目的 探讨复方甘草酸苷联合葛根素对非酒精性脂肪性肝病(NAFLD)患者血清瘦素水平及胰岛素抵抗指数的影响.方法 将120例NAFLD患者应用计算机随机分为4组,基础治疗组、复方甘草酸苷组、葛根素组、联合治疗组各30例.基础治疗组采用基础护肝疗法,给予维生素、肝泰乐、多种氨基酸等治疗;复方甘草酸苷组应用复方甘草酸苷60ml入液静脉滴注;葛根素组应用葛根素注射液400mg入液静脉滴注;联合治疗组给予复方甘草酸苷60ml及葛根素400 mg静脉滴注.4组患者疗程均为4周.检测治疗4周前后患者血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆固醇、甘油三酯、瘦素、空腹血糖及胰岛素,并计算胰岛素抵抗指数,应用德国西门子双源CT仪行肝脏CT检查.结果 基础治疗组治疗前、后血清ALT、AST、总胆固醇、甘油三酯、瘦素及胰岛素抵抗指数分别为(83.08±15.68)、(43.32±11.72) U/L,(52.12±15.62)、(36.08 ±7.28) U/L,(6.20±1.30)、(5.60±0.70)mmol/L,(2.70±0.50)、(2.10±0.40) mmol/L,(14.63±3.26)、(7.61±2.46) μg/L,7.9±1.8、7.0±1.2,组内比较差异均有统计学意义(t值分别为12.828、4.244、16.648、21.442、3.341、16.152,P均＜0.01);复方甘草酸苷组治疗前、后血清ALT、AST、总胆固醇、甘油三酯、瘦素及胰岛素抵抗指数分别为(83.06±14.38)、(43.28±11.06) U/L,(51.68±15.48)、(37.28±7.22) U/L,(6.30±1.50)、(5.70±0.80) mmol/L,(2.60±0.40)、(2.20±0.50) mmol/L,(15.13±3.87)、(7.89 ±2.26) μg/L,(7.8±2.2)、(7.1±1.6),组内比较差异均有统计学意义(t值分别为8.893、4.225、16.520、24.708、6.353、21.137,P均＜0.01);葛根素组治疗前、后血清ALT、AST、总胆固醇、甘油三酯、瘦素及胰岛素抵抗指数分别为(82.68±14.36)、(44.26±9.68) U/L,(50.06±15.23)、(36.86±6.88) U/L,(6.20±1.60)、(5.60±0.70) mmol/L,(2.70±0.52)、(2.26±0.48) mmol/L,(15.68±3.26)、(6.89±2.18)μ∥L,7.7±2.8、7.0±1.8,组内比较差异均有统计学意义(t值分别为7.087、8.138、18.159、7.244、7.470、32.283,P均＜0.01);联合治疗组治疗前、后血清ALT、AST、总胆固醇、甘油三酯、瘦素及胰岛素抵抗指数分别为(84.62±14.88)、(22.28±9.38) U/L,(49.12±16.56)、(28.48±9.06) U/L,(5.70±1.60)、(5.00±0.60) mmol/L,(2.78±0.50)、(1.70 ±0.40) mmol/L,(14.78±3.68)、(4.63±2.36) μg/L,7.6±2.1、6.2±1.6,组内比较差异均有统计学意义(t值分别为14.255、11.272、8.371、9.941、8.102、37.626,P均＜0.01).4组治疗前各指标比较差异均无统计学意义(P均＞0.05),治疗后联合治疗组低于其他3组(P均＜0.05),基础治疗组、复方甘草酸苷组、葛根素组之间比较差异均无统计学意义(P均＞0.05).结论 复方甘草酸苷联合葛根素治疗NAFLD通过降低患者血清瘦素水平、改善胰岛素抵抗,增加肝细胞对胰岛素的敏感性,从而调节血脂代谢,达到治疗NAFLD的目的.
