目的:观察中医益气化痰解毒法防治酒精性脂肪肝(AFLD)的临床疗效,探讨中医药防治酒精性肝病可能的作用机制。方法:对照组30例以复方蛋氨酸胆碱片治疗,治疗组30例采用益气化痰解毒法中药复方加复方蛋氨酸胆碱片治疗,20例健康体检人为正常对照,疗程4周。观察临床症状,检测肝功能、血脂等水平并作统计分析。结果:治疗后两组患者肝区不适、乏力、腹胀、黄疸、便溏等症状积分均明显下降(P〈0.01,0.05),治疗组在改善乏力、黄疸、便溏方面及总有效率优于对照组(P〈0.01,0.05)。治疗后两组各项肝酶指标(ALT、AST、ALP、γ-GT)、血脂指标(TC、TG、FFA)均较前明显下降(P〈0.05,0.01)。除ALT、γ-GT外,与正常组比较差异无统计学意义(P〉0.05);在改善ALT、FFA方面,治疗组优于对照组(P〈0.05)。结论:益气化痰解毒法能有效改善AFL患者临床表现,降低肝酶活性,降低有关脂质水平,达到防治AFLD目的。降酶保肝、调整肝脏脂质及调节酒精(毒)代谢是其可能的作用机制。
Objective:To research the therapeutic effects and the mechanism of traditional therapy by TCM with the method of strengthening qi, dissipating phlegm and detoxicating on patients with alcoholic fatty liver disease (AFLD). Methods :30 patients in control group were treated with Compound methionine acetylcholine while 30 patients in treatment group were given the traditional Chinese medicine with the method of strengthening qi, dissipating phlegm and detoxicating at the same time, for 4 weeks a course of treatment. 20 persons were controlled as normal. The changes of liver enzymes (ALT, AST, ALP and γ- GT) , blood fat ( TC, TG and FFA)and symptoms (hypochondriac pain ,feeble, ventosity ,jaundice and loose stool) scores of the two groups were recorded and analyzed. Results : The clinical symptoms scores and liver enzymes, blood fat of treatment group were lowered significantly ( P 〈 0. 01 ,P 〈0. 05). The therapeutic effects of treatment group was better than that of control group, especial on feeble,jaundice, loose stool,ALT, FFA and total effective rate (P 〈 0. 01, P 〈 0. 05 ). Conclusion:The therapy of TCM could lower the activity of liver enzymes and adjust metabolism of blood fat and relieve the clinical symptoms, achieving to treat alcoholic fatty liver disease. This is maybe its principle mechanism.