实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 349-352.doi: 10.3969/j.issn.1672-5069.2026.03.008

• 代谢相关性脂肪性肝病 • 上一篇    下一篇

清化祛瘀法结合针刺疗法治疗湿热蕴结型代谢相关性脂肪性肝病患者临床疗效研究*

潘菊花, 陈茜, 王红妹, 季永胜, 蔡政   

  1. 226200 江苏省南通市 启东市中医院脾胃病科(潘菊花,陈茜,季永胜);如皋市中医院脾胃病科(王红妹);南京中医药大学教学医院/启东市中医院脾胃病科(蔡政)
  • 收稿日期:2025-09-12 出版日期:2026-05-10 发布日期:2026-05-18
  • 通讯作者: 陈茜,E-mail:602537442@qq.com
  • 作者简介:潘菊花,女,39岁,大学本科,副主任医师。E-mail:panjuhua309@163.com
  • 基金资助:
    *江苏省南通市中医医疗联盟科研项目(编号:TZYK202403)

Clinical efficacy of an herbal compound in combination with acupuncture in the treatment of patients with metabolic-associated fatty liver disease with dampness-heat accumulation TCM type

Pan Juhua, Chen Qian, Wang Hongmei, et al   

  1. Department of Spleen and Stomach Diseases, Qidong Traditional Chinese Medicine Hospital, Nantong 226200, Jiangsu Province, China
  • Received:2025-09-12 Online:2026-05-10 Published:2026-05-18

摘要: 目的 观察清化祛瘀法结合针刺疗法治疗湿热蕴结型代谢相关性脂肪性肝病(MAFLD)患者的临床疗效。方法 2024年1月~2025年9月我院和如皋市中医院诊治的70例湿热蕴结型MAFLD患者,被随机分为对照组35例和观察组35例,分别给予饮食调整、运动计划、控制血糖和血脂等一般治疗,或在此基础上给予清化祛瘀方口服和针刺疗法,持续干预治疗8周。采用中医证候积分评估证候疗效,使用超声检测肝脏超声衰减参数(UAP)和肝脏硬度检测(LSM),常规临床检测,计算脂肪肝指数(FLI)。结果 在治疗8 w末,观察组证候疗效总有效率为94.3%,显著高于对照组的77.1%(P<0.05);观察组血清ALT和AST水平分别为(42.7±19.3)U/L和(29.5±9.3)U/L,均显著低于对照组【分别为(76.2±20.6)U/L和(43.7±10.4)U/L,P<0.05】;观察组血清TC和TG水平分别为(5.4±0.8)mmol/L和(1.7±0.6)mmol/L,均显著低于对照组【分别为(6.0±0.4)mmol/L和(2.3±0.8)mmol/L,P<0.05】;观察组UAP和FLI分别为(263.6±24.8)dB/m和(38.1±16.3),均显著低于对照组【分别为(277.5±23.5)dB/m和(55.7±21.5),P<0.05】。结论 应用清化祛瘀法中药联合针刺疗法治疗干预湿热蕴结型MAFLD患者可改善临床中医症候,恢复肝功能指标,降低血脂,其长期作用还需要观察。

关键词: 代谢相关性脂肪性肝病, 湿热蕴结型, 清化祛瘀法, 针刺疗法, 脂肪肝指数, 超声衰减参数, 治疗

Abstract: Objective The aim of this study was to investigate the clinical efficacy of an herbal, Qinghua Quyu, compound in combination with acupuncture in the treatment of patients with metabolic-associated fatty liver disease (MAFLD) with dampness-heat accumulation TCM type. Methods 70 patients with MAFLD and a damp-heat accumulation TCM type were encountered in our hospital and in Rugao Traditional Chinese Medicine Hospital between January 2024 and September 2025, and were randomly assigned to receive general diet and exercise guidance in 35 cases in control, or receive an oral herbal medicine compound and acupuncture at base of general intervention in another 35 cases in observation group for 8 weeks. TCM syndrome scores were evaluated. Ultrasound attenuation parameter (UAP) and liver stiffness measurement (LSM) were detected by ultrasonography. Fatty liver index (FLI) was calculated based on clinical materials. Results By end of eight week treatment, total effectiveness about TCM syndrome improvement in the observation was 94.3%, much higher than 77.1%(P<0.05) in the control; serum ALT and AST levels in the observation were (42.7±19.3)U/L and (29.5±9.3)U/L, both significantly lower than [(76.2±20.6)U/L and (43.7±10.4)U/L, respectively, P<0.05] in the control; serum TC and TG levels were (5.4±0.8)mmol/L and (1.7±0.6)mmol/L, both significantly lower than [(6.0±0.4)mmol/L and (2.3±0.8)mmol/L, respectively, P<0.05] in the control; UAP and FLI were (263.6±24.8)dB/m and (38.1±16.3), both much lower than [(277.5±23.5)dB/m and (55.7±21.5), respectively, P<0.05] in the control group. Conclusion Combination of Qinghua Quyu decoction with acupuncture could effectively ameliorate clinical TCM-symptoms, improve liver function test and blood lipid normalization at base of diet control and exercise in dealing with patients with MALFD, which needs further clinical investigation.

Key words: Metabolism-associated fatty liver disease, Herbal medicine, Acupuncture, Ultrasound attenuation parameter, Fatty liver index, Therapy