关键词: 非酒精性脂肪性肝病, 黄连解毒汤, 益生菌, 中医症候积分, 肠道菌群平衡

Abstract: Objective The aim of this study was to investigate the short-term efficacy of Huanglian Jiedu decoction, a herbal medicine, and probiotics supplement in intervention of patients with non-alcoholic steatohepatitis (NASH). Methods 72 patients with NASH were enrolled in our hospital between December 2018 and June 2020, and we guided 35 patients in the control for appropriate sports and diet control and taking bifidobacterium triple viable, and other 37 patients received Huanglian Jiedu decoction at base of what in the control. The intervention in the two groups lasted for 12 weeks. The traditional Chinese medicine (TCM) symptoms scores were evaluated and blood biochemical indicators were routinely detected, including fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC ), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin (ALB). The controlled attenuation parameters was detected by Fibroscan, the body mass index (BMI) and fatty liver index (FLI) were calculated, and intestinal flora examination was performed. Results At the end of week 12 of treatment, the scores of TCM syndromes of distending pain in hypochondrium, abdominal fullness and distention, uncomfortable body and sleepiness, and dry mouth and bitter taste in the observation group were(1.4±0.6),(0.7±0.4), (1.2±0.6) and (1.0±0.5), all significantly lower than [(1.8±0.8),(1.3±0.6),(1.8±0.9) and (1.5±0.6), respectively, P<0.05] in the control; the FBF, HOMA-IR, serum TC and LDL-C levels were (5.4±0.7)mmol/L, (4.1±0.7),(4.7±1.1)mmol/L and (2.6±0.8)mmol/L, all significantly lower than [(5.8±0.9)mmol/L, (4.9±0.8), (5.6±1.3)mmol/L and (3.1±0.9)mmol/L, respectively, P<0.05] in the control; serum ALT and AST levels were (47.2±7.4)U/L and (43.5±6.2)U/L, both significantly lower than [(62.3±8.1)U/L and (57.9±8.4)U/L, respectively, P<0.05] in the control; the BMI, CAP and FLI were (25.1±2.0)kg/m2, (252.6±12.7)db/m and (19.8±4.7), significantly lower than [(28.1±2.0)kg/m2, (261.1±15.2)db/m and (22.9±4.2), respectively, P<0.05] in the control; the fecal Enterobacter counts was (7.4±0.9)CFU/g, significantly lower than [(8.1±1.0)CFU/g, P<0.05], while the fecal Bacteroides and Bifidobacterium counts were (8.3±1.1)CFU/g and (8.9±1.0)CFU/g, both significantly higher than [(7.6±1.2)CFU/g and (8.0±0.9)CFU/g, respectively, P<0.05] in the control. Conclusion The application of Huanglian Jiedu decoction and probiotics supplement for patients with NASH could efficiently improve the TCM syndrome evaluation, which might be related to the regulation of glucolipid metabolism and improvement of intestinal flora balance.

Key words: Non-alcoholic steatohepatitis, Huanglian Jiedu decoction, Probiotics, TCM syndromes scores, Intestinal flora