复方葛根芩连汤治疗脾虚肝郁、痰瘀内阻型糖尿病合并非酒精性脂肪肝临床观察

目的 观察复方葛根芩连汤治疗脾虚肝郁、痰瘀内阻型2型糖尿病（type 2 diabetes mellitus，T2DM）合并非酒精性脂肪肝（non-alcoholic fatty liver disease，NAFLD）的临床疗效。方法 将60例患者分为对照组和治疗组，每组30例，在基础治疗的基础上，对照组采用非诺贝特治疗，治疗组予以复方葛根芩连汤治疗，治疗3个月后观察两组患者治疗前后中医证候评分，空腹血糖（fast plasma glucose，FPG）、糖基化血红蛋白A1c（glycosylated hemoglobin A1c，HbA1c）、空腹胰岛素（fasting insulin，FINS）、稳态模型胰岛素抵抗指数（homeostasis model assessment of insulin resistance，HOMA-IR）、总胆固醇（total cholesterol，TC）、三酰甘油（triglyceride，TG）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）水平，采用B型超声观察肝脏脂肪样变化情况。结果 与治疗前比较，两组患者治疗后中医证候评分，血清FPG、HbA1c、FINS、HOMA-IR、TC、TG、LDL-C水平均显著降低（P<0.05），HDL-C水平显著升高（P<0.05）；治疗组治疗后中医证候评分以及血清FPG、HbA1c、FINS、HOMA-IR、TC水平降低值和HDL-C水平升高值均大于对照组（P<0.05）。治疗组治疗后肝脏B型超声分级较治疗前明显改善（P<0.05），而对照组治疗前后B型超声分级比较，差异无统计学意义（P>0.05）。结论 复方葛根芩连汤治疗脾虚肝郁、痰瘀内阻型T2DM合并NAFLD的临床疗效确切。

Clinical Efficacy of Compound Gegen Qinlian Decoction in Treatment of Diabetes Mellitus with Spleen Deficiency and Stagnation of Liver Qi as well as Phlegm Stasis and Internal Obstruction Comorbid with Non-alcoholic Fatty Liver

Objective To observe the clinical efficacy of Compound Gegen Qinlian Decoction in treating type 2 diabetes mellitus (T2DM) with spleen deficiency and stagnation of liver Qi as well as phlegm stasis and internal obstruction comorbid with non-alcoholic fatty liver disease (NAFLD). Methods Sixty cases of T2DM with spleen deficiency and stagnation of liver Qi as well as phlegm stasis and internal obstruction comorbid with NAFLD were randomly and equally divided into treatment group and control group. On the basis of basic treatment, the control group was given fenofibrate, and the treatment group was given Compound Gegen Qinlian Decoction. After 3 months of treatment, the clinical outcome was evaluated and compared in terms of traditional Chinese medicine (TCM) syndrome score, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), and ultrasound was used to observe fatty changes in the liver. Results After treatment, both groups showed significant reductions in TCM syndrome score, serum levels of FPG, HbA1c, FINS, TC, TG, and LDL-C, and HOMA-IR (P<0.05) and a significant increase in HDL-C (P<0.05); the treatment group had significantly greater reductions in TCM syndrome score, serum levels of FPG, HbA1c, FINS, and TC, and HOMA-IR and a significantly greater increase in HDL-C compared with the control group (P<0.05). After treatment, the treatment group showed a significant improvement in the grade of fatty liver on ultrasound (P>0.05), while the control group showed no significant improvement (P>0.05). Conclusion Compound Gegen Qinlian Decoction has good clinical efficacy in treating T2DM with spleen deficiency and stagnation of liver Qi as well as phlegm stasis and internal obstruction comorbid with NAFLD.