目的 探討複方甘草痠苷聯閤葛根素對非酒精性脂肪性肝病(NAFLD)患者血清瘦素水平及胰島素牴抗指數的影響.方法 將120例NAFLD患者應用計算機隨機分為4組,基礎治療組、複方甘草痠苷組、葛根素組、聯閤治療組各30例.基礎治療組採用基礎護肝療法,給予維生素、肝泰樂、多種氨基痠等治療;複方甘草痠苷組應用複方甘草痠苷60ml入液靜脈滴註;葛根素組應用葛根素註射液400mg入液靜脈滴註;聯閤治療組給予複方甘草痠苷60ml及葛根素400 mg靜脈滴註.4組患者療程均為4週.檢測治療4週前後患者血清丙氨痠氨基轉移酶(ALT)、天鼕氨痠氨基轉移酶(AST)、總膽固醇、甘油三酯、瘦素、空腹血糖及胰島素,併計算胰島素牴抗指數,應用德國西門子雙源CT儀行肝髒CT檢查.結果 基礎治療組治療前、後血清ALT、AST、總膽固醇、甘油三酯、瘦素及胰島素牴抗指數分彆為(83.08±15.68)、(43.32±11.72) U/L,(52.12±15.62)、(36.08 ±7.28) U/L,(6.20±1.30)、(5.60±0.70)mmol/L,(2.70±0.50)、(2.10±0.40) mmol/L,(14.63±3.26)、(7.61±2.46) μg/L,7.9±1.8、7.0±1.2,組內比較差異均有統計學意義(t值分彆為12.828、4.244、16.648、21.442、3.341、16.152,P均＜0.01);複方甘草痠苷組治療前、後血清ALT、AST、總膽固醇、甘油三酯、瘦素及胰島素牴抗指數分彆為(83.06±14.38)、(43.28±11.06) U/L,(51.68±15.48)、(37.28±7.22) U/L,(6.30±1.50)、(5.70±0.80) mmol/L,(2.60±0.40)、(2.20±0.50) mmol/L,(15.13±3.87)、(7.89 ±2.26) μg/L,(7.8±2.2)、(7.1±1.6),組內比較差異均有統計學意義(t值分彆為8.893、4.225、16.520、24.708、6.353、21.137,P均＜0.01);葛根素組治療前、後血清ALT、AST、總膽固醇、甘油三酯、瘦素及胰島素牴抗指數分彆為(82.68±14.36)、(44.26±9.68) U/L,(50.06±15.23)、(36.86±6.88) U/L,(6.20±1.60)、(5.60±0.70) mmol/L,(2.70±0.52)、(2.26±0.48) mmol/L,(15.68±3.26)、(6.89±2.18)μ∥L,7.7±2.8、7.0±1.8,組內比較差異均有統計學意義(t值分彆為7.087、8.138、18.159、7.244、7.470、32.283,P均＜0.01);聯閤治療組治療前、後血清ALT、AST、總膽固醇、甘油三酯、瘦素及胰島素牴抗指數分彆為(84.62±14.88)、(22.28±9.38) U/L,(49.12±16.56)、(28.48±9.06) U/L,(5.70±1.60)、(5.00±0.60) mmol/L,(2.78±0.50)、(1.70 ±0.40) mmol/L,(14.78±3.68)、(4.63±2.36) μg/L,7.6±2.1、6.2±1.6,組內比較差異均有統計學意義(t值分彆為14.255、11.272、8.371、9.941、8.102、37.626,P均＜0.01).4組治療前各指標比較差異均無統計學意義(P均＞0.05),治療後聯閤治療組低于其他3組(P均＜0.05),基礎治療組、複方甘草痠苷組、葛根素組之間比較差異均無統計學意義(P均＞0.05).結論 複方甘草痠苷聯閤葛根素治療NAFLD通過降低患者血清瘦素水平、改善胰島素牴抗,增加肝細胞對胰島素的敏感性,從而調節血脂代謝,達到治療NAFLD的目的.
목적 탐토복방감초산감연합갈근소대비주정성지방성간병(NAFLD)환자혈청수소수평급이도소저항지수적영향.방법 장120례NAFLD환자응용계산궤수궤분위4조,기출치료조、복방감초산감조、갈근소조、연합치료조각30례.기출치료조채용기출호간요법,급여유생소、간태악、다충안기산등치료;복방감초산감조응용복방감초산감60ml입액정맥적주;갈근소조응용갈근소주사액400mg입액정맥적주;연합치료조급여복방감초산감60ml급갈근소400 mg정맥적주.4조환자료정균위4주.검측치료4주전후환자혈청병안산안기전이매(ALT)、천동안산안기전이매(AST)、총담고순、감유삼지、수소、공복혈당급이도소,병계산이도소저항지수,응용덕국서문자쌍원CT의행간장CT검사.결과 기출치료조치료전、후혈청ALT、AST、총담고순、감유삼지、수소급이도소저항지수분별위(83.08±15.68)、(43.32±11.72) U/L,(52.12±15.62)、(36.08 ±7.28) U/L,(6.20±1.30)、(5.60±0.70)mmol/L,(2.70±0.50)、(2.10±0.40) mmol/L,(14.63±3.26)、(7.61±2.46) μg/L,7.9±1.8、7.0±1.2,조내비교차이균유통계학의의(t치분별위12.828、4.244、16.648、21.442、3.341、16.152,P균＜0.01);복방감초산감조치료전、후혈청ALT、AST、총담고순、감유삼지、수소급이도소저항지수분별위(83.06±14.38)、(43.28±11.06) U/L,(51.68±15.48)、(37.28±7.22) U/L,(6.30±1.50)、(5.70±0.80) mmol/L,(2.60±0.40)、(2.20±0.50) mmol/L,(15.13±3.87)、(7.89 ±2.26) μg/L,(7.8±2.2)、(7.1±1.6),조내비교차이균유통계학의의(t치분별위8.893、4.225、16.520、24.708、6.353、21.137,P균＜0.01);갈근소조치료전、후혈청ALT、AST、총담고순、감유삼지、수소급이도소저항지수분별위(82.68±14.36)、(44.26±9.68) U/L,(50.06±15.23)、(36.86±6.88) U/L,(6.20±1.60)、(5.60±0.70) mmol/L,(2.70±0.52)、(2.26±0.48) mmol/L,(15.68±3.26)、(6.89±2.18)μ∥L,7.7±2.8、7.0±1.8,조내비교차이균유통계학의의(t치분별위7.087、8.138、18.159、7.244、7.470、32.283,P균＜0.01);연합치료조치료전、후혈청ALT、AST、총담고순、감유삼지、수소급이도소저항지수분별위(84.62±14.88)、(22.28±9.38) U/L,(49.12±16.56)、(28.48±9.06) U/L,(5.70±1.60)、(5.00±0.60) mmol/L,(2.78±0.50)、(1.70 ±0.40) mmol/L,(14.78±3.68)、(4.63±2.36) μg/L,7.6±2.1、6.2±1.6,조내비교차이균유통계학의의(t치분별위14.255、11.272、8.371、9.941、8.102、37.626,P균＜0.01).4조치료전각지표비교차이균무통계학의의(P균＞0.05),치료후연합치료조저우기타3조(P균＜0.05),기출치료조、복방감초산감조、갈근소조지간비교차이균무통계학의의(P균＞0.05).결론 복방감초산감연합갈근소치료NAFLD통과강저환자혈청수소수평、개선이도소저항,증가간세포대이도소적민감성,종이조절혈지대사,체도치료NAFLD적목적.
