Abstract:

Objective　To investigate the efficacy of pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula combined with vitamin D in the treatment of children with obesity-related metabolic fatty liver disease of spleen deficiency and impaired transportation type. Methods　This study is a prospective, single-center, controlled study. A total of 118 children diagnosed with obesity-related metabolic fatty liver disease of spleen deficiency and impaired transportation type were selected from Ankang Traditional Chinese Medicine Hospital between January and October 2024. They were randomly divided into a control group and an observation group, with 59 cases in each group. There were 31 males and 28 females in the control group, aged (11.41±2.21) years. There were 34 males and 25 females in the observation group, aged (11.67±2.58) years old. Both groups received a comprehensive intervention focused on a reasonable dietary structure and oral silymarin capsules. The control group also received oral vitamin D drops, while the observation group received the pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula in addition to the treatment in the control group. Both groups were treated continuously for 12 weeks. Clinical efficacy, blood lipids [total cholesterol (TC) and triglycerides (TG)], liver function [aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB)], body mass index (BMI), liver/spleen CT ratio, and traditional Chinese medicine syndrome scores were compared, along with the recording of adverse reactions. Statistical analysis was performed using χ² and t tests. Results　The overall effective rate in the observation group was 94.92% (56/59), compared to 79.66% (47/59) in the control group, with a statistically significant difference (χ²=6.186, P=0.013). After treatment, the observation group's TC, TG, and BMI were (3.72±0.29) mmol/L, (1.48±0.19) mmol/L, and (24.86±2.02) kg/m², respectively, while the control group's values were (4.18±0.34) mmol/L, (1.69±0.21) mmol/L, and (27.18±2.19) kg/m². The ALB levels and liver/spleen CT ratio in the observation group were higher than those in the control group, while AST, ALT, and traditional Chinese medicine syndrome scores were lower in the observation group, with all differences being statistically significant (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.902, P=0.342). Conclusion　pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula combined with vitamin D can improve clinical efficacy, effectively reduce blood lipid levels and improve liver function in the treatment of metabolic-related fatty liver disease in obese children with spleen deficiency and loss of transportation.

Key words:

Metabolic associated fatty liver disease, Obesity, Pediatric  , spleen-strengthening,  , turbidity-resolving  , and  , fat-reducing  , formula, Vitamin D, Spleen deficiency loss of transport syndrome

摘要：

目的　探讨小儿健脾化浊消脂方联合维生素D治疗脾虚失运型儿童肥胖型代谢相关脂肪性肝病的效果。方法　本研究为前瞻性、单中心、对照研究。选取2024年1月至10月安康市中医医院收治的118例脾虚失运型儿童肥胖型代谢相关脂肪性肝病患儿为研究对象，按照随机数字表法分为对照组和观察组，每组59例。对照组男31例，女28例，年龄（11.41±2.21）岁；观察组男34例，女25例，年龄（11.67±2.58）岁。两组患儿均采用以合理饮食结构为主的综合干预，同时口服水飞蓟宾胶囊。对照组在此基础上口服维生素D滴剂胶囊；观察组在对照组基础上加用小儿健脾化浊消脂方。两组均连续治疗12周。比较两组患儿的临床疗效、血脂［总胆固醇（TC）和三酰甘油（TG）］、肝功能［天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、白蛋白（ALB）］、体重指数（BMI）、肝/脾CT比值、中医症候评分，记录不良反应发生情况。采用χ²、t检验进行统计分析。结果　观察组和对照组治疗总有效率分别为94.92%（56/59）和79.66%（47/59），差异有统计学意义（χ²=6.186，P=0.013）。治疗后，观察组的TC、TG、BMI均低于对照组［（3.72±0.29）mmol/L比（4.18±0.34）mmol/L、（1.48±0.19）mmol/L比（1.69±0.21）mmol/L、（24.86±2.02）kg/m²比（27.18±2.19）kg/m²］，ALB、肝/脾CT比值均高于对照组，AST、ALT和中医症候各项评分均低于对照组，差异均有统计学意义（均P<0.05）。两组不良反应总发生率差异无统计学意义（χ²=0.902，P=0.342）。结论　小儿健脾化浊消脂方联合维生素D治疗脾虚失运型儿童肥胖型代谢相关脂肪性肝病，可提高临床疗效，有效降低血脂水平、改善肝功能。

关键词:

代谢相关脂肪性肝病, 肥胖, 小儿健脾化浊消脂方, 维生素D, 脾虚失运