抗脂益肝汤联合二甲双胍对非酒精性脂肪肝患者胰岛素、瘦素抵抗的影响

Effects of Kangzhi Yigan Decoction combined with metformin on the insulin and leptin resistance in patients with non-alcoholic fatty liver disease

目的:观察抗脂益肝汤联合二甲双胍对非酒精性脂肪肝(NAFLD)患者胰岛素、瘦素抵抗的影响。方法:123例NAFLD患者分成4组,抗脂益肝汤联合二甲双胍治疗组、二甲双胍治疗组、抗脂益肝汤治疗组、安慰剂组。各组均同时予饮食控制和运动处方,疗程为6个月。治疗前后检测肝功能、血脂、空腹血糖、空腹血胰岛素、血清瘦素水平,计算BMI、胰岛素抵抗指数,比较治疗前后各指标的变化。结果:4组患者治疗后肝功能、血脂紊乱均明显改善,差异有显著性(P<0.05或P<0.01);抗脂益肝汤联合二甲胍治疗组、二甲双胍治疗组、抗脂益肝汤组胰岛素、瘦素抵抗均明显改善,差异有显著性,以抗脂益肝汤联合二甲双胍治疗组改善最显著(P<0.05或P<0.01),安慰剂组无明显改善。结论:在饮食控制和运动的基础上,抗脂益肝汤联合二甲双胍能更明显地改善NAFLD患者肝功能,促进脂质代谢,并改善胰岛素及瘦素抵抗。

Objective To investigate the effects of Kangzhi Yigan Decoction combined with metformin on the insulin and leptin resistance in patients with non-alcoholic fatty liver disease （NAFLD）. Methods 123 patients with NAFLD were divided into four groups： Kangzhi Yigan Decoction combined with metformin group （combined group）, metfo1~nin group, Kangzhi Yigan Decoction group and the placebo group. All groups were given dietary and exercise prescription at the same time for six months. Liver function, serum lipid levels, fasting blood glucose, fasting serum insulin and leptin levels were deteced and compared before and after treatment respectively. BMI and insulin resistance index were calculated. Results Liver function and lipid disorders of every group patients were significantly improved after treatment（P 〈 0.05 or P 〈 0.01）; In the combined group, metformin group,and Kangzhi Yigan Decoction group, insulin resistance and leptin levels were significantly improved after treatment, and the most significant improvement occurred in the the combined group （P 〈 0.05 or P 〈 0.01 ）. Conclusion Kangzhi Yigan Decoction combined with metformin can improve liver function in patients with NAFLD, promote lipid metabolism and improve insulin and leptin resistance.