葛根芩连祛浊方联合西药治疗2型糖尿病合并非酒精性脂肪性肝炎的疗效及对血浆可溶性CD36、脂肪分化相关蛋白的影响  

Efficacy of Gegen Qinlian Quzhuo decoction in treating type 2 diabetes patients with non-alcoholic fatty liver and its influence on the levels of sCD36 and ADRP

作　　者：张卫欢[1] 吴军 李秋云[1] 王珊[3] 刘星[1] 杨春伟[1] 郭智慧 王彩宁 ZHANG Wei-huan;WU Jun;LI Qiu-yun(Kailuan General Hospital Endocrine Department(Hebei,Tangshan,063000),China;不详)

机构地区：[1]开滦总医院内分泌科,河北唐山063000 [2]唐山市120急救指挥中心 [3]开滦总医院消化科

出　　处：《中西医结合肝病杂志》2021年第9期792-794,798,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河北省医学科学研究课题项目(No.20160758)。

摘　　要：目的:探讨葛根芩连祛浊方联合西药治疗2型糖尿病(T2DM)合并非酒精性脂肪性肝炎(NASH)患者的疗效及对血浆可溶性CD36(sCD36)、脂肪分化相关蛋白(ADRP)水平的影响。方法:选取2019年5月至2020年5月我院内分泌科收治住院的T2DM合并NASH患者62例,随机分为两组,各31例。对照组患者在常规治疗基础上加服二甲双胍肠溶胶囊和阿托伐他汀钙片;中药组患者,在对照组患者治疗基础上加服自拟葛根芩连祛浊方汤剂。比较两组患者治疗前后血糖、血脂、蛋白、促炎性因子相关指标的变化及临床疗效。结果:治疗后两组患者的FPG、2 hPG、FINS、HOMA-IR、TG、Chol、FFA、sCD36、ADRP、CRP、IL-6、TNF-α水平均比治疗前下降,且中药组患者各指标下降更明显(P<0.05);治疗后两组患者的症状积分均比治疗前降低,且中药组患者降低更显著(P<0.05);中药组患者NASH的治疗总有效率为90.32%,明显高于对照组的70.97%。两组患者不良反应事件发生率比较,无统计学意义(P>0.05)。结论:葛根芩连祛浊方联合西药治疗T2DM合并NASH临床疗效显著,能改善HOMA-IR,达到降糖调脂,纠正炎症状态的目的。Objective:To explore the curative effect of Gegen Qinlian Quzhuo Decoction in the treatment of non-alcoholic fatty liver in patients with type 2 diabetes and its influence on the levels of sCD36 and ADRP.Methods:From May 2019 to May 2020,62 patients with T2DM combined with NAFLD who were admitted to the Department of Endocrinology in our hospital were selected and randomly divided into the traditional Chinese medicine group(31 cases,metformin enteric-coated capsules+atorvastatin calcium)Tablet treatment)and the reference group(31 cases,given the self-made Gegen Qinlian Quzhuo Decoction based on the treatment of the reference group).The differences in blood glucose,blood lipids,protein,pro-inflammatory factors,and clinical efficacy between the two groups before and after treatment were compared.Results:Before treatment,there was no significant difference in the levels of FPG,2 hPG,FINS,HOMA-IR,TG,CHOL,FFA,sCD36,ADRP,CRP,IL-6,and TNF-αbetween the two groups of patients(P>0.05);After 12 weeks,the above indicators in the Chinese medicine group were lower than those before treatment and the reference group(P<0.05).The total effective rate of NAFLD treatment in the traditional Chinese medicine group was 90.32%,which was significantly higher than the 70.97%in the western medicine group,while the TCM symptom score was significantly lower than that in the western medicine group,and the difference was statistically significant(P<0.05);the incidence of adverse events in the two groups was no Statistical significance(P>0.05).Conclusion:Gegen Qinlian Quzhuo Decoction is effective in treating patients with T2DM combined with NAFLD,improving HOMA-IR,achieving the purpose of lowering blood sugar,regulating lipids,and correcting inflammation.

关 键 词：2型糖尿病 非酒精性脂肪性肝炎 葛根芩连祛浊方 血浆可溶性CD36 脂肪分化相关蛋白 

分 类 号：R575.1[医药卫生—消化系统] R587.1[医药卫生—内科学]