疏肝化浊方治疗糖尿病合并非酒精性脂肪肝的临床效果及机制研究

Study on the clinical effect and mechanism of Shugan Huazhuo Decoction in treating diabetes mellitus complicated with nonalcoholic fatty liver disease

目的观察疏肝化浊方对糖尿病合并非酒精性脂肪肝(NAFLD)患者的临床疗效,研究其作用机制。方法选择2015年6月~2017年1月吉林大学第一医院收治的80例糖尿病合并NAFLD患者,采用随机数字表法分为对照组及观察组,每组各40例。对照组服用多烯磷脂酰胆碱胶囊,观察组服用多烯磷脂酰胆碱胶囊及疏肝化浊方;比较两组患者肝功能、血脂代谢、胰岛素抵抗变化情况。结果两组患者治疗后谷草转氨酶、谷丙转氨酶、谷氨酰转肽酶、转化生长因子-β1、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素水平及胰岛素抵抗指数均显著降低(P<0.05)。与对照组治疗后比较,除LDL-C、空腹血糖外,观察组其他指标均显著降低(P<0.05)。观察组治疗有效率显著高于对照组,差异有统计学意义(P<0.05)。结论疏肝化浊方对糖尿病合并NAFLD患者的临床疗效确切,其作用机制可能与改善血脂代谢,降低胰岛素抵抗有关。

Objective To observe the clinical effect of Shugan Huazhuo Decoction on patients with diabetes mellitus combined with nonalcoholic fatty liver disease （NAFLD）, in order to study its mechanism. Methods From June 2015 to January 2017, 80 patients with diabetes mellitus combined with NAFLD treated in the First Hospital of Jilin University were selected and divided into control group and observation group by random number table, with 40 cases in each group. The control group was treated with Polyene Phosphatidylcholine Capsule, while the observation group was treated with Polyene Ph6sph atidy leholine Capsule Shugan Huazhuo Decoction. The liver function, lipid metabolism and insulin resistance in the two groups were compared. Results After treatment, the levels of aspartate aminotransferase, alanine aminotransferase, glutamyl transpeptidase, transforming growth factor-~ （TGF-13j）, total cholesterol triglyceride, low den- sity lipoprotein cholesterol （LDL-C）, fasting insulin and insulin resistance index （HOMA-IR） were significantly decreased, with statistically significant difference （P 〈 0.05）. Compared with the control group after treatment, except for the levels of LDL-C and fasting blood glucose （FPG）, the other indexes in the observation group were significantly lower, with statisti- cally significant difference （P 〈 0105）. The effective rate of the observation group was significantly higher than that of the control group, with statistically significant difference （P 〈 0.05）. Conclusion The clinical effect of Shugan Huazhuo Decoction on patients with diabetes mellitus combined with NAFLD is accurate, and its mechanism may be related to improve blood lipid metabolism, reduce insulin resistance.