化痰法对痰瘀互结证非酒精性脂肪性肝炎患者纤溶状态的影响

[Effects of resolving phlegm method on fibrinolytic status in non-alcoholic steatohepatitis patients of phlegm and blood-stasis syndrome].

作者信息

Chen Li, Jiang Yang-Kun, Cai Yan-Bo

机构信息

Department of Liver and Gallbladder Diseases, Ruikang Hospital Affiliated to Guangxi College of Traditional Chinese Medicine, Nanning.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006 Dec;26(12):1090-3.

PMID:17205821

Abstract

OBJECTIVE

To observe the effect of resolving phlegm method (RPM) on fibrinolytic status in non-alcoholic steatohepatitis (NASH) patients of phlegm blood-stasis (PBS) syndrome type.

METHODS

Sixty-two patients were randomly assigned to 2 groups, namely the treated group (n = 34) treated with Chinese herbs for resolving phlegm and dampness, smoothing liver and gallbladder, promoting blood circulation and removing blood stasis (composition: Indigo Naturalis 10 g, Alumen 3 g, Semen Cassiae 15 g, Fructus Crataegi 15 g, vinegar prepared Radix Bupleuri 10 g, Radix Curcumae 10 g, Radix Salviae Miltiorrhizae 12 g, Herba Lycopi 12 g, talc 12 g and Radix Glycyrrhizae 2 g), one dose twice per day orally, and the control group (n = 28) with ursodeoxycholic acid tablet (UAT) 150 mg three times per day. The treatment course for both groups was 12 weeks. Liver function (ALT, AST, ALP), insulin resistance (IR) index represented by homeostasis model-IR (HOMA-IR) and insulin (Ins), levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1), as well as main symptoms and physical signs were assessed before and after treatment.

RESULTS

(1) Compared with those before treatment, levels of ALT, AST, HOMA-IR, t-PA, PAl-1 and main symptoms were all improved in the treated group (P < 0.05 or P < 0.01); (2) There was significant difference in ALP, HOMA-IR, t-PA and PAI-1 between the treated group and the control group (P < 0.05 or P < 0.01); (3) The improvement in liver function related indexes in the control group was mainly the level of ALT, t-PA (P < 0.01), and also shown on HOMA-IR, Ins and PAI-1.

CONCLUSION

RPM could effectively improve liver function and fibrinolytic status. Its effect was better than that of UAT.

摘要

目的

观察化痰法对非酒精性脂肪性肝炎（NASH）痰瘀互结证患者纤溶状态的影响。

方法

将62例患者随机分为2组，即治疗组（n = 34），采用化痰祛湿、疏肝利胆、活血化瘀中药治疗（组成：青黛10g、白矾3g、决明子15g、山楂15g、醋制柴胡10g、郁金10g、丹参12g、泽兰12g、滑石12g、甘草2g），每日1剂，分2次口服；对照组（n = 28），口服熊去氧胆酸片（UAT）150mg，每日3次。两组疗程均为12周。治疗前后评估肝功能（ALT、AST、ALP）、以稳态模型胰岛素抵抗指数（HOMA-IR）表示的胰岛素抵抗（IR）指数及胰岛素（Ins）、组织型纤溶酶原激活剂（t-PA）和纤溶酶原激活剂抑制剂-1（PAI-1）水平，以及主要症状和体征。

结果

（1）治疗组治疗后ALT、AST、HOMA-IR、t-PA、PAI-1水平及主要症状均较治疗前改善（P < 0.05或P < 0.01）；（2）治疗组与对照组在ALP、HOMA-IR、t-PA及PAI-1方面比较，差异有统计学意义（P < 0.05或P < 0.01）；（3）对照组肝功能相关指标的改善主要为ALT、t-PA水平（P < 0.01），在HOMA-IR、Ins及PAI-1方面也有改善。