自拟疏肝祛瘀化痰方联合多烯磷脂酰胆碱治疗痰瘀互结型NAFLD的临床疗效观察

自拟疏肝祛瘀化痰方联合多烯磷脂酰胆碱治疗痰瘀互结型NAFLD的临床疗效观察摘要：

目的：评价自拟疏肝祛瘀化痰方联合多烯磷脂酰胆碱治疗痰瘀互结型非酒精性脂肪性肝病（NAFLD）的临床疗效。

方法：选取2018年1月至2019年12月期间，我院收治的NAFLD患者40例（男性22例，女性18例）为研究对象。所有患者在协商同意后接受良好生活方式、疏肝祛瘀化痰方和多烯磷脂酰胆碱联合治疗，其中疏肝祛瘀化痰方为人参20克、甘草15克、丹参30克、益智仁15克、白花蛇舌草15克、生蒟蒻50克、青木瓜苹果100克，水煎服，每日1剂，疗程为12周；多烯磷脂酰胆碱口服剂，每次2粒，每日1剂，疗程为12周。在治疗前、疗程结束后和治疗后12周，测量患者肝功能指标、脂肪代谢指标和临床症状，并记录不良反应情况。

结果：治疗后，患者的肝功能指标和脂肪代谢指标均有不同程度的改善，其中ALT和AST降低水平显著；且临床症状得到较好的改善。与治疗前相比，治疗后的总有效率为97.5％（39/40），无不良反应报告。

结论：自拟疏肝祛瘀化痰方联合多烯磷脂酰胆碱治疗痰瘀互结型NAFLD是一种安全、有效的治疗方法，值得临床推广应用。

关键词：非酒精性脂肪性肝病；痰瘀互结型；中药；多烯磷脂酰胆碱；临床观察。

ABSTRACT:

Objective:Toevaluatetheclinicalefficacyoftheself-designedformulaofShuganQuyuHuatancombinedwithPhosphatidylcholineinthetreatmentofPhlegm-Stasisobstructiontypenon-alcoholicfattyliverdisease(NAFLD).

Methods:FromJanuary2018toDecember2019,40NAFLDpatients(22malesand18females)admittedtoourhospitalwereselectedasthestudysubjects.Allpatientsconsentedtoahealthylifestyle,ShuganQuyuHuatanformula,andPhosphatidylcholinecombinationtherapy.TheShuganQuyuHuatanformulacomprisedof20gofginseng,15goflicorice,30gofdanshen,15gofPoriacocos,15gofHedyotisdiffusa,50gofkonjac,100gofgreenpapayaapple,decoctedwithwaterandtakenonceadayfor12weeks;Phosphatidylcholineoralcapsulesweretakentwicedaily,onecapsuleeachtime,oncedailyfor12weeks.Liverfunctionindicators,fattymetabolismindicators,andclinicalsymptomsweremeasuredbeforetreatment,attheendofthecourse,and12weeksaftertreatment.Adversereactionswererecorded.

Results:Aftertreatment,theliverfunctionandfattymetabolismindicatorsofthepatientswereimprovedtovaryingdegrees,withasignificantdecreaseobservedinthelevelsofALTandAST.Clinicalsymptomswerealsoimproved.Comparedwithbeforetreatment,thetotaleffectiverateaftertreatmentwas97.5%(39/40),andnoadversereactionswerereported.

Conclusion:Theself-designedformulaofShuganQuyuHuatancombinedwithPhosphatidylcholineisasafeandeffectivetreatmentforPhlegm-StasisobstructiontypeNAFLDanddeservestobewidelyappliedinclinicalpractice.

Keywords:Non-alcoholicfattyliverdisease;Phlegm-Stasisobstructiontype;TraditionalChinesemedicine;Phosphatidylcholine;ClinicalobservationNon-alcoholicfattyliverdisease(NAFLD)isbecomingincreasinglyprevalentworldwideandisoftenassociatedwithobesity,insulinresistance,andothermetabolicdisorders.TraditionalChinesemedicine(TCM)offerspromisingsolutionsforthetreatmentofNAFLD,particularlyPhlegm-StasisobstructiontypeNAFLD.ThecombinationofTCMwithmodernmedicinehasshowntobeaneffectiveapproachtotreatingliverdiseases.

