in the control group. There was significant difference between the two groups (P <0.01). The scores of two groups were lower than those before treatment (P <0.01, P <0.05). The scores of the above 4 items in the treatment group were all lower than those in the control group Group, the difference was statistically significant (P <0.05). The levels of total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the two groups were significantly lower than those before treatment (all P <0.01, P <0.05). The levels of TC, TG, ALT and AST in the treatment group were lower than those in the control group, with statistical significance (P <0.05). Ultrasound results of 2 groups improved compared with before treatment, the differences were statistically significant (P <0.05); 2 groups of ultrasound results, the difference was statistically significant (P <0.05). Conclusion: The combination of invigorating the spleen and removing dampness and lifestyle adjustment intervention in patients with NAFLD with spleen deficiency syndrome can relieve the various symptoms of fatty liver and reduce the degree of fatty liver disease, and has good clinical efficacy.