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目的:观察中药结合有氧运动治疗儿童非酒精性脂肪肝的临床效果及其对脂肪细胞因子的影响。方法:对44例患非酒精性脂肪肝(NAFLD)和40例无NAFLD的肥胖儿童进行身体成分、血清生化和脂肪细胞因子等指标检查,并将44例患NAFLD儿童随机分为中药干预组(n=22)和中药加运动干预组(n=22),观察两组对象经12周干预后的临床疗效和身体成分、血清生化以及脂肪细胞因子等指标的变化。结果:(1)中药加运动干预组的临床疗效显著高于中药组(P<0.05);(2)NAFLD儿童的血清TG、ALT、AST、TNF-α、NF-κB水平和HOMA-IR指数均明显高于无NAFLD儿童(P<0.05或P<0.01),血清APN水平则显著低于无NAFLD组(P<0.05);(3)经12周干预后,中药加运动干预组的BF、WHR、FM、TG、LDL、AST和HOMA-IR以及TNF-α、NF-κB等指标显著低于中药干预组(P<0.05或P<0.01),APN显著高于中药治疗组(P<0.05)。结论:中药结合运动疗法可以通过调节多种脂肪细胞因子的合成与分泌,改善脂质代谢和胰岛索抵抗,对NAFLD病变程度的改善具有积极促进作用。
Objective: To observe the clinical effect of traditional Chinese medicine combined with aerobic exercise on children with non-alcoholic fatty liver and its effect on adipocytokines. Methods: Forty-four patients with NAFLD and 40 obese children without NAFLD were examined for body composition, serum biochemistry and adipocytokines, and 44 children with NAFLD were randomly divided into TCM intervention group (n = n = 22) and Chinese medicine plus exercise intervention group (n = 22). The clinical curative effect, body composition, serum biochemistry and adipocytokines of the two groups were observed after 12 weeks intervention. Results: (1) The clinical curative effect of traditional Chinese medicine plus exercise intervention group was significantly higher than that of traditional Chinese medicine group (P <0.05). (2) The levels of serum TG, ALT, AST, TNF-α, NF-κB and HOMA-IR (P <0.05 or P <0.01), serum APN levels were significantly lower than those without NAFLD (P <0.05); (3) After 12 weeks of intervention, the levels of BF, The indexes of WHR, FM, TG, LDL, AST and HOMA-IR as well as TNF-α and NF-κB were significantly lower than those of traditional Chinese medicine intervention group (P <0.05 or P <0.01) ). Conclusion: Chinese medicine combined with exercise therapy can improve lipid metabolism and islet resistance by regulating the synthesis and secretion of many adipocyte factors, and has a positive effect on the improvement of the degree of NAFLD.