化浊解毒中药联合利拉鲁肽治疗2型糖尿病合并非酒精性脂肪肝疗效及对血脂、肝功能的影响

摘要

目的 观察化浊解毒中药联合利拉鲁肽治疗2型糖尿病(T2DM)合并非酒精性脂肪肝疗效及对血脂、肝功能的影响.方法 将110例T2DM合并非酒精性脂肪肝患者随机分为2组,对照组55例给予利拉鲁肽治疗,观察组55例在此基础上加用化浊解毒中药治疗,观察2组治疗前后中医证候积分、体质量指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)释放水平、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、谷氨酸氨基转移酶(ALT)及丙氨酸氨基转移酶(AST)水平变化情况,统计2组近期疗效.结果 2组治疗后胁肋隐痛、胃脘胀满、食欲不振、身重困倦、舌红胖大苔黄腻及脉濡缓积分均显著低于治疗前(P均＜0.05),且观察组治疗后各项积分均显著低于对照组(P均＜0.05);2组治疗后BMI、FPG、2hPG、HbA1c、FINS、HOMA-IR、TC、TG、LDL-C、AST及ALT水平均显著降低(P均＜0.05),HDL-C水平显著提高(P均＜0.05),且观察组治疗后各项指标改善情况均显著优于对照组(P均＜0.05);观察组近期治疗总有效率显著高于对照组(P＜0.05).结论 化浊解毒中药联合利拉鲁肽治疗T2DM合并非酒精性脂肪肝可有效改善临床症状,调节血糖和血脂水平,并有助于保护肝脏功能.%Objective It is to observe the effect of Huazhuojiedu Chinese medicine combined with Liraglutide on type 2 diabetes mellitus (T2DM)with non-alcoholic fatty liver and its effect on blood lipid and liver function.Methods 110 cases of patients with T2DM with nonalcoholic fatty liver disease were randomly divided into 2 groups,then control group (55 cases)was treated with Liraglutide,the observation group (55 cases) was treated with Huazhuojiedu Chinese medicine additionally on the basis of treatment in control group.The changes of traditional Chinese medicine syndrome scores,body mass index (BMI),the levels of fasting plasma glucose (FPG),2 h postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),insulin resistance index (HOMA-IR),TC,TG,LDL-C,HDL-C,ALT and AST before and after treatment were observed and the recent curative effect was evaluated in both groups.Results After treatment,the syndrome scores such as hypochondriac pain,gastral cavity pain,loss of appetite,heavy body,big red or fat tongue,yellow and greasy fur and soft slow pulse were significantly lower than before treatment in both groups,and the decrease of these scores in observation group were more significant than those in control group (P ＜ 0.05);the levels of BMI,FPG,2hPG,HbA1c,FINS,HOMA-IR,TC,TG,LDL-C,AST and ALT were lower,while that of HDL-C was higher in both groups,and the improvements of these indexes in the observation group were significantly better than those in the control group (P ＜0.05).The total effective rate of treatment was significantly higher in the observation group than that in the control group (P ＜0.05).Conclusion Huazhuojiedu Chinese medicine combined with Liraglutide can effectively improve clinical symptoms,regulate the levels of blood glucose and blood lipid,and help to protect liver function in the treatment of T2DM with non-alcoholic fatty liver.