柴胡疏肝散对肝郁脾虚型非酒精性脂肪肝患者的临床疗效及肠道菌群的影响

被引：52

作者：

谢维宁

彭红兵

李烨

黄腊平

陈声鑫

吴艺锋

李晔

机构：

[1] 广东省中西医结合医院

来源：

中国实验方剂学杂志 | 2021年 / 27卷 / 03期

关键词：

柴胡疏肝散; 生活方式干预; 非酒精性脂肪肝; 肠道菌群;

D O I：

10.13422/j.cnki.syfjx.20210212

中图分类号：

R259 [现代医学内科疾病];

学科分类号：

100506 ;

摘要：

目的:研究柴胡疏肝散对肝郁脾虚型非酒精性脂肪肝患者的临床疗效及肠道菌群的影响。方法:该研究纳入2019年1月至2020年1月在广东省中西医结合医院肝病门诊就诊的非酒精性脂肪肝(NAFLD)患者80例。随机分为治疗组(柴胡疏肝散组,n=40)和对照组(安慰剂组,n=40)。两组患者予生活方式干预作为基础方案。治疗组予口服柴胡疏肝散辨证加减;对照组口服安慰剂。每次1剂,分早晚服,疗程为12周。观察治疗前、后脂肪肝疗效;丙氨酸氨基转移酶(ALT),天冬氨酸氨基转氨酶(AST),谷氨酰转肽酶(γ-GT);血脂:高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),总胆固醇(TC),甘油三酯(TG);炎症指标:白细胞介素(IL)-6,IL-1β,外周血单个核细胞Toll样受体-4(TLR-4)及肠道菌群变化。结果:彩超评估显示,治疗组总有效率81.08%(30/37),对照组总有效率68.57%(24/35)(Z=2.67,P<0.05)。两组治疗后与基线的差值比较,治疗组治疗后BMI,ALT,AST,TC,LDL-C,γ-GT与基线的差值低于对照组,而HDL-C差值高于对照组(P<0.05),两组TG的差值差异无统计学意义。炎症因子、肝脏受控衰减系数(CAP)及肝脏硬度值(LSM)比较,两组治疗后与基线的差值比较,治疗组在IL-6,TNF-α,IL-1β,TLR-4,CAP及LSM与基线差值显著低于对照组(P<0.01)。肠道菌群治疗后比较,治疗组双歧杆菌及乳杆菌丰度显著升高,而大肠埃希菌及肠球菌丰度则显著下降(P<0.01)。结论:生活方式干预基础上,柴胡疏肝散可以更好地改善NAFLD患者血脂代谢及肝功能,调节肠道菌群,抑制炎症因子水平。

引用

页码：129 / 137

页数：9

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