1.河南省传染病医院 郑州市第六人民医院中西医结合重肝科,郑州 450015
2.河南省传染病医院 郑州市第六人民医院重症医学科,郑州450015
李会杰,男,40岁,硕士研究生,副主任医师。研究方向:中西医结合治疗肝病。
张安娜,E-mail:15938798016@163.com
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李会杰,郑五州,郭亚南,等.从虚郁痰瘀论治糖尿病合并非酒精性脂肪肝效果观察[J].北京中医药,2023,42(2):151-155.
LI Hui-jie,ZHENG Wu-zhou,GUO Ya-nan,et al.Treatment of diabetes mellitus complicated with nonalcoholic fatty liver disease from deficiency, depression, phlegm and blood stagnation[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(02):151-155.
李会杰,郑五州,郭亚南,等.从虚郁痰瘀论治糖尿病合并非酒精性脂肪肝效果观察[J].北京中医药,2023,42(2):151-155. DOI: 10.16025/j.1674-1307.2023.02.007.
LI Hui-jie,ZHENG Wu-zhou,GUO Ya-nan,et al.Treatment of diabetes mellitus complicated with nonalcoholic fatty liver disease from deficiency, depression, phlegm and blood stagnation[J]. Beijing Journal of Traditional Chinese Medicine,2023,42(02):151-155. DOI: 10.16025/j.1674-1307.2023.02.007.
目的,2,观察从虚郁痰瘀论治糖尿病(DM)合并非酒精性脂肪肝(NAFLD)的临床效果。,方法,2,选取2019年7月—2021年3月收治的DM合并NAFLD患者95例,按照随机数字表法分为对照组47例、观察组48例,2组均给予控制饮食、制定运动方案等常规干预,对照组予基础治疗,观察组在对照组治疗基础上加理脾化痰祛瘀方治疗,持续治疗4个月。观察比较2组临床疗效及治疗前后肝脏脂肪含量[脂肪肝指数(FLI)、脂肪体积分数(FVF)];酶联免疫吸附试剂盒测定的脂联素(APN)、肿瘤坏死因子(TNF)⁃α和核因子(NF)⁃κB;逆转录荧光定量PCR法测定的血清miR⁃126情况。记录2组治疗期间所发生的不良反应。,结果,2,治疗4个月后,观察组临床总有效率高于对照组(,P,<,0.05)。治疗4个月后2组FLI、FVF较治疗前降低(,P,<,0.05),且观察组低于对照组(,P,<,0.05)。治疗4个月后2组末肠球菌、肠杆菌、酵母菌水平较治疗前降低(,P,<,0.05),且观察组低于对照组(,P,<,0.05);双歧杆菌、乳杆菌、拟杆菌水平较治疗前升高(,P,<,0.05),且观察组高于对照组(,P,<,0.05)。治疗4个月后2组APN、miR⁃126水平较治疗前升高(,P,<,0.05),且观察组高于对照组(,P,<,0.05);TNF⁃α、NF⁃κB水平较治疗前降低(,P,<,0.05),且观察组低于对照组(,P,<,0.05)。对照组发生恶心呕吐3例、皮疹1例;观察组发生恶心呕吐1例。观察组不良反应发生率低于对照组,但差异无统计学意义(,χ,2,=0.890,,P,>,0.05)。,结论,2,从虚郁痰瘀立论治疗DM合并非NAFLD,可改善右上腹疼痛、口渴多饮等症状,调节肝脏脂肪含量,改善肠道菌群及血清相关因子水平。
Objective,2,To explore the effect of diabetes mellitus (DM) complicated with non-alcoholic fatty liver disease (NAFLD) from deficiency, depression, phlegm and blood stagnation.,Methods,2,A total of 95 patients with DM complicated with NAFLD admitted to our hospital from July 2019 to March 2021 were selected and divided into control group (,n,=47) and traditional Chinese medicine group (,n,=48) according to the random number table method.The two groups were given routine intervention such as diet control and exercise program.The control group was given basic treatment,while the traditional Chinese medicine group was treated with Lipi Huatan Quyu Prescription from the perspective of deficiency,depression, phlegm and blood stagnation on this basis of basic treatment.The treatment was given for four months in both groups.The clinical efficacy,liver fat content including FLI and FVF,APN,TNF⁃α,NF⁃κB of two groups were observed;reverse transcription fluorescence quantitative PCR was used to determine serum miR⁃126.The adverse reactions of two groups were recorded.,Results,2,After four months at the end of treatment,the total effective rate of TCM group was higher than that of control group (,P,<,0.05).The levels of fatty liver index (FLI) and fat volume fraction (FVF) in the two groups after treatment were lower than those before treatment,and those in the TCM group were lower than those in the control group (,P,<,0.05).The levels of adiponectin (APN) and Mir-126 in the two groups were higher than those before treatment,and those in the TCM group were higher than those in the control group.The levels of tumor necrosis factor-α (TNF-α) and NF-κB in the TCM group were significantly lower than those in the control group (,P,<,0.05).There were 3 cases of nausea and vomiting and 1 case of rash occurred in the control group,and 1 case of nausea and vomiting in the observation group.The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference was not statistically significant.,Conclusion,2,Treatment of DM combined with non-NAFLD from deficiency,depression,phlegm and blood stagnation based on the intestinal microecology can reduce liver fat accumulation,regulate liver fat content,improve right upper abdominal pain,thirst and polydipsia and other symptoms,and regulate liver fat content,improve the level of intestinal flora and serum related factors.
理脾化痰祛瘀方糖尿病非酒精性脂肪肝
Lipi Huatan Quyu Prescriptiondiabetesnonalcoholic fatty liver disease
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