活血降脂保肝汤联合西药治疗2型糖尿病合并非酒精性脂肪性肝病临床研究

Clinical Study on Huoxue Jiangzhi Baogan Tang Combined with Western Medicine for T2DM Complicated with NAFLD

目的:观察活血降脂保肝汤联合西药治疗2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的临床疗效及其对肝功能、脂肪肝指数的影响。方法:将在本院接受治疗的T2DM合并NAFLD患者102例,随机分为2组各51例。对照组行西医常规治疗,治疗组在对照组的基础上加用活血降脂保肝汤治疗;2组疗程均为8周,检测2组治疗前后血清谷氨酰转移酶(GGT)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、天冬氨酸转氨酶(AST)、甘油三酯(TG)、空腹血糖(FBG)、餐后2小时血糖(P2hBG)、糖化血红蛋白(HbA1c)含量,测定体质量指数(BMI)、腰围(WC),计算脂肪肝指数(FLI)。结果:治疗后总有效率治疗组为84.31%,对照组为68.63%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者HbA1c、FBG、P2hBG水平较治疗前明显降低(P <0.05),且治疗组Hb A1c、FBG、P2hBG水平均低于对照组(P <0.05)。治疗后,2组患者血清ALP、GGT、ALT及AST含量较治疗前明显降低(P <0.05),且治疗组上述各项指标均低于对照组(P <0.05)。治疗后,2组患者TG、BMI、WC及FLI值均较治疗前明显降低(P <0.05),且治疗组TG、FLI值明显低于对照组(P <0.05)。结论:活血降脂保肝汤联合常规西药可显著改善T2DM合并NAFLD患者肝功能和血糖含量,降低脂肪肝指数,疗效优于单纯西药治疗。

Objective:To observe the clinical effect of Huoxue Jiangzhi Baogan tang combined with western medicine for type 2 diabetes mellitus(T2 DM)complicated with nonalcoholic fatty liver disease(NAFLD),and its effect on the liver function and fatty liver indexes.Methods:A total of 102 cases of patients with T2 DM complicated with NAFLD in our hospital were randomly divided into two groups,51 cases in each group.The control group was treated with routine western medicine,and the treatment group was additionally treated with Huoxue Jiangzhi Baogan tang based on the treatment of the control group.Both groups were treated for eight weeks.The contents of gamma-glutamyl transferase(GGT),alanine aminotransferase(ALT),alkaline phosphatase(ALP),aspartate aminotransferase(AST),triglyceride(TG),fasting blood glucose(FBG),postprandial 2 h blood glucose(P2 hBG)and hemoglobin A1 c(HbA1 c)in serum before and after treatment in the two groups were detected;the body mass index(BMI)and waist circumference(WC)were measured;the fatty liver indexes(FLI)were calculated.Results:After treatment,the total effective rate was 84.31%in the treatment group and 68.63%in the control group,the difference being significant(P<0.05).After treatment,the levels of HbA1 c,FBG and P2 hBG in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the above levels in the treatment group were lower than those in the control group(P<0.05).After treatment,the contents of ALP,GGT,ALT and AST in serum in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the above indexes in the treatment group were lower than those in the control group(P<0.05).After treatment,the values of TG,BMI,WC and FLI in the two groups were significantly decreased when compared with those before treatment(P<0.05),and the values of TG and FLI in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion:The therapy of Huoxue Jiangzhi Baogan tang combined with routine western medicine in treating patients with T2 DM complicated with NAFLD can significantly improve the liver function,regulate blood glucose content and reduce fatty liver indexes,whose curative effect is superior to that of simple western medicine.