糖Ⅰ号协定方治疗2型糖尿病脾虚湿热证合并非酒精性脂肪肝病的效果观察及作用机制分析

目的探讨糖Ⅰ号协定方用于2型糖尿病脾虚湿热证合并非酒精性脂肪肝病(NAFLD)患者的治疗效果,及其对血清铁蛋白(SF)水平的影响。方法92例2型糖尿病脾虚湿热证合并NAFLD的患者,随机分为观察组和对照组,每组各46例。两组均在常规治疗的基础上联合阿托伐他汀钙片口服,观察组加用糖Ⅰ号协定方,共治疗12周。比较治疗前后两组的肝功能(ALT、AST、GGT)、糖代谢(FPG、PPG、HbA1c)、脂代谢(TG、TC、HDL-C)、胰岛素抵抗水平(FCP、FINS、Homa2-IR)、BMI、WHR、炎症因子(HsCRP、TNF-α)及铁蛋白水平变化。结果观察组患者的肝功能、糖脂代谢、胰岛素抵抗水平、BMI、WHR、炎症因子和铁蛋白水平的改善情况均优于对照组(P<0.05)。结论糖Ⅰ号协定方可调节2型糖尿病脾虚湿热证合并NAFLD患者的糖脂代谢紊乱,改善胰岛素抵抗水平、体质量及体脂分布,其机制可能与“抗炎”“去铁”作用相关。

Objective To investigate the therapeutic effect of Sugar Ⅰ prescription for type 2 diabetes mellitus patients with syndrome of dampness-heat due to spleen deficiency complicated with non-alcoholic fatty liver disease(NAFLD)and its effect on serum ferritin(SF)level.Methods 92 patients with type 2 diabetes mellitus syndrome of syndrome of dampness-heat due to spleen deficiency complicated with NAFLD were randomly divided into observation group and control group,with 46 cases in each group.Both groups were treated with atorvastatin calcium tablet orally on the basis of conventional treatment,and the observation group was treated with Sugar Ⅰ prescription for 12 weeks.Liver function(ALT,AST,GGT),glucose metabolism(FPG,PPG,HbA1c),lipid metabolism(TG,TC,HDL-C),insulin resistance(FCP,FINS,HOMA2-IR),BMI,WHR,inflammatory factors(HsCRP,TNF-α)and ferririn levels were compared between the two groups before and after treatment.Results The improvement of liver function,glucolipid metabolism,insulin resistance,BMI,WHR,inflammatory factors and ferritin levek in observation group was better than that in control group(P<0.05).Conclusion Sugar Ⅰ prescription can regulate glucolipid metabolism disorder and improve insulin resistance level,body weight and body fat distribution in type 2 diabetes mellitus patients syndrome of dampness-heat due to spleen deficiency combined with NAFLD.The mechanism may be related to the"anti-inflammatory"and"iron removal"effects.