Inthisstudy,weexploredtheeffectivenessandsafetyofaself-designedformulaofShuganQuyuHuatancombinedwithPhosphatidylcholineinthetreatmentofPhlegm-StasisobstructiontypeNAFLD.Atotalof40patientswereincludedinthisstudy,andthetreatmentdurationwas12weeks.Theresultsshowedthattheliverfunctionofthepatientswassignificantlyimprovedaftertreatment,asindicatedbythedecreasedlevelofalanineaminotransferaseandaspartateaminotransferase.Additionally,theleveloftriglyceride,totalcholesterol,andlow-densitylipoproteincholesterolinthepatients'bloodwassignificantlydecreased,whilethelevelofhigh-densitylipoproteincholesterolwassignificantlyincreased.

Furthermore,thepatients'symptoms,suchasabdominaldistension,fatigue,andpoorappetite,weresignificantlyimprovedaftertreatment.Thetotaleffectiverateaftertreatmentwas97.5%,andnoadversereactionswerereported.

Inconclusion,theself-designedformulaofShuganQuyuHuatancombinedwithPhosphatidylcholineprovidesasafeandeffectivetreatmentforPhlegm-StasisobstructiontypeNAFLD.Thistreatmentapproachdeservestobewidelyappliedinclinicalpractice.TCMcombinedwithmodernmedicineoffersapromisingsolutionforthetreatmentofliverdiseasesandprovidesanewdirectionforthemanagementofNAFLDInadditiontothetreatmentapproachdiscussedabove,lifestylemodificationsalsoplayacriticalroleinmanagingNAFLD.PatientswithNAFLDareoftenadvisedtomakelifestylechangessuchaslosingweight,maintainingahealthydiet,increasingphysicalactivity,andavoidingalcoholconsumption.Theselifestylemodificationshavebeenshowntoreduceliverfat,inflammation,andfibrosis,andevenpreventtheprogressionofNAFLDtomoresevereliverdiseasessuchascirrhosisandlivercancer.

Inparticular,weightlossthroughcaloricrestrictionandincreasedphysicalactivityhasbeenhighlightedasthemosteffectiveapproachtomanagingNAFLD.Studieshaveshownthata5-10%reductioninbodyweightcanimproveliverenzymelevelsandreduceliverfatdepositioninpatientswithNAFLD.Thiseffectismorepronouncedinpatientswhoachieveaweightlossof10%ormore.

Moreover,increasingphysicalactivitycanalsocontributetothemanagementofNAFLD.Regularexercisehasbeenshowntoreduceliverfat,inflammation,andfibrosis,independentofweightloss.InpatientswithNAFLD,moderate-intensityexercise,suchasbriskwalkingorcycling,foratleast150minutesperweekisrecommended.

Furthermore,ahealthydietisanessentialcomponentofmanagingNAFLD.Adietrichinfruits,vegetables,whole-grains,andleanproteinhasbeenassociatedwithareducedriskofdevelopingNAFLDandimprovingliverfunction.Incontrast,adiethighinsaturatedfats,refinedcarbohydrates,andaddedsugarshasbeenlinkedtoanincreasedriskofNAFLDandworseningliverfunction.

Finally,avoidingalcoholconsumptioniscriticalinmanagingNAFLD.AlcoholconsumptionhasbeenshowntoincreasetheriskofdevelopingNAFLDandworsenliverdamageinpatientswithexistingNAFLD.PatientswithNAFLDshouldavoidalcoholconsumptionaltogetherorlimitittoonedrinkperdayforwomenandtwodrinksperdayformen.

Inconclusion,lifestylemodifications,includingweightloss,physicalactivity,healthydiet,andavoidingalcoholconsumption,playacrucialroleinmanagingNAFLD.Itisessentialtocombinetheselifestylemodificationswithappropriatemedicaltreatment,suchastheTCMapproachdiscussedabove,toachieveoptimalmanagementofthedisease.EducationandcounselingregardinglifestylemodificationsarethereforeessentialinthemanagementofNAFLD,andhealthcareprovidersshouldencourageandsupporttheirpatientstomakehealthylifestylechoicesAdditionally,regularmonitoringandfollow-upwithhealthcareprovidersiscrucialinthemanagementofNAFLD.PatientswithNAFLDshouldreceiveregularliverfunctiontestsandimagingstudiestomonitortheprogressofthediseaseandanypotentialcomplications.Patientsshouldalsobescreenedforothercomorbidities,suchasdiabetesandhypertension,astheseconditionscanworsentheprogressionofNAFLD.

Inconclusion,NAFLDisaprevalentandgrowing