二甲双胍联合降脂、生活方式干预对非酒精性脂肪性肝病的治疗作用

The efficacy of combined therapeutic life style change with metformin and lipid-lowering drug therapy in nonalcoholic fatty liver disease

目的观察二甲双胍联合降脂、生活方式干预治疗对非酒精性脂肪性肝病患者治疗效果。方法对2007年8月至2009年10月在广东省揭阳市红十字会慈云医院门诊确诊100例NAFLD患者。随机分治疗组和对照组各50例,治疗组给予二甲双胍、降脂、运动、饮食控制。对照组应用运动、生活方式干预,治疗观察6个月。比较两组治疗前后肝酶学、肝脏超声、体质量指数、血脂、血糖、胰岛素以及HOMA胰岛素抵抗指标变化。结果治疗组有效率为90%,对照组有效率为56%,两组差异有统计学意义(P<0.05)。肝酶学、肝脏超声、体质量指数、血脂、血糖、胰岛素以及HOMA胰岛素抵抗指标改善情况治疗组优于对照组(P<0.05)。结论对NAFLD患者在进行饮食、运动治疗同时予以二甲双胍、降脂药治疗,改善NAFLD症状及肝酶学及胰岛素抵抗疗效优于单纯的节食减重治疗。

Objective To oberserve the effect of life style change with metformin and lipid-lowering drug in treatment nonalcoholic fatty liver disease （NAFLD） .Methods One-hundred cases of NAHLD were divided into two groups,and each group had fifty cases.The control group was offered therapeutic life style change advice,treatement group was given metformin and lipid-lowering drug on the basis of control group for six months.The changes of liver enzyme tests,ultrasonic examination,body mass index,lipid profiles,plasma glucose,insulin and the HOMA insulin resistance index were analyzed in two groups.Results In two groups after six months treatment： liver enzyme tests,ultrasonic examination,body mass index,lipid profiles,plasma glucose,insulin and the HOMA insulin resistance index decreased.the effect was more evident in treatment group than in control group. The total effective rate in treatment group was 90%, in the control group 56%. The total effective rate in treatment group was obviously higher than control group（P〈0.05）.Conclusion Life style change with combination metformin and lipid-lowering drug thrapy improves the abnormalities of liver enzyme tests in NAFLD.The efficacy is superior to simple diet control to reduce weight.