[1]杨斯皓,马方霞,詹 云.一贯煎合六味地黄汤配合西药治疗2型糖尿病合并非酒精性脂肪肝临床疗效及对患者生活质量的评价*[J].陕西中医,2019,(8):1006-1009.
　YANG Sihao,MA Fangxia,ZHAN Yun..Clinical efficacy and quality of life evaluation of Yiguanjian plus Liuwei Dihuang decoction with western medicine in the treatment of type 2 diabetes with nonalcoholic fatty liver disease[J].,2019,(8):1006-1009.
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一贯煎合六味地黄汤配合西药治疗2型糖尿病合并非酒精性脂肪肝临床疗效及对患者生活质量的评价*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1006-1009
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Clinical efficacy and quality of life evaluation of Yiguanjian plus Liuwei Dihuang decoction with western medicine in the treatment of type 2 diabetes with nonalcoholic fatty liver disease
文章编号:
DOI:10.3969/j.issn.1000-7369.2019.08.006
作者:
杨斯皓; 马方霞; 詹 云
四川省宜宾市第二人民医院中医科(宜宾 644000)
Author(s):
YANG Sihao; MA Fangxia; ZHAN Yun.
Traditional Chinese Medicine Department,the Second People’s Hospital of Yibin in Sichuan Province(Yibin 644000)
关键词:
一贯煎; 六味地黄汤; 格华止; 2型糖尿病; 非酒精性脂肪肝; 生活质量
Keywords:
Key words Yiguanjian; Liuwei Dihuang decoction; Glucophage; T2DM; NAFLD; Quality of life
分类号:
R587.1
文献标志码:
A
摘要:
摘 要 目的：对一贯煎合六味地黄汤加减联合盐酸二甲双胍片治疗2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）患者的临床疗效进行研究，并评价其生活质量。方法：将121例T2DM合并NAFLD患者随机分为对照组60例和联用组61例，对照组给予盐酸二甲双胍片口服治疗，联用组在此基础上给予一贯煎合六味地黄汤加减口服治疗。比较两组患者治疗前后的中医证候评分、血糖指标（FPG、HbA1c、2hPG）水平、血脂指标（TG、TC）水平、肝功能指标（ALT、AST、GGT、ALP、TBil）水平及血管内皮功能指标（ET-1、ADMA、sICAM-1、FMD、RHI）。比较两组患者的临床疗效、不良反应发生情况及治疗前后的生活质量。结果：联用组治疗后的中医证候评分、血糖指标水平、血脂指标水平、肝功能指标水平及血管内皮功能指标等均与对照组治疗后相比有显著差异（P＜0.05）。联用组的NAFLD疗效显著高于对照组（P＜0.05）。两组患者治疗期间的不良反应发生率无显著差异（P＞0.05），且联用组治疗后的生活质量更佳。结论：一贯煎合六味地黄汤加减联合盐酸二甲双胍片治疗T2DM合并NAFLD患者能够显著提高临床疗效，改善中医证候，安全性好，提升生活质量。
Abstract:
Abstract Objective：To study the clinical efficacy of Yiguanjian plus Liuwei Dihuang decoction with western medicine in the treatment of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD),and to evaluate the quality-of-life of patients. Methods:121 cases of T2DM with NAFLD were randomly divided into the control group (n=60) and the combined group (n=61). The control group was given the oral treatment of Glucophage on the basis of routine treatment,and the combined group were was given Yiguanjian plus Liuwei Dihuang decoction on the basis of the control group. The TCM syndrome score,the level of blood glucose indexs (FPG,HbA1c,2hPG),blood lipid indexs (TG,TC),liver function indexes (ALT,AST,GGT,ALP,TBil) and vascular endothelial function index (ET-1,ADMA,sICAM-1,FMD,RHI) of two groups was compared. The clinical efficacy and adverse reactions of two groups were compared. At the same time,the quality-of-life of the two groups before and after treatment was compared. Results：The TCM syndrome score,the level of blood glucose indexs,blood lipid indexs,liver function indexes and vascular endothelial function index of the combined group after treatment were significantly different from those in the control group after treatment (P＜0.05). The efficacy of NAFLD in the combined group was significantly higher than that in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups (P＞0.05). The quality-of-life in combined group was better after treatment. Conclusion：Yiguanjian plus Liuwei Dihuang decoction combined with Glucophage in the treatment of T2DM with NAFLD can significantly improve the clinical efficacy,improve TCM syndromes. It is safe and can improve the quality of life.

参考文献/References:

[1] 杨文英. 中国糖尿病的流行特点及变化趋势[J]. 中国科学：生命科学,2018,48(8)：812-819.
[2] 莫 湘，刘松华，黄大荣，等. 苓术二陈汤联合隔姜灸治疗非酒精性脂肪肝50例[J].陕西中医,2017,38(6)：722-724. 
[3] Bril F,Cusi K. Nonalcoholic fatty liver disease：the new complication of type 2 diabetes mellitus [J]. Endocrinol Metab Clin North Am,2016,45(4)：765-781. 
[4] Herath MMH,Iroshani K,Thilak PW,et al. Prevalence and associations of non-alcoholic fatty liver disease (NAFLD) in Sri Lankan patients with type 2 diabetes：A single center study[J]. Diabetes & Metabolic Syndrome：Clinical Research & Reviews,2019,13：246-250.
[5] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南：2013年版[J]. 中华糖尿病杂志,2014,6(7)：447-498. 
[6] 中华医学会肝病学分会脂肪肝和酒精性肝病学组，中国医师协会脂肪性肝病专家委员会.非酒精性脂肪性肝病防治指南：2018年版[J]. 实用肝脏病杂志,2018,21(2)：177-186. 
[7] 伊合拉斯·赛衣达合买提. 内皮功能检测与代谢综合征发生水平相关性研究[D]. 新疆：新疆医科大学,2016：6.
[8] 李会娟. 非酒精性脂肪性肝病对2型糖尿病患者心功能进展的相关性研究及潜在机制的探讨[D]. 苏州：苏州大学,2017：36-37.
[9] 申青艳. 非酒精性脂肪肝中医PRO量表的制定[D]. 北京：北京中医药大学,2017：58-62.
[10] 向 谦，陈 霞，陈旭平. 非酒精性脂肪肝与非酒精性脂肪肝炎患者健康相关生活质量调查比较[J]. 安徽医学,2017,38(5)：598-601.
[11] 延 华，张粉利，高艳琼，等. 非酒精性脂肪肝与同型半胱氨酸水平及胰岛素抵抗的关系探讨[J]. 陕西医学杂志,2017,46(10)：1451-1452.
[12] 周赛君，于德民，于 珮. 糖尿病非酒精性脂肪肝防治新进展[J]. 世界华人消化杂志,2015,23(32)：5113-5122.
[13] Mazzotti A,Caletti MT,Marchignoli F,et al. Which treatment for type 2 diabetes associated with non-alcoholic fatty liver disease?[J].Dig Liver Dis,2017,49(3)：235-240. 
[14] 宋丽丽，刘怀珍，张进军，等. 2型糖尿病合并非酒精性脂肪肝中医药治疗进展[J]. 中医临床杂志,2015,27(9)：1322-1324.
[15] 黄 虹，杨丕坚，李舒敏，等. Ⅱ型糖尿病伴非酒精性脂肪肝病患者炎症因子与内皮功能的改变[J]. 西部医学,2015,27(4)：529-533.

备注/Memo

备注/Memo:
*四川省宜宾市科技局资助重点项目（ 200103002）
更新日期/Last Update: 2019-08-15