化浊颗粒治疗2型糖尿病合并非酒精性脂肪肝(痰湿困脾型)

目的:观察应用中医浊毒理论配制的中药复方制剂化浊颗粒,对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)痰湿困脾型患者治疗的临床疗效。方法:采用平行对照的研究方法,将纳入治疗的患者,随机分为治疗组(45例)和对照组(45例)。两组患者均给予基础治疗加西药降糖治疗,治疗组再给予化浊颗粒,1个疗程为3个月,治疗2个疗程。评价两组治疗前后中医临床证候的变化,及血糖、糖化血红蛋白(Hb A1c),血脂、肝酶、空腹胰岛素(FINS)释放水平、胰岛素抵抗指数(HOMA-IR)和体重指数(BMI)等指标的变化。结果:两组临床疗效比较:治疗组总有效率87.80%,对照组总有效率53.84%,组间比较P0.05;中医证候比较:治疗组总有效率78.04%,对照组总有效率64.10%,组间比较P0.05;两组治疗后与治疗前比较:空腹血糖(FPG),餐后2 h血糖(2 h PBG),Hb A1c(P0.05);FINS,HOMA-IR(P0.01);总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)(P0.05);治疗组谷氨酸氨基转移酶(ALT),天冬氨酸氨基转移酶(AST)(P0.01);对照组ALT,AST(P0.05);BMI(P0.05);治疗后组间比较:FPG,Hb A1c与对照组比P0.05;FINS,HOMA-IR与对照组比P0.05;ALT,AST与对照组比P0.05;BMI与对照组比P0.05。结论:应用中医浊毒理论配制的中药复方制剂化浊颗粒联合降糖西药治疗痰湿困脾型T2DM合并NAFLD效果明显优于单纯西药治疗。

Clinical Effect of Huazhuo Granule in Treating Type 2 Diabetes Mellitus Combined with Nonalcoholic Fatty Liver(Phlegm-dampness Accumulating Spleen Type)

Objective: To observe the curative effect of Huazhuo granule prepared with traditional Chinese medicine(TCM) turbidity toxin theory on type 2-diabetes mellitus(T2DM) combined with nonalcoholic fatty liver(phlegm-dampness accumulating spleen type). Method: The 90 cases were randomly divided into treatment group(45 cases) and control group(45 cases). Both groups received basic therapy plus western medicine hypoglycemic therapy, while treatment group also received Huazhuo granule for 2 treatment courses, 3 months a course. Changes in TCM clinical symptoms before and after treatment in two groups, and changes in blood glucose, glycosylated hemoglobin(HbA1c), blood lipid, liver enzymes, fasting insulin(FINS) release level, insulin resistance index(HOMA IR), body mass index(BMI) and other indicators were observed. Result: Comparison of clinical effect between two groups:the total effective rate was 87.80% in treatment group and 53.84% in control group(P<0.05). Comparison of TCM symptoms:the total effective rate was 78.04% in treatment group and 64.10% in control group(P<0.05). Comparison of the conditions before and after treatment:P<0.05 for fasting plasma glucose(FPG), 2-hour postprandial blood glucose(2 hPBG), and HbA1c;P<0.01 for fasting insulin(FINS), HOMA-IR;P<0.05 for cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C);P<0.01 for alanine aminotransferase(ALT), aspartate amino transferase(AST) in treatment group;P<0.05 for ALT and AST in control group;P<0.05 for body mass index(BMI). Comparison between treatment group and control group after treatment:P<0.05 for FPG and HbA1c,P<0.05 for FINS and HOMA-IR,P<0.05 for ALT and AST,P<0.05 for BMI. Conclusion: Compared with the treatment with western medicine alone, treatment with Huazhuo granule combined with western hypoglycemic medicine achieves better efficacy for T2DM of phlegm-dampness accumulating spleen type combined with nonalcoholic fatty liver.