调脂疏肝汤联合二甲双胍治疗糖耐量异常合并非酒精性脂肪肝患者的临床研究

Clinical Study of Tiaozhi Shugan Decoction Combined with Metformin in the Treatment of Patients with Impaired Glucose Tolerance and Non-Alcoholic Fatty Liver Disease

目的:观察调脂疏肝汤联合二甲双胍治疗糖耐量异常(IGT)合并非酒精性脂肪肝(NAFLD)患者的临床效果。方法:选取2020年7月-2021年12月抚州市第一人民医院收治的60例IGT合并NAFLD患者,依据随机数字表法将患者分为对照组与观察组,每组30例。对照组予以二甲双胍治疗,观察组在对照组基础上联合应用调脂疏肝汤。比较两组临床疗效、中医症候积分、肝脏超声评分、肝脏脂肪含量、NAFLD纤维化评分(NFS)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、谷草转氨酶(AST)、谷丙转氨酶(ALT)与不良反应。结果:观察组总有效率高于对照组(P<0.05)。治疗后,两组主症积分、次症积分、中医症候积分均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗后,两组肝脏超声评分、肝脏脂肪含量及NFS均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗后,两组FBG、2 h PG、FINS、HOMA-IR均较治疗前降低,且观察组均低于对照组(P<0.05)。治疗后,TC、TG、AST、ALT均较治疗前降低,且观察组均低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:调脂疏肝汤联合二甲双胍治疗IGT合并NAFLD可协同增效,缓解临床症状,并改善血糖水平与肝功能,具有临床推广应用价值。

Objective:To observe the clinical effect of Tiaozhi Shugan Decoction combined with Metformin in the treatment of patients with impaired glucose tolerance(IGT)and non-alcoholic fatty liver disease(NAFLD).Method:A total of 60 patients with IGT and NAFLD admitted to the First People’s Hospital of Fuzhou from July 2020 to December 2021 were selected,the patients were divided into control group and observation group by random number table method,with 30 patients in each group.Patients in the control group were treated with Metformin,and patients in the observation group were treated with Tiaozhi Shugan Decoction on the basis of the control group.The clinical efficacy,traditional Chinese medicine syndrome scores,hepatic ultrasound scores,liver fat content,NAFLD fibrosis scores(NFS),fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),fasting insulin(FINS),insulin resistance index(HOMA-IR),total cholesterol(TC),triglyceride(TG),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and adverse reactions were compared between the two groups.Result:The total effective rate in observation group was higher than that in control group(P<0.05).After treatment,the scores of main symptoms,secondary symptoms and traditional Chinese medicine syndrome scores in both groups were lower than those before treatment,those in the observation group were lower than those in the control group(P<0.05).After treatment,the hepatic ultrasound scores,liver fat content and NFS in both groups were lower than those before treatment,those in the observation group were lower than those in the control group(P<0.05).After treatment,FBG,2 h PG,FINS and HOMA-IR in both groups were lower than those before treatment,those in the observation group were lower than those in the control group(P<0.05).After treatment,TC,TG,AST and ALT in both groups were lower than those before treatment,those in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Tiaozhi Shugan Decoction combined with Metformin in the treatment of IGT complicated with NAFLD can improve the curative effect,relieve clinical symptoms,and improve blood glucose level and liver function.