| ObjectiveIn this study,we observed the changes of liver fat content in patients with nonalcoholic fatty liver disease(NAFLD)by ultrasound imaging,to explore the clinical efficacy of traditional Chinese medicine combined with caloric restriction on NAFLD,and to establish a safe,convenient,economic and effective intervention scheme for NAFLD.MethodsAccording to the inclusion criteria,120 patients with NAFLD were recruited and randomly divided into heat restriction group,traditional Chinese medicine group and experimental group,40 cases in each group.The caloric restriction group was given a low-carbon diet with a daily intake of 800 kcal of food and 3000 ml of warm water;In the traditional Chinese medicine group,1000ml of modified Lingguizhugan Decoction and 2000ml of warm water were used daily;In the experimental group,1000 ml of Jiawei Linggui Zhugan Decoction and 2000 ml of warm water were added on the basis of caloric restriction group.The three groups were followed up for 3 months after 4 weeks of treatment.The clinical efficacy of all patients was evaluated.Before and after the intervention,and after 3 months of follow-up,the body weight(BW),total cholesterol(TC),triglyceride(TG),serumalanine transaminase(ALT),aspartate aminotransferase(AST),γglutamyl transpeptidase(GGT),creatinine(CRE),Urea(UREA),liver fat content(B-ratio)and liver elasticity(Emean)were used to observe the therapeutic effect.Results1.Results of liver elastosonography(1)Results of B-ratio test1)Intra group comparisonThere were significant differences among the three groups at each observation time point(P<0.01),indicating that the three treatment methods could reduce liver fat deposition,and the effect was still sustained within 3 months.2)Comparison between groups① Comparison of the results after intervention:there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),there was significant difference between the caloric restriction group and the traditional Chinese medicine group(P<0.01),and there was no difference between the experimental group and the caloric restriction group(P>0.05),which showed that the experimental group and the caloric restriction group could effectively reduce liver fat deposition,and the curative effect of the two groups was equivalent,which was better than that of the traditional Chinese medicine group.② After 3 months of follow-up,there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01).There was significant difference between the experimental group and the caloric restriction group(P<0.01),but there was no difference between the caloric restriction group and the traditional Chinese medicine group(P>0.05),indicating that the sustained efficacy of the experimental group was better than that of the traditional Chinese medicine group and the caloric restriction group.(2)Results of Emean test1)Intra group comparisonThere were significant differences among the three groups at each observation time point((P<0.01),which indicated that the three treatment methods could improve the liver elasticity,and the effect was still sustained within 3 months.2)Comparison between groups① Comparison of the results after the intervention:there was no difference between the experimental group and the traditional Chinese medicine group(P>0.05),the curative effect of the experimental group was significantly better than that of the caloric restriction group(P<0.01),and there was significant difference between the traditional Chinese medicine group and the caloric restriction group(P<0.01),indicating that the experimental group and the traditional Chinese medicine group had the same curative effect in improving liver elasticity,and their curative effects were better than those of the caloric restriction group.②Comparison of the results after 3 months of follow-up:there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),between the experimental group and the heat restriction group(P<0.01),between the traditional Chinese medicine group and the heat restriction group(P<0.01),indicating that the continuous curative effect of the experimental group was better than that of the traditional Chinese medicine group and the heat restriction group,and the traditional Chinese medicine group was better than that of the heat restriction group.2.Results of curative effectIn the caloric restriction group,6 cases were cured(15%).8 cases were markedly effective(20%),12 cases were effective(30%),14 cases were ineffective(35%),and the total effective rate was 65%.In the traditional Chinese medicine group,9 cases were cured(22.5%),9 cases were markedly effective(22.5%),13 cases were effective(32.5%),9 cases were ineffective(22.5%),and the total effective rate was 77.5%.In the experimental group,14 cases were cured(35%),10 cases were markedly effective(25%),13 cases were effective(32.5%),3 cases were ineffective(7.5%),and the total effective rate was 92.5%.The results showed that the experimental group was more effective than the traditional Chinese medicine group and caloric restriction group in the treatment of fatty liver.3.Results of BW test(1)Intra group comparisonAnalysis of variance showed that there were significant differences in the BW values of the three groups at each observation time point(P<0.01),indicating that the weight of the three different treatment methods decreased after intervention,and there was a sustained effect.(2)Comparison between groups:1)Comparison of the results after the intervention:there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),between the experimental group and the heat restriction group((P<0.01),between the heat restriction group and the traditional Chinese medicine group(P<0.01),indicating that the weight loss effect of the heat restriction group was better than that of the traditional Chinese medicine group,but the weight loss effect of the experimental group was significantly better than that of the heat restriction group and the traditional Chinese medicine group.2)Comparison of results after 3 months of follow-up:there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),there was no difference between the experimental group and the heat restriction group(P>0.05),and there was significant difference between the heat restriction group and the traditional Chinese medicine group(P<0.01),indicating that the sustained efficacy of the experimental group was significantly better than that of the heat restriction group and the traditional Chinese medicine group.4.Results of blood lipid test(1)Intra group comparisonThere were significant differences in the detection results of TC and TG at each observation time point among the three groups(P<0.01),which showed that the three treatment methods had the effect of reducing TC and TG,and the curative effect was persistent.