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

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。

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

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.