二甲双胍联用六味地黄丸对新诊断2型糖尿病合并非酒精性脂肪肝疗效观察

Observation of Clinical Effects of Metfor min Combined with Liuwei Dihuang Bolus in Patients with Newly Diagnosed T2DM and NAFLD

目的:探讨二甲双胍与六味地黄丸联合用于新诊断2型糖尿病(T2DM)并发非酒精性脂肪肝(NAFLD)患者的临床效果。方法:138例新诊断T2DM合并NAFLD患者随机分为观察组(n=69)与对照组(n=69),观察组给予二甲双胍联合六味地黄丸治疗,对照组仅给予二甲双胍治疗,治疗12周后对比两组患者空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、空腹血胰岛素(FINS)、糖化血红蛋白(Hb A1C)、胰岛素抵抗指数(HOMA-IR)、血甘油三酯(TG)、胆固醇(TC)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、体重指数(BMI)、肝脏超声变化。结果:两组患者治疗后FBG、2 h PBG、FINS、Hb A1C、TG、TC、ALT、AST、HDL-C、LDL-C以及BMI均显著降低(P<0.01),且治疗后观察组均显著低于对照组(P<0.05或P<0.01),治疗后观察组HOMA-IR显著降低(P<0.01),且显著低于对照组(P<0.01),但观察组治疗前后未见明显变化(P>0.05);观察组脂肪肝治疗有效率为94.2%,显著高于对照组的71.0%(P<0.01)。结论:二甲双胍与六味地黄丸联合用于初诊T2DM合并NAFLD患者,能够在有效控制血糖的基础上,减轻胰岛素抵抗状态,从而逆转肝脂肪变性的进程,降低血脂水平,对于初诊T2DM合并NAFLD患者具有确切疗效。

Objective：To discuss the clinical effects of metfor min combined with Liuwei Dihuang Bolus in patients with newly diagnosed T2 DM and NAFLD. Methods：138 patients with newly diagnosed T2 DM and NAFLD were randomly divided into the observation group（n=69）and the control group（n=69）,the observation group were treated with metfor min combined with Liuwei Dihuang Bolus and the control group were treated with metfor min only,then FBG,2 h PBG,FINS,Hb A1 C,HOMA-IR,TG,TC,ALT,AST,BMI,and liver ultrasound were contrasted between the two groups. Results：FBG,2 h PBG,FINS,Hb A1 C,TG,TC,ALT,AST,HDL-C,LDL-C and BMI were significantly reduced after the treatment in the two groups（P0.01）,and the observation group significantly lower than the control group（P0.01）,HOMAIR in the observation group was significantly reduced after the treatment（P0.01）,and significantly lower than the control group（P0.01）,but no significantly difference in the control groups（P0.05）. The effective rate of fatty liver in the observation group was 94.2%,significantly higher than 71.0% in the control group（P0.01）. Conclusion：Metfor min combined with Liuwei Dihuang Bolus can reduce insulin resistance state based on the effective control of blood sugar in patients with newly diagnosed T2 DM and NAFLD,thereby reversing the process of hepatic steatosis,reduce blood lipid levels,have definite effects.