摘要
目的评价复方鳖甲软肝片(biejia-ruangan compound,BRC)对于非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)肝纤维化的治疗效果。方法回顾性收集并分析2018年1月—2023年2月就诊于解放军总医院第五医学中心的144例NAFLD患者临床资料,根据治疗方案,将采用单纯保肝治疗的76例患者作为对照组,采用保肝治疗联合BRC治疗方案的68例患者作为治疗组,以治疗6个月后肝纤维化改善率为疗效评价标准。肝纤维化改善定义为肝脏纤维化-4指数(fibrosis-4 score,FIB-4)或天冬氨酸氨基转移酶与血小板比值指数(aspartate aminotransferase to platelet ratio index,APRI)或肝硬度检测值(liver stiffness measurement,LSM)下降20%及以上。通过多因素分析评价BRC治疗NAFLD的疗效。结果治疗组的FIB-4、APRI和LSM改善率分别为75.6%、69.9%和88.6%,显著高于对照组的24.4%、30.1%和11.4%(P均<0.05)。治疗组总胆固醇水平较治疗前降低(P<0.05),对照组则无明显变化(P>0.05);2组甘油三酯水平治疗前后均无明显变化(P均>0.05)。Logistic回归结果显示,BRC治疗是NAFLD肝纤维化的保护因素,BRC对NAFLD肝纤维化有治疗效果。结论BRC可显著改善NAFLD患者的肝纤维化程度。
Objective To evaluate the therapeutic effectiveness of biejia-ruangan compound(BRC)in liver fibrosis caused by non-alcoholic fatty liver disease(NAFLD).Methods The clinical data of 144 patients in the Fifth medical center of PLA general hospital from January 2018 to February 2023 were retrospectively enrolled.According to the treatment,76 patients were divided into only liver protection treatment(control group)and 68 patients were divided into the liver protection treatment combining BRC(treatment group).The effectiveness was evaluated based on the improvement rate of liver fibrosis after 6-month treatment,which was defiend as≥20%reduction in fibrosis-4 score(FIB-4),aspartate aminotransferase to platelet ratio index(APRI),or liver stiffness measurement(LSM).Multivariate analysis was conducted to explore BRC treatment associated with the effectiveness of NAFLD.Results The improvement rates of FIB-4,APRI and LSM in treatment group were 75.6%,69.9%and 88.6%,respectively,which were significantly higher than the control group(24.4%,30.1%and 11.4%,P<0.05).The level of total cholesterol(TC)was lower after treatment(P=0.009),while there was no significant change in control group(P>0.05).The level of triglycerides(TG)showed no statistical change in two groups before and after treatment(P>0.05).The logistic regression analysis showed that BRC treatment was a protective factor for liver fibrosis,indicating effectiveness of BRC in NAFLD with liver fibrosis.Conclusion BRC could significantly improve the liver fibrosis in NAFLD.
作者
吕桂基
陈椿
贺梦雯
柏兆方
纪冬
LYU Guiji;CHEN Chun;HE Mengwen;BAI Zhaofang;JI Dong(Peking University 302 Clinical Medical School,100039,China;不详)
出处
《传染病信息》
2024年第1期1-4,10,共5页
Infectious Disease Information
基金
“十三五”国家科技重大专项(2018ZX10725506)
国家自然科学基金资助项目(U23A20519)
北京市新星交叉课题(20230484395)。
关键词
非酒精性脂肪性肝病
肝纤维化
中药
复方鳖甲软肝片
non-alcoholic fatty liver disease
liver fibrosis
traditional Chinese medicine
biejia-ruangan compound
