健脾益肾、活血化痰法联合罗格列酮早期治疗非酒精性脂肪肝并胰岛素抵抗29例临床观察

Clinical Study on 29 Cases of Nonalcoholic Fatty Liver Disease with Insulin Resistance Treated by Strengthening Spleen,Tonifying Kidney,Invigorating Blood Flow and Dissolving Phlegm plus Rosiglitazone

目的探讨健脾益肾、活血化痰法联合罗格列酮对非酒精性脂肪肝并胰岛素抵抗的早期治疗意义。方法90例患者随机分为空白组29例、西药组(口服罗格列酮)32例、治疗组(口服罗格列酮和健脾益肾、活血化痰方)29例,1个月为1个疗程,共2个疗程。观察治疗前后肝功能、血脂、空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)、血清瘦素、脂联素的变化。结果治疗组患者肝功能、血脂、FBG、FINS、IRI、瘦素、脂联素与治疗前比较差异均有统计学意义(P<0.05或<0.01);与西药组比较,在改善γ-谷氨酰转肽酶(GGT)及FINS方面差异有统计学意义(P<0.05或<0.01)。治疗组总有效率79.31%。结论健脾益肾、活血化痰法联合罗格列酮早期干预非酒精性脂肪肝并胰岛素抵抗有着较好的临床意义。

Objective To observe the effect of herbal treatment to strengthen spleen, tonify kidney, invigorate blood flow and dissolve phlegm plus Rosiglitazone on nonalcoholic fatty liver disease （NAFLD） with insulin resistance （IR）. Methods The 90 cases were randomized into 3 groups： blank group of 29 cases; western medicine group of 32 cases, treated with Rosiglitazone; treatment group of 29 cases treated with herbal medicine plus Rosiglitazone. The changes in liver function, blood lipid, fasting blood glucose （FBG）, fasting insulin （FIN）, insulin resistance index （IRI）, serum leptin and adiponcetin were observed. Results In the treatment group, changes of liver function, blood lipid, FBG, FIN, IRI, serum leptin and adiponcetin compared after treatment was significant （P〈0.05 or P〈0.01） ; compared with the western medicine group, the improvement in glutamyl transferase （GGT） and FINS was significant （P〈0.05 or P〈0. 01）. The total effective rate of the treatment group was 79.31%. Conclusion The herbal treatment with the principle to strengthen spleen, tonify kidney, invigorate blood flow and dissolve phlegm plus Rosiglitazone was effective for NAFLD with IR.