二甲双胍联用六味地黄丸对T2DM并NAFLD患者血清病情相关分子含量的影响

Effect of metformin combined with Liuwei Dihuang pill on serum illness-related molecule contents in T2DM patients with NAFLD

目的:研究二甲双胍联用六味地黄丸对2型糖尿病(T2DM)并非酒精性脂肪性肝病(NAFLD)患者血清病情相关分子含量的影响。方法:选择86例初诊T2DM合并NAFLD患者进行研究,随机分为联合用药组和单药组,分别接受二甲双胍联用六味地黄丸治疗以及二甲双胍单药治疗,检测两组患者血清中糖脂代谢指标、肝功能指标、氧化应激反应和炎症反应指标。结果:(1)糖脂代谢指标:联合用药组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、日内平均血糖波动幅度(MAGE)、HOMA-IR、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)以及体重指数(BMI)、腰臀比均低于单药组(P<0.05),高密度脂蛋白胆固醇(HDL-C)含量显著高于单药组(P<0.05);(2)肝功能指标:联合用药组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-转肽酶(γ-GT)、血清胆红素(STB)、甘胆酸(CG)含量均显著低于单药组(P<0.05);(3)氧化应激反应和炎症反应指标:联合用药组患者的丙二醛(MDA)、晚期蛋白氧化产物(AOPP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)含量显著低于单药组(P<0.05)。结论:二甲双胍联用六味地黄丸有助于调节T2DM并NAFLD患者的糖脂代谢,减轻肝功能损伤,缓解氧化应激反应和炎症反应。

Objective：To study the effect of metformin combined with Liuwei Dihuang pill on serum illness-related molecule contents in type 2diabetes mellitus（T2DM）patients with non-alcoholic fatty liver disease（NAFLD）.Methods：A total of 86 cases of newly diagnosed T2 DM patients with NAFLD were selected for study and randomly divided into combination therapy group and monotherapy group who received metformin combined with Liuwei Dihuang pill therapy and metformin monotherapy respectively,and then serum glycolipid metabolism indexes,liver function indexes as well as oxidative stress response and inflammatory response indexes of two groups were detected.Results：（1）Glycolipid metabolism indexes：fasting plasma glucose（FPG）,2-h plasma glucose（2hPG）,haemoglobin A1c（HbA1c）,mean amplitude of glycemic excursion（MAGE）,HOMA-IR,triglyceride（TG）,total cholesterol（TC）and low-density lipoprotein cholesterol（LDL-C）as well as body mass index（BMI）and waist hip ratio of combination therapy group were lower than those of monotherapy group（P〈0.05）,and high-density lipoprotein cholesterol（HDL-C）content was significantly higher than that of monotherapy group（P〈0.05）;（2）liver function indexes：aspartate transaminase（AST）,alanine aminotransferase（ALT）,γ-glutamyl transpeptidase（γ-GT）,serum total bilirubin（STB）and cholyglycine（CG）contents of combination therapy group were significantly lower than those of monotherapy group（P〈0.05）;（3）oxidative stress response and inflammatory response indexes：malondialdehyde（MDA）,advanced oxidation protein products（AOPP）,tumor necrosis factor-α（TNF-α）and interleukin（IL）-6contents of combination therapy group were significantly lower than those of monotherapy group（P〈0.05）.Conclusion：Metformin combined with Liuwei Dihuang pill helps to regulate glycolipid metabolism,reduce liver function damage and alleviate oxidative stress response and inflammatory response in T2 DM patients with NAFLD.