实用肝脏病杂志 ›› 2018, Vol. 21 ›› Issue (3): 409-412.doi: 10.3969/j.issn.1672-5069.2018.03.023

• 非酒精性脂肪性肝病 • 上一篇    下一篇

葛根素联合二甲双胍治疗NAFLD合并2型糖尿病前期患者初步临床研究

赵文涛, 曹高峰, 焦小红, 马辰辰, 林苗   

  1. 710600 西安市 核工业417医院内二科(赵文涛,曹高峰,焦小红,马辰辰); 内三科(林苗)
  • 收稿日期:2017-09-06 出版日期:2018-05-10 发布日期:2018-05-25
  • 作者简介:赵文涛,男,37岁,大学本科,主治医师。E-mail:sut3478@163.com

Efficacy of puerarin combined with metformin in the treatment of patients with non-alcoholic fatty liver disease and prediabetes

Zhao Wentao, Cao Gaofeng, Jiao Xiaohong, et al   

  1. Department of Internal Medicine,417th Hospital,Nuclear Industry,Xi'an 710600,Shaanxi Province,China
  • Received:2017-09-06 Online:2018-05-10 Published:2018-05-25

摘要: 目的 探讨葛根素联合二甲双胍治疗非酒精性脂肪性肝病(NAFLD)合并糖尿病前期患者的临床效果。方法 2014年4月~2017年6月我院收治的84例NAFLD合并糖尿病前期患者,被随机分为对照组42例和观察组42例,分别给予盐酸二甲双胍片或二甲双胍联合葛根素治疗,观察3 m。常规检测血C反应蛋白(CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)。结果 治疗后,观察组空腹血糖、餐后2 h血糖、胰岛素和HOMA-IR水平均显著低于对照组[分别为(5.92±0.51) mmol/L、(6.01±0.81) mmol/L、(5.90±0.62) mmol/L和(1.52±0.42)对(6.32±0.35) mmol/L、(6.39±0.71) mmol/L、(6.72±0.83) mmol/L和(1.71±0.39),P<0.05];血TC、TG、LDL-C显著低于对照组[分别为(4.15±0.14) mmol/L、(1.12±0.22) mmol/L、(1.91±0.12) mmol/L 对(4.56±0.21) mmol/L、(1.31±0.13) mmol/L、(2.14±0.11) mmol/L],HDL-C显著高于对照组[(1.31±0.22) mmol/L对 (1.11±0.09) mmol/L,P<0.05];AST和ALT显著低于对照组[分别为(分别为(49.71±4.75)U/L和(52.16±4.93) U/L 对(59.13±4.30) U/L和(77.52±7.15)U/L,P<0.05];血清炎症因子水平也显著低于对照组(P<0.05)。结论 葛根素联合二甲双胍治疗NAFLD合并糖尿病前期患者疗效显著,可能与调节血糖和血脂代谢,改善肝功能有关。

关键词: 非酒精性脂肪性肝病, 糖尿病前期, 二甲双胍, 葛根素, 治疗

Abstract: Objective To investigate the clinical efficacy of puerarin combined with metformin in the treatment of patients with non-alcoholic fatty liver disease (NAFLD) and prediabetes. Methods 84 patients with NAFLD and prediabetes were recruited in our hospital between April 2014 and June 2017,and they were randomly divided into the control group(n=42) and the observation grou (n=42),receiving metformin hydrochloride or combination of metformin and puerarin,a herbal medicine,respectively. Fasting blood glucose (FBG),postprandial 2h blood glucose(2hPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),insulin resistance index(HOMA-IR)],and C reactive protein(CRP),malondialdehyde(MDA),superoxide dismutase (SOD),interleukin-6(IL-6),and tumor necrosis factor α(TNF- α)] were assayed. Results At the end of 3 month observation,blood levels of FBG, 2hPG, FINS and HOMA-IR in the observation group were lower than those in the control group[(5.92±0.51) mmol/L,(6.01±0.81) mmol/L,(5.90±0.62)mmol/L,(1.52±0.42) vs. (6.32±0.35) mmol/L,(6.39±0.71) mmol/L,(6.72±0.83) mmol/L,(1.71±0.39),respectively,P<0.05];plasma levels of TC,TG and LDL-C in the observation group were lower than those in the control group[(4.15±0.14)mmol/L,(1.12±0.22) mmol/L,(1.91±0.12) mmol/L vs.(4.56±0.21) mmol/L,(1.31±0.13) mmol/L,(2.14±0.11) mmol/L],while HDL-C level was higher than that in the control group [(1.31±0.22) mmol/L vs. (1.11±0.09) mmol/L,P<0.05];serum AST and ALT levels in the observation group were much lower than those in the control group [(49.71±4.75) U/L and(52.16±4.93) U/L vs. (59.13± 4.30) U/L and (77.52 ±7.15) U/L,P<0.05];serum inflammationary cytokine levels were also lower than those in the control (P<0.05). Conclusion Puerarin combined with metformin is effective in the treatment of patients with NAFLD and prediabetes, which might be related to the regulation of blood glucose and lipid metabolism, and improvement of the liver function.

Key words: Non-alcoholic fatty liver disease, Prediabetes, Puerarin, Metformin, Therapy