基于磁共振氢谱探讨交泰丸改善2型糖尿病非酒精性脂肪肝的临床疗效

聂可馨 黄召谊 徐丽君 巩静 董慧 陆付耳

摘要 目的：采用磁共振氢谱观察交泰丸治疗2型糖尿病（T2DM）合并非酒精性脂肪肝的临床疗效。方法：选取2009年10月至2010年3月华中科技大学同济医学院附属同济医院收治的T2DM患者40例作为研究对象，按照随机数字表法分为对照组和观察组，每组20例，2组均给予西医基础治疗，观察组同时加用交泰丸口服治疗，比较2组患者治疗12周前后的一般情况、血糖水平、血脂水平、肝功能的改变，采用磁共振氢谱法比较2组肝脏脂肪含量的差异。结果：治疗前2组患者人口学资料及生化指标、肝脏三酰甘油（TG）含量差异均无统计学意义（均P<0.05）;12周后，与治疗前比较，观察组腰围、腰臀比、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、血清胆固醇、低密度脂蛋白胆固醇、TG和肝脏TG含量均显著下降（均P<0.05），对照组除肝脏TG含量显著增高（P<0.05）外其他指标均未发生明显改变。结论：交泰丸可以改善T2DM合并非酒精性脂肪肝患者胰岛素抵抗，调节糖脂水平，改善肝脏脂肪沉积。

关键词 交泰丸;2型糖尿病;非酒精性脂肪肝;磁共振氢谱

Abstract Objective：To observe the clinical effect of Jiaotai pills on type 2 diabetes mellitus with nonalcoholic fatty liver disease by means of magnetic resonance hydrogen spectroscopy.Methods：There were 40 patients with type 2 diabetes，who were admitted to Tongji Hospital from October，2009 to March 2010，randomly divided into a Jiaotai pill treatment group and a control group.They both received basic treatment of western medicine，but the treatment group was offered Jiaotai pills.The general health status，blood glucose level，blood lipid level，liver function of the two groups were observed before and after 12 weeks oftreatment.Liver fat content of the two groups were also obtained with magnetic resonance hydrogen spectroscopy.Results：Before treatment，there was no significant difference in demographic data，biochemical indexes and liver triglyceride content between the two groups.Twelve weeks later，waist circumference（WC），waist to hip ratio（WHR），fasting plasma glucose（FPG），2 h postprandial blood glucose（2 h PBG），hemoglobin A1c（HbA1c），fasting insulin（FINS），total cholesterol（TC），（LDL-C），Triglyceride（TG） and hepatic triglyceride content（HTC） in Jiaotai pill group were significantly decreased（P<0.05），while in control group HTC was significantly increased（P<0.05）.Conclusion：Jiaotai pill can improve insulin resistance，regulate glucose and lipid levels and improve liver fat deposition in type 2 diabetes patients with nonalcoholic fatty liver disease.

Keywords Jiaotai pill; Type 2 diabetes mellitus ; Nonalcoholic fatty liver disease;Magnetic resonance hydrogen spectroscopy

中圖分类号：R587.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.19.003

糖尿病（Diabetes Mellitus，DM）是由遗传因素和环境因素相互作用而引起的一种以糖代谢和脂质代谢紊乱为主要变现的代谢紊乱综合征，根据中华医学会糖尿病学分会组织编写的《中国2型糖尿病防治指南（2020年版）》所示，依据2015—2017年中华医学会内分泌学分会在全国31个省进行的甲状腺、碘营养状态和DM的流行病学调查数据，我国18岁及以上人群DM患病率为11.2%，患病人数为全球第一[1]。……