丹栀调脂汤治疗2型糖尿病合并非酒精性脂肪性肝病78例  

Clinical effect of Danzhi Tiaozhi decoction in treatment of type 2 diabetes mellitus comorbid with nonalcoholic fatty liver disease:An analysis of 78 cases

作　　者：杨晓琳[1] 王晓歌[1] 刘芳[1] 周传礼[1] 隋淼[1] YANG Xiaolin;WANG Xiaoge;LIU Fang;ZHOU Chuanli;SUI Miao(Xuzhou Hospital of Traditional Chinese Medicine,Nanjing University of Chinese Medicine,Xuzhou 221000,Jiangsu,China)

机构地区：[1]南京中医药大学附属徐州市中医院,江苏徐州221000

出　　处：《湖南中医杂志》2025年第3期1-5,共5页Hunan Journal of Traditional Chinese Medicine

摘　　要：目的:探究丹栀调脂汤治疗2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:选取160例确诊为T2DM合并NAFLD的患者,随机分为治疗组和对照组,每组各80例。对照组采用多烯磷脂酰胆碱胶囊治疗,治疗组在对照组治疗基础上联合丹栀调脂汤治疗,疗程均为12周。比较2组治疗前后中医证候积分、体质量指数(BMI)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、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)水平,计算胰岛素抵抗指数(HOMA-IR),并根据临床症状改善情况评估综合疗效。结果:每组各脱落2例,最终有效样本量为156例。总有效率治疗组为96.15%(75/78),对照组为87.18%(68/78),2组比较,差异有统计学意义(P<0.05)。2组中医证候积分、ALT、TG、HOMA-IR治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P<0.05);治疗后治疗组BMI低于对照组(P<0.05)。结论:丹栀调脂汤治疗T2DM合并NAFLD疗效确切,能有效调节脂代谢异常,减轻肝脏损害,其作用机制可能与改善胰岛素抵抗有关。Objective:To investigate the clinical effect of Danzhi Tiaozhi decoction in the treatment of type 2 diabetes mellitus(T2DM)comorbid with nonalcoholic fatty liver disease(NAFLD).Methods:A total of 160 patients who were diagnosed with T2DM and NAFLD were randomly divided into treatment group and control group,with 80 patients in each group.The patients in the control group were given polyene phosphatidylcholine capsules,while those in the treatment group were given Danzhi Tiaozhi decoction in addition to the treatment in the control group,and the course of treatment was 12 weeks for both groups.The two groups were compared in terms of traditional Chinese medicine(TCM)syndrome score,body mass index(BMI),alanine aminotransferase(ALT),aspar-tate aminotransferase,alkaline phosphatase,gamma-glutamyl transpeptidase,total cholesterol,triglyceride(TG),low-density lipoprotein cholesterol,and high-density lipoprotein cholesterol before and after treatment,Homeostasis Model Assessment of Insulin Resistance(HOMA-IR)was calculated,and overall response was assessed based on the improvement in clinical symptoms.Results:Two patients were lost to follow-up in each group,resulting in a final valid sample size of 156 cases.There was a significant difference in overall response rate between the treatment group and the control group[96.15%(75/78)vs 87.18%(68/78),P<0.05].After treatment,both groups had significant changes in TCM syndrome score,ALT,TG,and HOMA-IR,and there were significant differences in these indicators between the two groups after treatment(P<0.05).The treatment group had a significantly lower BMI than the control group after treatment(P<0.05).Conclusion:Danzhi Tiaozhi decoction has a marked clinical effect in the treatment of T2DM comorbid with NAFLD and can effectively regulate abnormal lipid metabolism and alleviate liver injury,possibly by improving insulin resistance.

关 键 词：丹栀调脂汤 2型糖尿病 非酒精性脂肪性肝病 胰岛素抵抗 脂代谢 多烯磷脂酰胆碱胶囊 

分 类 号：R259.871[医药卫生—中西医结合] R259.75[医药卫生—中医内科学]