Effect of self-made Shugan Jianpi prescription on short chain fatty acids in patients with non-alcoholic fatty liver of stagnation of liver qi and spleen deficiency type

doi:10.3877/cma.j.issn.1674-0785.2021.11.013

Abstract

Abstract:

Objective

To explore the effect of self-made Shugan Jianpi prescription on short-chain fatty acids (SCFAs) in patients with non-alcoholic fatty liver (NAFL) of stagnation of liver qi and spleen deficiency type.

Methods

One hundred and twenty patients with NAFL of stagnation of liver qi and spleen deficiency type treated at Dalian Sixth People's Hospital from June 2019 to December 2020 were selected. Using the random number table method, the patients were randomly divided into a control group and an observation group, with 60 cases in each group. Both groups were treated with conventional Western medicine, and the observation group was additionally given self-made Shugan Jianpi prescription. All patients were treated for 3 months, and the clinical curative effect was compared between the two groups. Traditional Chinese medicine (TCM) symptom score, controlled attenuation parameter (CAP), visceral fat area (VFA), blood lipid index, liver function index, and adverse reactions were compared between the two groups before and after treatment. The levels of SCFAs in the two groups were detected by gas chromatograph and compared.

Results

The total clinical effective rate in the observation group was significantly higher than that of the control group (91.67% vs 71.67%, P＜0.05). After treatment, the TCM symptom score, CAP, VFA, and serum TC, TG, LDL-C, AST, ALT, and GGT in both groups were significantly lower than those before treatment (P＜0.05), and serum HDL-C was significantly higher (P＜0.05); the improvement of these indexes in the observation group after treatment was significantly better than that in the control group (P＜0.05). After treatment, acetic acid levels in the two groups were higher than those before treatment (P＜0.05), while isovaleric acid levels were lower (P＜0.05); the improvement of these indexes in the observation group after treatment was significantly better than that of the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (8.33% vs 6.67%, P＞0.05).

Conclusion

On the basis of Western medicine treatment, Shugan Jianpi prescription has obvious clinical effects in the treatment of NAFL of stagnation of liver qi and spleen deficiency type, which is helpful to alleviate clinical symptoms and improve blood lipid levels and liver function. The mechanism may be related to the improvement of intestinal SCFA level.

Key words: Non-alcoholic fatty liver, Stagnation of liver qi and spleen deficiency, Shugan Jianpi prescription, Short-chain fatty acids

Haiyan Lin, Ning Cheng, Xin Huang, Wei Liu, Yuanyuan Wang. Effect of self-made Shugan Jianpi prescription on short chain fatty acids in patients with non-alcoholic fatty liver of stagnation of liver qi and spleen deficiency type[J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(11): 871-876.

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Figures/Tables 7

组别	例数	性别（例，男/女）	年龄（岁， $x ¯$ ±s）	病程（年， $x ¯$ ±s）	体质量指数（kg/m²， $x ¯$ ±s）
对照组	60	37/23	41.53±6.11	5.54±0.88	24.11±0.79
观察组	60	39/21	40.19±7.20	5.70±0.92	24.06±0.85
统计值		χ²=0.144	t=1.099	t=0.973	t=0.334
P值		0.705	0.137	0.166	0.370

组别	例数	性别（例，男/女）	年龄（岁， $x ¯$ ±s）	病程（年， $x ¯$ ±s）	体质量指数（kg/m²， $x ¯$ ±s）
对照组	60	37/23	41.53±6.11	5.54±0.88	24.11±0.79
观察组	60	39/21	40.19±7.20	5.70±0.92	24.06±0.85
统计值		χ²=0.144	t=1.099	t=0.973	t=0.334
P值		0.705	0.137	0.166	0.370

组别	例数	痊愈	显效	有效	无效	总有效
对照组	60	7（11.67）	17（28.33）	19（31.67）	17（28.33）	43（71.67）
观察组	60	12（20.00）	26（43.33）	17（28.33）	5（8.33）	55（91.67）
χ²值						8.015
P值						0.005

组别	例数	肢体困重	脘腹胀满	胁肋胀痛	口苦口干	舌苔黄腻
对照组	60
治疗前		2.33±0.42	2.23±0.38	2.16±0.31	2.08±0.29	1.98±0.35
治疗后		1.65±0.30^a	1.72±0.26^a	1.64±0.25^a	1.70±0.23^a	1.65±0.26^a
观察组	60
治疗前		2.31±0.50	2.20±0.36	2.14±0.33	2.05±0.28	1.96±0.31
治疗后		1.22±0.24^ab	1.21±0.20^ab	1.12±0.19^ab	1.29±0.21^ab	1.24±0.21^ab

组别	例数	TC	TG	LDL-C	HDL-C
对照组	60
治疗前		5.36±1.04	1.87±0.31	3.83±0.66	1.05±0.22
治疗后		4.95±0.62^a	1.61±0.21^a	3.40±0.50^a	1.32±0.25^a
观察组	60
治疗前		5.32±1.09	1.85±0.27	3.81±0.68	1.08±0.19
治疗后		4.61±0.55^ab	1.40±0.14^ab	3.11±0.41^ab	1.36±0.28^ab

组别	例数	AST	ALT	GGT
对照组	60
治疗前		45.08±8.33	68.31±7.50	142.25±28.24
治疗后		36.11±4.05^a	45.40±4.16^a	64.48±8.84^a
观察组	60
治疗前		45.16±7.17	68.27±7.13	140.43±29.67
治疗后		29.25±3.11^ab	36.30±2.75^ab	50.21±6.71^ab

组别	例数	CAP（db/m）	VFA（cm²）
对照组	60
治疗前		286.02±13.37	139.77±11.35
治疗后		260.31±12.52^a	112.27±9.15^a
观察组	60
治疗前		285.89±14.66	139.62±10.63
治疗后		241.14±10.84^ab	78.43±8.04^ab

组别	例数	乙酸	异戊酸	丙酸	丁酸	戊酸
对照组	60
治疗前		40.11±8.48	4.04±1.11	20.20±8.77	14.43±5.30	2.08±0.96
治疗后		71.20±10.85^a	2.25±0.68^a	21.15±8.05	15.22±6.71	1.99±1.14
观察组	60
治疗前		41.52±9.15	3.98±1.05	19.89±9.20	15.29±5.68	2.07±1.04
治疗后		82.24±13.39^ab	1.30±0.43^ab	19.43±10.01	14.18±7.29	2.05±0.88

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