Effect analysis of double filtration plasmapheresis combined with Bugan Lizhi decoction in the treatment of severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease
Objective To explore the effect of double filtration plasmapheresis(DFPP)combined with Bugan Lizhi decoction in the treatment of severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease.Methods This study was a randomized controlled trial.A total of 68 patients diagnosed with severe hypertriglyceridemia combined with non-alcoholic fatty liver disease in the Gastroenterology Department of Ankang Hospital of Traditional Chinese Medicine from June 2021 to June 2022 were selected as the study objects,and were divided into a control group and an observation group by the random number table method,with 34 cases in each group.In the control group,18 males and 16 females,aged(42.62±8.55)years,were treated with DFPP plus oral bezafibrate:on the first day after DFPP treatment,bezafibrate 0.2 g was taken orally,3 times a day,for 24 weeks.In the observation group,20 males and 14 females,aged(43.43±7.25)years,were treated with DFPP+oral Bugan Lizhi decoction:the above traditional Chinese medicine was taken orally on the first day after blood purification treatment,200 ml each time,1 dose per day,within 30 minutes before meals,for 24 weeks.Biochemical indexes such as triglyceride,apolipoprotein A-Ⅰ(ApoA-Ⅰ),apolipoprotein B(ApoB),high density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C)and liver function biochemical indexes such as alanine aminotransferase(ALT),albumin(ALB),and aspartate aminotransferase(AST)were compared between the two groups before and after treatment.The liver function indexes and liver imaging results were compared between the two groups before and after treatment.x2 test and t test were used for statistical analysis.Results After 24 weeks of treatment,the levels of triglyceride,LDL-C,and ApoB in the observation group were lower than those in the control group[(4.13±1.09)mmol/L vs.(6.03±1.65)mmol/L,(3.13±0.58)mmol/L vs.(3.91±0.75)mmol/L,(0.76±0.23)g/L vs.(0.86±0.17)g/L],and the levels of HDL-C and ApoA-Ⅰ were higher than those in the control group[(1.88±0.53)mmol/L vs.(1.42±0.43)mmol/L,(1.81±0.39)g/L vs.(1.58±0.32)g/L],with statistically significant differences(t=5.602,4.797,2.039,3.930,and 2.658,all P＜0.05).After 24 weeks of treatment,the levels of ALT and AST in the observation group were lower than those in the control group[(28.62±3.23)U/L vs.(34.32±1.68)U/L,(21.29±4.34)U/L vs.(35.44±5.72)U/L],and the level of ALB was higher than that in the control group[(49.21±4.31)g/L vs.(45.34±4.28)g/L],with statistically significant differences(t=9.138,11.488,and 3.715,all P＜0.05).The results of liver imaging examination after 24 weeks of treatment showed that the oblique diameter of liver subcostal in the observation group was smaller than that in the control group[(9.98±3.54)cm vs.(12.05±4.78)cm],with a statistically significant difference(t=2.029,P=0.046).There were 7 cases(20.59％),15 cases(44.12％),and 12 cases(35.29％)of mild,moderate,and severe hepatic cellular fat infiltration in the control group,and 20 cases(58.82％),11 cases(32.35％),and 3 cases(8.82％)in the observation group,with a statistically significant difference(x2=12.275,P=0.002).Conclusion DFPP combined with Bugan Lizhi decoction can effectively improve the biochemical indicators and liver function in severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease patients,with positive effects on hepatic imaging manifestations,suggesting its potential application value in the treatment of severe hypertriglyceridemia complicated with non-alcoholic fatty liver disease.
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