胰岛素抵抗与2型糖尿病合并脂肪肝的关系及益气养阴活血法干预研究  

Study of relation between insulin resistance and fatty liver in type 2 diabetes and clinical effect of Yiqi Yangyin and Huoxue prescription

作　　者：吴凌康[1] 厉有名[2] 王章流[1] 刘英超[1] 史亮亮[1] 

机构地区：[1]浙江中医药大学附属第二医院内科,杭州310005 [2]浙江大学医学院附属第一医院消化内科,杭州310009

出　　处：《中华中医药杂志》2011年第6期1385-1388,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药青年基金项目研究计划(No.B2005Y044)~~

摘　　要：目的:探讨胰岛素抵抗与2型糖尿病合并脂肪肝(DFL)之间的关系,及益气养阴活血法中药组方的干预作用。方法:收集196例2型糖尿病患者进行回顾性研究,非合并脂肪肝的100例病例归为对照组,合并脂肪肝的96例病例(DFL)归为实验组,对两组病例进行生化检查和胰岛素抵抗分析。另外,对实验组的96例病例进行益气养阴活血干预的前瞻性研究,实验组的96例病例随机分成基础治疗组(50例)和中药治疗组(46例),两组均接受基础治疗:饮食体质量控制、加强运动并使用口服降糖药物调节血糖。中药治疗组在基础治疗之外加以益气养阴活血中药组方治疗,疗程为3个月,治疗前后进行肝脏B超检查、胰岛素抵抗分析。结果:①实验组与对照组相比较,其胰岛素抵抗指数HOMA-IR有显著差异(P<0.01)。②实验组下的两个治疗组(基础治疗组和中药治疗组)病例在治疗前脂肪肝分度无显著差异,治疗后脂肪肝分度得以不同程度逆转,中药治疗组呈显著逆转(P<0.01);两个治疗组病例在治疗前HOMA-IR无显著差异,在治疗后该指标有不同程度的改善,中药治疗组改善更明显;结论:胰岛素抵抗是2型糖尿病并发脂肪肝的原因之一,益气养阴活血法中药组方对这种生化异常有显著改善作用,这可能是益气养阴活血法治疗2型糖尿病并发脂肪肝的主要机制之一。Objective： This paper aimed to study the relation between insulin resistance and the development of fatty liver in type 2 diabetes （DFL）, then to study the clinical effect of Yiqi Yangyin and Huoxue prescription on this disease. Methods： 196 patients with type 2 diabetes were selected to retrospective study. The experimental group consisted of 96 patients who had already developed to fatty liver while the control group included 100 patients who had not yet developed to fatty liver. We did biochemical test and insulin resistance analysis for the two group subjects. Otherwise, the 96 patients of the experimental groups were selected to prospective study. These 96 patients were grouped into base treatment group including of 50 patients and Chinese medicine treatment group including of 46 patints randomly. They all performed basic treatment, like oral antidiabetic drug, diet control as well as more exercise to regulate the blood sugar level, while the patients of Chinese medicine treatment group, in addition to the above treatment, were given the Chinese medicine of Yiqi Yangyin and Huoxue. The treatment period was 3 months. Liver ultrasound examination and evaluation of insulin resistance were carried out for those 96 patients before and after the treatment. Results： ①There appeared a significant difference in HOMA-IR level between the experimental group and the control group （P0.01）. ②There was no significant difference between the DFL degree of the two groups before treatment and the DFL degree of two groups was reversed to different degrees after the 3-month treatment, wherein, the DFL degree of the experimental group was significantly improved （P0.01） and that of the control group was not significantly improved. There was no significant difference of HOMA-IR between the two groups before treatment and the HOMA-IR of the two groups were both improved to different degrees after the 3-month treatment, However, those of the Chinese treatment group was improved more significantly than those of t

关 键 词：2型糖尿病合并脂肪肝 胰岛素抵抗 益气养阴活血法 

分 类 号：R259[医药卫生—中西医结合]