益气养阴活血治则对2型糖尿病合并脂肪肝患者之胰岛素抵抗和血清瘦素水平的影响

目的:研究益气养阴活血治则对糖尿病合并脂肪肝(DFL)之胰岛素抵抗和瘦素异常的改善作用,探讨益气养阴活血治则治疗2型糖尿病并发脂肪肝的部分机制。方法:96例中医辩证为气阴两虚伴血瘀的2型糖尿病合并脂肪肝患者,随机分成对照组和实验组。两组均接受基础治疗—饮食体重控制、加强运动并使用口服降糖药物调节血糖。实验组在基础治疗之外加以益气养阴活血治则中药组方,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、并考察血清瘦素及可溶性瘦素受体的改变情况。结果:①两组病例在治疗前脂肪肝等级无差异(P0.05)但治疗后脂肪肝得以不同程度逆转,其中实验组治疗后呈显著逆转(P0.01)而对照组治疗后逆转不显著(P0.05),实验组治疗后脂肪肝等级统计上显著低于对照组(P0.05)。②两组病例在治疗后胰岛素抵抗指数HOMA-IR均有所改善,但实验组改善程度更大,统计上有显著差异(P0.01)。③对照组治疗后leptin和leptin-R无明显改善(P0.05)而实验组后两者改善显著(P0.01,P0.01)。结论:益气养阴活血治则对2型糖尿病并发脂肪肝(DFL)患者体内的胰岛素抵抗和瘦素水平异常有显著的改善作用,这可能是益气养阴活血治则治疗2型糖尿病并发脂肪肝的主要机制之一。

Effect of Yiqi Yangyin Huoxue Principle on Insulin Resistance And Serum leptin level in Patients with Type 2 Diabetes Mellitus Combined with Fatty liver Disease

Objective:This paper aimed to investigate the efficacies of Yiqi Yangyin Huoxue principle on insulin resistance and abnormal serum leptin/leptin-R level and to discuss the partial mechanism of Yiqi Yangyin Huoxue principle in patients with type 2 diabetes mellitus combined with fatty liver disease.Methods:We selected 96 patients with type 2 diabetes mellitus combined with fatty liver disease who were diagnosed with qiyinliangxu and xueyu by traditional Chinese medical.These patients were grouped into control and experimental group 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 experimental group,in addition to the above treatment,were given the Chinese medicine of Yiqi Yangyin Huoxue.The treatment period was 3 months.Liver ultrasound examination and biochemical tests,including lipid,insulin resistance and leptin/leptin-receptor analysis were carried out for those 96 patients before and after the treatment.Result:1.There was no significant difference between the DFL degree of two groups before treatment(P>0.05).The DFL degree was reversed to different degrees after the 3-month treatment.The DFL degree of the experimental group was significantly improved(P<0.01)while that of the control group was not so significantly improved(P>0.05).The DFL degree of the experimental group was significantly better than that of the control group after 3 months(P<0.05).2.Insulin resistance level of the two groups were both significantly reduced after the 3-month treatment.The insulin level of the experimental group was reduced more significantly than that of the control group(P<0.01).3.The serum leptin/leptin-R level of the control group was not significantly improved(P>0.05)but that of the experimental group was significantly improved(P<0.01,P<0.01)after the treatment.Conclusion: The Yiqi Yangyin Huoxue principle could siginificantly improve the insulin resistance and abnormal serum leptin/leptin-R level of patients with type 2 diabetes mellitus combined with fatty liver disease and this could be one of the main mechanisms of the effects of the Yiqi Yangyin Huoxue principle on type 2 diabetes mellitus combined with fatty liver disease.