血脂康胶囊联合利拉鲁肽对糖尿病性脂肪肝患者血清脂联素、氧化应激水平的影响及机制

Efficacy and mechanism of Xuezhikang capsule plus liraglutide in regulating serum adiponectin and oxidative stress levels in patients with diabetic fatty liver

目的:探究血脂康胶囊联合利拉鲁肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者血清脂联素、氧化应激水平的影响,并分析其作用机制。方法:选取2018年3月~2020年9月芜湖市第五人民医院收治的112例T2DM合并NAFLD患者为研究对象,采用随机数字表法分为对照组及观察组各56例。对照组给予口服降糖药及血脂康胶囊治疗,观察组在对照组基础上联合利拉鲁肽注射治疗。比较两组治疗前及治疗24周后各代谢指标变化情况,并记录两组治疗期间不良反应发生情况。结果:两组治疗后FPG、2 hPG、HbA1c、TC、TG、HOMA-IR、ALT、AST、MDA水平分别低于治疗前(P<0.05),而脂联素、GSH-PX、SOD水平分别高于治疗前(P<0.05);且观察组效果优于对照组(P<0.05)。两组均未发生低血糖、转氨酶升高等严重不良反应,不良反应主要为胃肠道反应,且两组不良反应发生率差异无统计学意义(P>0.05)。结论:血脂康胶囊联合利拉鲁肽治疗T2DM合并NAFLD效果明显,且安全性良好,临床应用价值高。

Objective:To observe the effect of Xuezhikang capsule combined with liraglutide on serum adiponectin and oxidative stress levels,and analyze the mechanisms in patients of type 2 diabetes mellitus(T2DM)with nonalcoholic fatty liver disease(NAFLD).Methods:One hundred and twelve patients of T2DM with NAFLD treated in our hospital were included from March 2018 to September 2020,and were divided into control group and observational group by simple random sampling using random number table method(n=56 in each group).Patients in the control group received oral hypoglycemic drugs and Xuezhikang capsule,and those in the observational group were given liraglutide injection on the medication basis of control group.The two groups were compared regarding the changes of metabolism indexes before therapy and after 24 weeks of treatment.The occurrence of adverse reactions during treatment were recorded in the two groups.Results:The levels of FPG,2 hPG,HbA1c,TC,TG,HOMA-IR,ALT,AST and MDA were lower in the observational group and control group following therapy(P<0.05),while the adiponectin,GSH-PX and SOD levels were higher after treatment than those before treatment(P<0.05),and the effects were better in observational group than in control group(P<0.05).No serious adverse reactions,such as hypoglycemia and elevated transaminases,occurred in the two groups.The adverse event was primarily involved in gastrointestinal reactions,and there was no significant difference in the incidence rate of adverse reactions between groups(P>0.05).Conclusion:Xuezhikang capsule combined with liraglutide can be safe and clinically effective in the treatment of T2DM patients with NAFLD.