血清瘦素及其可溶性受体异常与2型糖尿病合并脂肪肝的关系及益气养阴活血法的干预作用

STUDIES ON RELATIONSHIP BETWEEN ABNORMITY OF SERUM LEPTIN/SLR AND ONSET OF FATTY LIVER IN TYPE 2 DIABETES MELLITUS AND INTERVENTION OF YIQI YANGYIN HUOXUE METHOD

目的:探讨血清瘦素(leptin)及其可溶性受体(SLR)异常与2型糖尿病合并脂肪肝(DFL)之间的关系,及益气养阴活血法中药组方的干预作用。方法:收集196例2型糖尿病患者进行回顾性研究,其中未合并脂肪肝者100例作为对照组,确诊合并脂肪肝者96例病例(DFL)作为实验组,实验组的96例病例随机分成基础治疗组(50例)和中药治疗组(46例),两组均接受3个月的基础治疗,中药治疗组在基础治疗之外同时加以3个月的益气养阴活血中药组方水煎口服治疗,治疗前后进行肝脏B超检查,并ELISA法检测血清瘦素及可溶性瘦素受体的改变情况。结果:实验组与对照组相比较,血清Leptin及SLR有显著性差异(P<0·01,P<0·01),且实验组中,血TG变化与Leptin呈正相关(r=0·742,P<0·01)。两治疗组治疗后脂肪肝病变得以不同程度逆转,中药治疗组呈显著逆转(P<0·01);基础治疗组治疗前后血清Leptin和SLR、TC、TG无明显改善(P>0·05),而中药治疗组治疗后改善明显(均P<0·01)。结论:血清瘦素及其受体异常是2型糖尿病并发脂肪肝的原因之一,益气养阴活血法中药组方对这种生化异常有显著改善作用,这可能是益气养阴活血法治疗2型糖尿病并发脂肪肝的主要机制之一。

Objective:To explore the relationship between the abnormity of serum leptin and soluble leptin receptor(SLR) and onset of fatty liver in type 2 diabetes mellitus,observe the intervention effect of yiqi yangyin huoxue method on it.Methods:196 cases with type 2 diabetes mellitus were selected to be retrospectively researched,100 cases type 2 diabetes mellitus without fatty liver were taken as control group,96 cases with fatty liver in type 2 diabetes mellitus were taken as observed group,than 96cases were divided into two groups again,one was given the basic treatment,the other was given Chinese herbs of yiqi yangyin huoxue on the basis of basic treatment,the treatment course was three months.The severity of fatty liver of patient was determined by type B ultrasound before and after treated,the serum leptin and SLR levels were detected by ELISA,meanwhile determined the levels of blood sugar,lipid and insulin,etc.Results:There were obvious difference between the control and observed groups on serum leptin and SLR levels,the changes of TG was showed positive correlation with serum leptin changes.The severity of fatty liver of patient in the two groups was improved,the effect of Chinese herbs group was significant.The leptin and SLR levels in the basic treatment group had no obvious changes,the changes of them in the Chinese herbs group were significant.The blood lipid was obviously improved in the Chinese herbs group.Conclusion:The abnormity of serum leptin and soluble leptin receptor(SLR) was one of the causes that type 2 diabetes mellitus combined with fatty liver,yiqi yangyin huoxue method could improve the abnormal changes.