CAJ | 학술논문

目的：观察消脂利肝方治疗非酒精性脂肪肝（NAFLD）临床疗效和对肿瘤坏死因子α（TNF-α）、胰岛素抵抗的影响。方法72例NAFLD患者随机分为治疗组和对照组各36例，两组均给予健康教育和生活方式指导，对照组给予易善复治疗，治疗组予消脂利肝方联合易善复治疗，疗程8周。治疗前后均检测ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、游离脂肪酸（FFA）、TNF-α、空腹胰岛素（FINS），计算胰岛素抵抗指数（HOMA-IR），肝脏超声检查，评定临床疗效和各观察指标。结果治疗组有效率86.11豫，对照组为63.89豫，两组比较差异有统计学意义（P约0.05）；两组治疗后ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、FFA、TNF-α、HOMA-IR均较治疗前改善（P约0.05）；治疗组治疗后ALT、AST、TC、TG、FFA、TNF-α、HOMA-IR较对照组改善明显（P约0.05）。结论消脂利肝方联合易善复治疗NAFLD较单用易善复疗效明显，其机制可能与降低TNF-α和HOMA-IR水平有关。
목적：관찰소지리간방치료비주정성지방간（NAFLD）림상료효화대종류배사인자α（TNF-α）、이도소저항적영향。방법72례NAFLD환자수궤분위치료조화대조조각36례，량조균급여건강교육화생활방식지도，대조조급여역선복치료，치료조여소지리간방연합역선복치료，료정8주。치료전후균검측ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、유리지방산（FFA）、TNF-α、공복이도소（FINS），계산이도소저항지수（HOMA-IR），간장초성검사，평정림상료효화각관찰지표。결과치료조유효솔86.11예，대조조위63.89예，량조비교차이유통계학의의（P약0.05）；량조치료후ALT、AST、TBIL、TC、TG、HDL-C、LDL-C、FFA、TNF-α、HOMA-IR균교치료전개선（P약0.05）；치료조치료후ALT、AST、TC、TG、FFA、TNF-α、HOMA-IR교대조조개선명현（P약0.05）。결론소지리간방연합역선복치료NAFLD교단용역선복료효명현，기궤제가능여강저TNF-α화HOMA-IR수평유관。
Objective To investigate the therapeutic effect of Xiaozhi Ligan decoction on nonalcoholic fatty liver disease(NAFLD) and its effect on tumor necrosis factor-α(TNF-α) and insulin resistance. Methods Seventy-two NAFLD patients were randomly divided into treatment group (n=36) and control group (n=36). Patients in two groups were given health education and living style guidance. Control group received essentiale for treatment of NAFLD, while treatment group was given essentiale plus Xiaozhi Ligan decoction, both for 8 weeks. The level of ALT, AST, TBIL, TC, TG, HDL-C, LDL-C, free fatty acid(FFA), TNF-α, fasting insulin(FINS) was measured and HOMA-IR was calculated before and after treatment. Ultrasound was performed to evaluate liver function. Results The effective rate of treatment group was 86.11% and that of control group was 63.89%, with a significant differ-ence between them (P<0.05). The parameters including ALT, AST, TBIL, TC, TG, HDL-C, LDL-C, FFA, TNF-α, HOMA-IR were all improved after treatment in both groups(P<0.05); the level of ALT, AST, TC, TG, FFA, TNF-α, HOMA-IR in treatment group was lower than that in control group after treatment (P<0.05). Conclusion Xi-aozhi Ligan decoction combined with essentiale has more satisfactory effect against NAFLD compared with simple essentiale, which may be related to down-regulating TNF-α and HOMA-IR.