1、床研究【中文摘要】非酒精性脂肪性肝炎(NASH),是西方國家最常見的肝臟疾病之一，隨著國人生活水平的提高，糖尿病、高脂血癥、高血壓、冠心病等“富貴病”的發病率不斷上升，NASH成為肝源性轉氨酶升高的主要原因之一。也是隱源性肝硬化的重要病因之一，目前尚缺乏理想的治療藥物。苦樂清湯是我們根據國醫大師一周仲瑛教授多年臨證經驗,從“肝腎不足，痰瘀濕阻”基本理論出發，綜合國內外多家研究成果,提煉整理出來的治療NASH方藥。經臨床初步觀察發現該方具有保肝降酶、調節血脂和血糖、降低肝內脂肪含量，逆轉肝纖維化及早期肝硬化等多重作用。研究通過臨床試驗，進一步觀察苦樂清湯治療NASH的臨床療效，評價其治療NASH

2、I臨床療效，觀察其安全性，為臨床治療NASH提供有效藥物。方法：選擇40例符合入選病例標準的患者，隨機分為治療組和對照組，治療組予苦樂清湯，對照組予易善復(多烯磷脂酰膽堿)。3個月為1療程，觀察ALTASTGGTAKP等肝臟酶學指標、肝臟脂肪浸潤程度及相關安全性指標，采用SPSS10.0進行統計學處理分析，客觀評價苦樂清湯的安全性及有效性。結果：苦樂清湯具有明顯的改善NASH患者乏力、消化不良、肝區隱痛等臨床癥狀及體征作用，對ALTASTGGTAKP等肝臟酶學指標改善作用顯著，可降低肝臟脂肪浸潤的程度及體重指數，對血常規、尿常規、腎功能等安全性指標無顯著性影響。結論：苦樂清湯確是有效治療NAS

3、H的方藥,值得進一步深入研究。【英文摘要】Background:Non-alcoholicsteatohepatitis(NASH)isoneofthemostcommonlyseenhepatopathyinwesterncountries.WhileinChina,withtheimprovementoflivingstandardandtheincreasinginmorbidityoftherichpeople'sdiseaseslikediabetes、hyperlipidemia、hypertension、coronaryheartdisease,NASHsbecoming

4、oneoftheprimarycausestotheriseofhepatogenicaminotransferaselackingofcertaineffectivemedicinecurrentlyandtocryptogeniccirrhosis.Kuleqing,basedupontheexperieneeofprofessorZhouZhongyingafamousexpertdevotinghiswholelifetoChinesemedicine,proceedingfromthebasicpathogenesisofdeficiencyofliverandkidneyaswel

5、lasphlegmaccumulatingwithstagnation',combiningthedomesticandoverseasresearchachievements,isexpectedtobeaneffectivepatentherbalmedicineforNASH.Afterthepreliminaryobservation,wefinditsmultiplerolesinprotectingliver-cellandreducingaminotransferase、adjustingthelipidemiaandbloodglucose、loweringdownth

6、elipidcontentintheliver、reversingliverfibrosisandearlycirrhosis.:tofurthertestandverifytheclinicaleffectofKuleqingonNASHandtoobserveitssafety,andallinall,toprovideaneffectivemedicineforthetreatmentofNASH.Method:weselect40qualifiedcasesanddivideintotreatmentgroup(withKuleqing)andcontrolgroup(withEsse

7、ntiale)randomly.weset3monthsasatherapeuticcourseandmonitorthebiologicalindicatorasALTASTTBIL、GGTAKPandalsotheinfiltratingdegreeoflipidintheliveraswellasrelevantsafetyindicator.Then,wedothestatisticanalysisbySPSS10.0andobjectivelyevaluateitsefficiencyandsafety.Result:Kuleqingcannotonlyimprovetheclini

8、calmanifestationsandsignslikefatigue、indigestion、dullpainintheliverarea、hepatosplenomegalybutalsothebiologicalindicatormarkedly、lowerdowntheleveloflipidinfiltrationandBMI.wehaven'tfoundanyadverseeffectfromthebloodroutinetest、urineroutinetestandrenalfunction.Conclusion:itistrueaeffectivemedicineforNASHanddeservefurtherresearches.【關鍵詞】非酒精性脂肪性肝炎苦樂清湯臨床研究【英文關鍵詞】Non-alcoholicsteatohepatitisKuleqingtangClinicalresearch【目錄】苦樂清湯治療非酒