五苓散治疗2型糖尿病合并代谢相关脂肪性肝病疗效观察

Efficacy observation of Wuling powder on type 2 diabetes mellitus complicated with metabolism-associated fatty liver disease

目的:观察五苓散治疗2型糖尿病合并代谢相关脂肪性肝病的临床疗效。方法:选取2型糖尿病合并代谢相关脂肪性肝病湿浊内停证患者60例,在生活方式干预基础上随机分为两组各30例,治疗组予五苓散口服,对照组予二甲双胍片口服,治疗12周。结果:治疗组总有效率为90.00%,对照组总有效率为70.33%,两组比较有统计学差异(P<0.05)。治疗前后两组体质指数、肝酶、稳态模型胰岛素抵抗指数、血糖、血脂及肝脏瞬时弹性成像可控衰减参数水平组内比较有统计学差异(P<0.01)。治疗后两组中医证候积分、体质指数、腰围、肝酶、稳态模型胰岛素抵抗指数、血脂及肝脏瞬时弹性成像可控衰减参数水平组间比较,治疗组优于对照组(P<0.05)。结论:五苓散治疗2型糖尿病合并代谢相关脂肪性肝病湿浊内停证患者,可明显改善患者临床症状,减轻体重,改善肝酶、血脂等生化指标水平,同时能减少肝脏脂肪含量,提高临床疗效。

Objective:To observe the clinical efficacy of Wuling powder on type 2 diabetes mellitus complicated with metabolism-associated fatty liver disease.Methods:60 cases of patients with 2 diabetes complicated with metabolism-associated fatty liver disease with syndrome of internal stagnation of dampness and turbidity were randomly divided into two groups on the basis of lifestyle intervention,30 cases in each group.The treatment group was treated with oral Wuling powder,while the control group was treated with oral metformin tablets.12 weeks as a course of treatment.Results:The total effective rate was 90.00%in the treatment group and 70.33%in the control group,and the comparative difference between two groups was statistically significant(P﹤0.05).Compared the levels of body mass index,liver enzymes,insulin resistance index of steady-state model,blood sugar,blood lipid and controllable attenuation parameters of instantaneous elastography of liver in the group before and after treatment,the difference was statistically significant(P﹤0.01).Compared the levels of TCM syndrome score,body mass index,waist circumference,liver enzymes,insulin resistance index of steady-state model,blood lipid and controllable attenuation parameters of instantaneous elastography of liver between two groups after treatment,the treatment group was better than control group(P﹤0.05).Conclusion:Wuling powder for treating type 2 diabetes mellitus complicated with metabolismassociated fatty liver disease with syndrome of internal stagnation of dampness and turbidity can obviously improve the clinical symptoms of patients,reduce the body weight,improve the biochemical indexes such as liver enzymes and blood lipids,etc.at the same time,reduce the fat content in the liver and enhance the clinical efficacy.