| Objective:Nonalcoholic fatty liver disease(NAFLD)is a chronic liver disease.With the change of people's lifestyle,the prevalence of NAFLD is increasing year by year.With the development of the disease,it can change to non-alcoholic steatohepatitis(NASH),but NASH has now become an invisible concern of people's health and quality of life.Based on the development trend of traditional Chinese medicine and clinical treatment effects,combined with the results of animal experiments in the previous period of this project,this study was conducted on patients with NASH phlegm internal resistance,dampness and heat dehydration syndrome,and from CAP value,liver function,and blood lipid levels,TCM syndrome scores,abdominal B ultrasound and other indicators.Then we can compare the clinical efficacy of Yinchen Linggui prescription to determine the role of Wenyun Qingli method in the treatment of NASH.To create a new treatment plan and clinical basis for the treatment of NASH,and to give play to the characteristics of TCM treatment.Methods:This study collected patients with NASH turbid internal resistance and dampness and heat depletion syndrome that met the diagnostic criteria and inclusion criteria of the Dongfang Hospital of Beijing University of Chinese Medicine.Using a randomized,positive control study method,72 patients who met the criteria were randomly divided into a treatment group and a control group,with 36 patients in the treatment group and 36 in the control group.The treatment group was given orally Yinchen Linggui prescription(Artemisia capillaris 18g,Gardenia 9g,Rhubarb 6g,Poria 12g,cassia twig 9g,Atractylodes 6g,licorice 6g,Gynostemma 15g,Silybum 12g).One dose per day,one hour after breakfast,morning and evening meals;the control group was given oral resuscitation.2 capsules(456 mg)each time.Three times a day,each group took three consecutive months.After entering the group,the patient's general condition,medical history,laboratory test results,and TCM symptoms were recorded in paper.During the treatment period,dietary and exercise interventions were performed in both groups.After 3 months,the clinical symptoms before and after treatment,the CAP value of liver fat,abdominal ultrasound,liver function,and blood lipids were analyzed.SPSS 20.0 statistical software was used to analyze the relevant data to evaluate the efficacy.Results:(1)Liver cell attenuation parameters(CAP values):The CAP values before and after treatment in both groups were P<0.05,which was statistically significant.Both groups were able to reduce the CAP value;both improved CAP values after treatment.Differences were statistically analyzed and the results showed that P<0.05,the difference was statistically significant,For the efficacy evaluation of CAP value,the total effective rate was 71.0%in the treatment group and 44.1%in the control group,P<0.05,and the difference was statistically significant,suggesting that the Yinchen Linggui prescription group was superior to the Yishanfu group in reducing the CAP value.(2)In terms of liver enzymes(ALT,AST):Both groups had improvement in ALT and AST before and after treatment,P<0.05,and the difference was statistically significant.Treatment groups and control groups were able to reduce liver enzymes;In comparison,the improvement of ALT and AST in NASH patients was better in the treatment group than in the control group(p<0.05).The efficacy of liver enzymes was evaluated in the treatment group and the control group after treatment.The total effective rate in the treatment group was 96.8%.The total effective rate of the group was 76.5%,P<0.05,indicating that there was a significant difference between the two groups,the treatment group was better than the control group;in the AST,the total effective rate of the treatment group was 77.4%,and the total effective rate of the control group was 57.6%,P<0.05.There was a significant difference between the two groups,and the treatment group was superior to the control group.(3)In terms of the effect of blood lipids:The effect of blood lipids was evaluated after treatment in the treatment group and the control group(P>0.05).There was no significant difference between the two groups.(4)In terms of clinical symptom scores,the clinical symptom scores before and after treatment in the treatment group and the control group were statistically analyzed,P<0.05,with significant differences,suggesting that the treatment group and the control group had significant improvement in clinical symptoms.For the improvement of symptoms before and after treatment in the treatment group,the points before and after right-threatening pain,epigastric fullness,dry mouth,nausea,and stool were compared,P<0.05,the difference was statistically significant;The scores before and after Right flank the ruffian,Louis Vuitton and yellowing were compared,P>0.05,the difference was not statistically significant.For the improvement of symptoms before and after treatment in the control group,there was a statistically significant difference in right and left threatening pain,upper abdominal fullness,nausea and vomiting,dejecta,and total score before and after integral scores;The scores before and after bitterness,body plumpness,and yellowing were compared,P>0.05,and the difference was not statistically significant;Comparing the symptom scores after treatment in the two groups,only right-threatening pain was P<0.05.There was a statistically significant difference between the two groups.The remaining 7 clinical symptom scores were all greater than 0.05.There was no significant difference between the two groups.(5)In terms of efficacy of clinical syndromes:After 3 months of treatment,34 cases of clinical symptoms recovered,including 21 cases in the treatment group and 13 cases in the western medicine group;13 cases were markedly effective,including 8 cases in the treatment group and 5 cases in the control group;A total of 10 cases were effective,including 0 in the treatment group and 10 in the control group;8 cases were invalid,including 2 cases in the treatment group and 6 cases in the control group.The clinical efficacy of the treatment group after treatment was compared with that of the control group.The total effective rate was 96.5%in the treatment group and 82.45%in the control group,P<0.05.The difference was statistically significant,suggesting that the treatment group was superior to the control group.(6)In abdominal B-mode ultrasound:After 3 months of treatment,there were 3 cases of clinical symptoms recovered,including 3 cases in the treatment group,0 cases in the western medicine group,and 4 cases in a significant effect,including 2 cases in the treatment group and 2 cases in the control group;A total of 30 cases were treated with 17 cases in the treatment group and 13 cases in the control group;28 cases were ineffective,including 9 cases in the treatment group and 19 cases in the control group.Compared with the results of abdominal B ultrasound in the treatment group and the control group,the total effective rate in the treatment group was 71%,and the total effective rate in the control group was 44.1%,P<0.05.The difference was statistically significant,suggesting that the treatment group was superior to the control group.Conclusions:Wenyun Qingli method can significantly improve the phlegm internal resistance,damp heat phlegm type NASH.Yinchen Linggui prescription can significantly improve the CAP value,liver function,abdominal B-ultrasound,and clinical symptoms of patients,and can also significantly improve the symptoms of right-threatening pain,abdominal fullness,mouth dry mouth,nausea,and stool symptoms in NASH patients.Yinchen Linggui prescription are safe and effective during treatment. |
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