中药复方或西药联合行为干预治疗糖代谢异常的非酒精性脂肪性肝炎临床研究  

Clinical study on the treatment of traditional Chinese medicine or Western medicine combined behavioral intervention on abnormal glucose metabolism in non-alcoholic fatty liver

作　　者：陈云飞[1] 陈伟霞[2] 刘洋[2] 张海燕[1] 李坤[2] 

机构地区：[1]上海中医药大学附属龙华医院肝科,上海200032 [2]上海中医药大学

出　　处：《中西医结合肝病杂志》2015年第2期80-82,I0001,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:观察不同治则中药复方或西药联合行为干预治疗糖代谢异常的非酒精性脂肪性肝炎(NASH)的疗效。方法:将119例糖代谢异常的非酒精性脂肪性肝炎患者随机分为单纯行为干预组(A组)、行为干预加吡格列酮组(B组)、行为干预加中药组(C组),3组患者均治疗16周。观察3组患者治疗前后空腹血糖(FBG)、早餐后2h血糖(2h BG)、糖化血红蛋白(Hb A1c)),血脂[TC、TG、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、肝功能(ALT、AST、γ-GT)]的变化。结果:B组和C组患者治疗后FBG、2h BG、Hb A1c下降均有统计学意义(P<0.05),而A组仅Hb A1c下降有显著性意义(P<0.05);B组患者治疗后血脂仅HDL-C下降有统计学意义(P<0.05),C组患者TC、TG、LDL-C下降差异有显著性意义(P<0.05);3组患者肝功能改善均有显著性意义(P<0.05)。3组间比较2h BG、血脂、ALT下降有显著性意义(P<0.05)。B组与A组治疗后血糖水平差异有统计学意义(P<0.05),C组与A组治疗后肝功能、TG下降差异有显著性意义(P<0.05),C组较B组TC下降有统计学意义(P<0.05)。结论:行为干预、吡格列酮和中药复方均可有效地改善NAFLD患者的糖代谢异常、肝功能、降低肝脏脂肪含量,中药复方在改善血脂方面优于其他两组。Objective：To observe the curative effect of the traditional Chinese medicine or western medicine treatment combined behav-ioral intervention in treatment of abnormal glucose metabolism in non-alcoholic fatty liver.Methods： One hundred and nineteen patients with abnormal glucose metabolism in nonalcoholic fatty liver were randomly divided into behavioral intervention group （group A）, pioglitazone group （group B）, traditional Chinese medicine group （group C）, were treated for 16 weeks.blood glucose levels, blood lipids, liver enzyme levels were observed before and after treatment.Results：Only HbA1c glucose levels were significantly decreased in Group A （P 〈0.05）, FBG, 2hBG, HbA1c were statistically significantly decreased in group B and group C （P 〈0.05）;Only HDL-c in group B had decreased sta-tistically significant （ P〈0.05）, only HDL-c decrease in group C was not statistically significant （P 〉0.05）; liver enzymes to improve in the three groups were statistically significant （P 〈0.05）.The decrease of lipids,2hBG and ALT in three groups was significant （P 〈0.05）. The decrease of blood glucose levels in group B compared with in group A group A were significant （P 〈0.05）; liver enzymes, TG in group C compared with group A decreased significantly （P 〈0.05）; TC decrease in group C compared with group B was statistically significant （P〈0.05）.Conclusion： The behavioral intervention, pioglitazone and traditional Chinese medicine can be effective in improving glucose metab-olism in NAFLD,liver fat content and the liver enzyme; Traditional Chinese medicine compound is better than the other two groups in im-provement of blood lipid spectrum.

关 键 词：非酒精性脂肪性肝炎 糖代谢异常 中药复方 肝功能 血脂 血糖 

分 类 号：R575.1[医药卫生—消化系统]