关键词:

2型糖尿病, 非酒精性脂肪性肝病, 三参降消胶囊, 二甲双胍, 血糖, 血脂, 肝功能

Abstract:

Objective　To study the effects of Sanshen Jiangxiao capsules combined with metformin on glucose and lipid metabolism and liver function in patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD). Methods　Ninety-four patients with type 2 diabetes mellitus and NAFLD treated at Shaanxi Provincial Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study objects, and were divided into a control group and a study group by the random number table method, with 47 cases in each group. There were 27 males and 20 females in the control group; they were (49.04±3.63) years old; their diabetic course was (5.35±0.74) years; there were 12 cases of mild fatty liver and 35 cases of moderate fatty liver. There were 23 males and 24 females in the study group; they were (50.41±3.04) years old; their diabetic course was (5.14±0.75) years; there were 17 cases of mild fatty liver and 30 cases of moderate fatty liver. The control group took metformin, once a day; the initial oral dose was 0.5 g; the blood glucose was detected every week; if the blood glucose was still high, the dose could be gradually increased; the highest dose was 1.0 g per time, twice a day; after the blood glucose was under control, the dose was reduced to 0.5 g per time, twice a day and maintained. On the basis of the control group, the study group orally took 6 Sanshen Jiangxiao capsules per time, 3 times/d. Both groups were treated for 3 months. The clinical efficacies, changes of blood glucose indicators (glycosylated hemoglobin, fasting blood glucose, and 2-hour postprandial blood glucose), blood lipids (high density lipoprotein cholesterol, low density lipoprotein cholesterol, triacylglycerol, and total cholesterol), liver function (aspartate aminotransferase, alanine aminotransferase), and quantitative parameters of liver ultrasound (liver echo failure coefficient and liver-kidney echo ratio) before and after the treatment, and safety were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The total effective rate of the study group was higher than that of the control group [85.11% (40/47) vs. 69.96% (31/47)], with a statistical difference (χ²=4.663; P=0.031). There were statistical differences in glucose and lipid metabolism, liver function, and quantitative parameters of liver ultrasound in both groups between before and after the treatment (all P<0.05). After the treatment, the levels of the glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, low-density lipoprotein cholesterol, triglyceride, total cholesterol, and high density lipoprotein in the study group were better than those in the control group [(7.02±0.73)% vs. (7.64±0.78)%, (5.49±0.81) mmol/L vs. (6.08±0.73) mmol/L, (8.04±1.14) mmol/L vs. (9.28±1.17) mmol/L, (1.37±0.16) mmol/L vs. (2.41±0.36) mmol/L, (1.24±0.27) mmol/L vs. (1.86±0.35) mmol/L, (4.10±0.63) mmol/L vs. (5.17±0.74) mmol/L, and (1.18±0.24) mmol/L vs. (1.03±0.21) mmol/L], with statistical differences (all P<0.05); the levels of aspartate aminotransferase, alanine aminotransferase in the study group were lower than those in the control group [(33.42±4.12) U/L vs. (40.87±5.14) U/L, (34.18±4.05) U/L vs. (38.56±5.73) U/L], with statistical differences (all P<0.05); the attenuation coefficient of liver echo and the ratio of liver and kidney echo in the study group were lower than those in the control group [(1.01±0.11) dB vs. (1.20±0.17) dB and 1.14±0.15 vs. 1.29±0.27], with statistical differences (both P<0.05). No adverse reactions occurred in both groups during the treatment. Conclusion　Sanshen Jiangxiao capsules combined with metformin for patients with type 2 diabetes mellitus and NAFLD is effective and safe, and can reduce blood glucose and lipids and protect liver function.

Key words:

Type 2 diabetes mellitus, Nonalcoholic fatty liver, Sanshen Jiangxiao capsules, Metformin, Blood glucose, Blood lipids, Liver function