谢建寰 张统海 刘春凤 李冬春

摘要：目的 探究健脾消脂方治療脾虚湿盛型非酒精性脂肪肝（NAFLD）的临床疗效。方法 选取脾虚湿盛型NAFLD患者84例，采用随机数字表法分为2组各42例。对照组口服水飞蓟宾胶囊，治疗组在上述治疗基础上加用健脾消脂方治疗。对比2组治疗前后肝功能指标[天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）及谷氨酰转肽酶（GGT）]、糖生化指标[空腹胰岛素（FINS）、空腹血糖（FBG）、胰岛素抵抗指数（HOMA-IR）]及血脂水平[甘油三酯（TG）、总胆固醇（TC）、体质量指数（BMI）]。结果 治疗后治疗组AST、ALT及GGT水平均低于对照组，差异有统计学意义（P<0.05）;治疗后治疗组FBG、FINS、HOMA-IR、TC、TG水平均低于对照组，差异有统计学意义（P<0.05）。结论 健脾消脂方治疗脾虚湿盛型NAFLD疗效确切，可改善肝功能各指标水平，调节血糖及血脂，安全可行。

关键词：非酒精性脂肪肝;脾虚湿盛型;健脾消脂方;肝功能;糖生化指标;血脂

中图分类号：R575.5 文献标志码：B 文章编号：1007-2349（2021）05-0042-03

【Abstract】Objective： To study the clinical effect of Jianpi Xiaozhi Decoction in treating non-alcoholic fatty liver patients with spleen deficiency and overabundant dampness（NAFLD）. Methods： 84 NAFLD patients with spleen deficiency and overabundant dampness were selected and divided into two groups according to random number table， 42 cases per group. The control group received oral silybin capsules and the treatment group was treated with Jianpi Xiaozhi Decoction on the basis treatment of the control group. The liver function indexes of the two groups were compared before and after treatment， i.e. AST， ALT， GGT， FINS， FBG， HOMA-IR， TG， TC and BMI. Results： After treatment， the AST， ALT and GGT levels in the treatment group were lower than those in the control group， and the difference was statistically significant（P<0.05）. After treatment， the FBG， FINS， HOMA-IR， TC and TG levels in the treatment group were lower than those in the control group， and the difference was statistically significant（P<0.05）. Conclusion： Jianpi Xiaozhi Decoction is effective in the treatment of NAFLD patients with spleen deficiency and overabundant dampness and can improve the levels of various indicators of liver function， and regulate blood sugar and blood lipids， and is safe and feasible.

【Key words】Non-Alcoholic Fatty Liver; Spleen Deficiency And Overabundant Dampness Type; Jianpi Xiaozhi Decoction; Liver Function; Glucose Biochemical Indicators; Blood Lipids

大量数据显示[1-2]，全国NAFLD发病率约为33%，2型糖尿病患者中NAFLD发病率可达75%。NAFLD在短时间内即可引发不可逆的肝脏损伤，并进一步发展为肝纤维化、脂肪性肝炎，甚至肝硬化，危及生命安全。现代医学在脂肪肝治疗中依据其发病机制将目标集中于纠正潜在致病因、改善代谢紊乱等，虽取得一定效果，但作用靶点单一，远期效果不佳[3]。近年来，中医药在NAFLD治疗中得到较好的发展，具有多靶点、多途径、多层次等优势，从内分泌及激素调节等方面对脂肪肝的发病机制做出进一步研究，充分发挥辨证与辨病结合的特点，实现多角度、多途径、多靶点的治疗[4]。鉴于此，本研究对脾虚湿盛型NAFLD患者给予健脾消脂方治疗，旨在探究其临床效果。现报道如下。

1 资料与方法

1.1 一般资料 选取2018年5月—2020年2月本院收治的脾虚湿盛型NAFLD患者84例，采用随机数字表法分为2组各42例。……