(2)Comparison between groups1)Results of TC test① Comparison of the results after the intervention:there was no difference between the experimental group and the traditional Chinese medicine group(P>0.05),there was significant difference between the experimental group and the heat restriction group(P<0.01),and there was significant difference between the traditional Chinese medicine group and the heat restriction group(P<0.01),which indicated that the traditional Chinese medicine group and the experimental group had an improvement effect on TC,and their effect was better than that of the heat restriction group.② After 3 months of follow-up,there was no significant difference between the two groups(P>0.05).2)Results of TG test① Comparison of the results after intervention:there was no significant difference between the two groups(P>0.05),indicating that the three treatment methods had the same effect on TG.② Comparison of results after 3 months of follow-up:there was a significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),there was a significant difference between the experimental group and the caloric restriction group(P<0.01),and there was no significant difference between the caloric restriction group and the traditional Chinese medicine group(P>0.05),indicating that the sustained efficacy of the experimental group was significantly better than that of the caloric restriction group and the traditional Chinese medicine group.5.Results of liver enzyme test(1)Intra group comparisonAfter the intervention of ALT,AST and GGT and the results after 3 months of follow-up,there were significant differences among the observation time points in the group(P<0.01),indicating that the three treatment methods had significant effects on reducing ALT,AST and GGT,and the curative effect was persistent.(2)Comparison between groups1)Results of ALT test① Comparison of the results after the intervention:there was significant difference between the experimental group and the caloric restriction group(P<0.01),there was significant difference between the traditional Chinese medicine group and the caloric restriction group(P<0.01),and there was no difference between the experimental group and the traditional Chinese medicine group(P>0.05),which indicated that the therapeutic effect of the traditional Chinese medicine group and the experimental group on ALT was similar,and both of them were better than the caloric restriction group.② Comparison of the results after 3 months of follow-up:there was significant difference between the experimental group and the caloric restriction group(P<0.01),between the experimental group and the traditional Chinese medicine group(P<0.01),between the traditional Chinese medicine group and the caloric restriction group(P<0.01),indicating that the continuous therapeutic effect of the experimental group was significantly better than that of the traditional Chinese medicine group and the caloric restriction group,and the traditional Chinese medicine group was better than the caloric restriction group.2)Results of AST test① Comparison of the results after the intervention:there was no significant difference between the experimental group and the caloric restriction group(P>0.05),there was no significant difference between the experimental group and the traditional Chinese medicine group(P>0.05),and there was no significant difference between the traditional Chinese medicine group and the caloric restriction group(P>0.05).② Comparison of the results after 3 months of follow-up:there was significant difference between the experimental group and the caloric restriction group(P<0.01),between the traditional Chinese medicine group and the experimental group(P<0.01),between the traditional Chinese medicine group and the caloric restriction group(P<0.01),indicating that the continuous therapeutic effect of reducing AST in the experimental group was better than that in the caloric restriction group,but the curative effect was not as good as that in the traditional Chinese medicine group.3)Results of GGT test① Comparison of the results after the intervention:there was significant difference between the traditional Chinese medicine group and the experimental group(P<0.01),significant difference between the traditional Chinese medicine group and the caloric restriction group(P<0.01),no difference between the experimental group and the caloric restriction group(P>0.05),indicating that the effect of reducing GGT in the traditional Chinese medicine group was significantly better than that in the caloric restriction group and the experimental group.② Comparison of the results after 3 months of follow-up:there was significant difference between the experimental group and the heat restriction group(P<0.01),there was significant difference between the experimental group and the traditional Chinese medicine group(P<0.01),and there was no difference between the traditional Chinese medicine group and the heat restriction group(P>0.05),indicating that the continuous effect of the experimental group in reducing GGT was significantly better than that of the traditional Chinese medicine group and the heat restriction group.6.Results of renal function testUrea and creatinine levels of the patients included in this study were within the normal range.Slight fluctuations were found in the test,but the changes were not statistically significant(P>0.05).ConclusionThe short-term treatment(4 weeks)can significantly reduce liver fat deposition,reverse fatty liver,and reduce weight,lipid,and transaminase.The curative effect is sustainable.It has more advantages than single Chinese medicine treatment or caloric restriction in the treatment of NAFLD,and is safe,feasible,high acceptance,and good compliance,which is worthy of promotion. |
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