二甲双胍和谷胱甘肽联合治疗非酒精性脂肪肝疗效观察

Effect of Metformin Combined with GSH in the Treatment of Nonalcoholic Fatty Liver Disease

目的探讨二甲双胍联合还原性谷胱甘肽治疗非酒精性脂肪肝的疗效。方法 80例非酒精性脂肪肝患者随机分成实验组(40例)和对照组(40例),实验组给予二甲双胍联合还原性谷胱甘肽治疗,对照组给予维生素E治疗,疗程都为6个月。比较两组治疗前后肝功能指标(ALT、AST、GGT)、血脂水平(TC、TG、HDL-C、LDL-C)和胰岛素抵抗指数。结果实验组患者治疗后血清ALT(t=11.203,P<0.01)、AST(t=5.924,P<0.01)、GGT(t=10.182,P<0.01)、TC(t=5.169,P<0.01)、TG(t=16.182,P<0.01)、LDL(t=6.280,P<0.01)、HOMA-IR(t=4.771,P<0.01)较治疗前明显降低,HDL(t=-4.368,P<0.01)较治疗前升高,差异显著,对照组治疗后ALT(t=11.203,P<0.01)有所下降,而其他指标无明显变化。结论非酒精性脂肪肝患者用二甲双胍联合还原性谷胱甘肽治疗可以明显改善肝功能、纠正血脂紊乱、增强胰岛素敏感性。

Objective To explore the therapeutic effect of metformin combined with reduced glutathione in treating nonalcoholic liver disease. Methods 80 cases of nonalcoholic fatty liver disease patients were randomly divided into treatment group（40 cases） and control group（40 cases）,treatment group were given the metformin with reduced glutathione and control group were given vitamin E for six months. Level of liver function indexes（ALT, AST, GGT）, lipid levels（TC and TG, HDL-c, LDL-c） and insulin resistance index before and after treatment were compared. Results Level of ALT（t= 11.203, P〈0.01）, AST（t= 5.924, P〈0.01）, GGT（t= 10.182, P〈0.01）, TC（t= 5.169, P〈0.01）and TG（t= 16.182, P〈0.01）, LDL（t= 6.280, P〈0.01）, HOMA （t=4.771, P〈0.01）were significantly reduced in treatment group, HDL （t=-4.368, P〈0.01 ） significantly increased, while no difference of the index was found except for ALT （t= 11.203, P〈0.01 ）in the control group. Conclusion Treating nonalcoholic fatty liver disease patients with metformin and reduced glutathione can significantly improve liver function, correct blood disorders, strengthen insulin sensitivity.