临床与病理杂志2024，Vol.44Issue(10)：1387-1397,11.DOI:10.11817/j.issn.2095-6959.2024.240338
降肺疏肝法治疗肝郁气滞型代谢相关脂肪性肝病的临床效果
Clinical efficacy of the descending lung and soothing liver method in treating metabolic associated fatty liver disease of liver depression and qi stagnation type
摘要
Abstract
Objective:The lungs and liver jointly regulate the ascending and descending movement of qi in the body,playing a significant role in maintaining metabolic balance.Ban-Xia-Hou-Pu Formula(BXHP)and Si-Ni Formula(SN)are classical prescriptions for descending the lung and soothing the liver.The combination of these two formulas may exert a synergistic effect in treating metabolic associated fatty liver disease(MAFLD)of liver depression and qi stagnation type.This study aims to evaluate the clinical efficacy of Si-Ni-Ban-Xia-Hou-Pu Formula(SNBXHP),a representative prescription of the descending lung and soothing liver method,in treating MAFLD of liver depression and qi stagnation type. Methods:A total of 120 MAFLD patients diagnosed with liver depression and qi stagnation type were enrolled from the outpatient and inpatient departments of Huizhou Hospital of Guangzhou University of Chinese Medicine between March 2023 and March 2024.Patients were stratified based on the severity of metabolic disorders and randomly assigned into 4 groups(n=30 per group):A SNBXHP group,a SN group,a BXHP group,and a polyene phosphatidylcholine(PPC)group.All groups received standard lifestyle interventions and treatment for metabolic complications over a 3-month period.Clinical efficacy was assessed by comparing changes in the following parameters before and after treatment:controlled attenuation parameter(CAP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),the glucose and lipid metabolism[including fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment of insulin resistance index(HOMA-IR),insulin sensitivity index(ISI),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)],blood pressure,uric acid(UA),body mass index(BMI),and traditional Chinese medicine syndrome scores. Results:Baseline characteristics were comparable among the 4 groups(P>0.05).After treatment,CAP,ALT,and AST levels in the SNBXHP group were lower than in the PPC group(all P<0.05).Lipid metabolism indicators(TC,TG,LDL-C)showed a significant decrease in all groups,with SNBXHP performing better than PPC(all P<0.05),while HDL-C showed no significant difference among groups(all P>0.05).Regarding glucose metabolism,FINS,HOMA-IR,and ISI improvements were greater in the SNBXHP group than in the PPC group(P<0.05).No significant changes in BMI were observed in any group(P>0.05).Blood pressure decreased in all groups,with the SNBXHP group showing the more pronounced reduction(P<0.05).No severe adverse reactions were reported in any group. Conclusion:SNBXHP,a representative prescription of the descending lung and soothing liver method,effectively alleviates clinical symptoms,reduces liver fat content,and significantly improves glucose and lipid metabolism,uric acid levels,and insulin sensitivity in MAFLD patients with liver qi stagnation.Compared to single-method interventions(BXHP for lung-descending or SN for liver-soothing),the combined approach of treating both organs showed superior efficacy.Future studies should further explore the mechanisms of SNBXHP in addressing various metabolic disorders,aiming to uncover new therapeutic advantages and potential applications of the descending lung and soothing liver method in other diseases.关键词
代谢相关脂肪性肝病/肝郁气滞/半夏厚朴汤/四逆散/降肺疏肝法Key words
metabolic associated fatty liver disease/liver depression and qi stagnation/Ban-Xia-Hou-Pu formula/Si-Ni formula/descending lung and soothing liver method引用本文复制引用
吴小叶,凌家生..降肺疏肝法治疗肝郁气滞型代谢相关脂肪性肝病的临床效果[J].临床与病理杂志,2024,44(10):1387-1397,11.基金项目
广东省中医药局科研项目(20231348).This work was supported by the Project of Guangdong Traditional Chinese Medicine Bureau,China(20231348). （20231348）