Objective To investigate the effect of Glycyrrhizin combined with puerarin on serum Leptin and insulin resistance in non-alcoholic fatty liver disease(NAFLD) patients.Methods One hundred and twenty patients with NAFLD were randomized into 4 groups,which were control group,compound Glycyrrhizin group,puerarin group,combined group,and each group was 30 cases.Patients in control group were received the regular liver protecting therapy including vitamins,amino acids,glucurolactone,in compound Glycyrrhizin group were given 60 ml compound glycyrrhizin solution (iv),in puerarin group were given puerarin at dose of 400 mg by intravenous infusion,and in combined group were given both compound glycyrrhizin and puerarin combination.All treatment period was 4 weeks.The levels of serum serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total cholesterol (TC),triglyceride (TG),leptin (LP),fasting blood glucose (FBG) and insulin(INS) were measured,and the insulin resistance index(IRI) was calculated.The liver CT image of patients were performed by Germany Siemens dual source CT instrument.Results The levels of serum ALT,AST,TC,TG,LP and IRI in control group at before and after treatment were ((83.08 ± 115.68) U/L vs.(43.32 ±11.72) U/L,(52.12±15.62) U/Lvs.(36.08 ±7.28) U/L,(6.20±1.30) mmol/Lvs.(5.60 ±0.70) mmol/L,(2.70 ±0.50) mmol/L vs.(2.10 ±0.40) mmol/L,(14.63 ±3.26) μg/L vs.(7.61 ± 2.46) μg/L,(7.9 ± 1.8) vs.(7.0 ± 1.2)),and the difference were statistically significant (t =12.828,4.244,16.648,21.442,3.341,16.152 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and IRI in compound glycyrrhizin group after treatment were ((43.28 ± 11.06) U/L,(37.28 ± 7.22) U/L,(5.70± 0.80) mmol/L,(2.20 ± 0.50) mmol/L,(7.89 ± 2.26) μg/L,(7.1 ± 1.6) respectively,significant different from before treatment ((83.06 ± 14.38) U/L,(51.68 ± 15.48) U/L,(6.30 ± 1.50) mmol/L,(2.60 ± 0.40) mmol/L,(15.13 ± 3.87) μg/L,(7.8 ± 2.2) respectively,t =8.893,4.225,16.520,24.708,6.353,21.137 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI in puerarin group after treatment were (44.26 ± 9.68) U/L,(36.86 ± 6.88) U/L,(5.60 ± 0.70) mmol/L,(2.26 ± 0.48) mmol/L,(6.89 ± 2.18) μg/L,(7.0 ± 1.8) respectively,significant different from that before treatment ((82.68±14.36) U/L,(50.06±15.23) U/L,(6.20±1.60) mmol/L,(2.70±0.52) mmol/L,(15.68 ±3.26)μg/L,(7.7 ±2.8) respectively,t =7.087,8.138,18.159,7.244,7.470,32.283 respectively,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI in combined treatment group after treatment were (22.28 ± 9.38)U/L,(28.48 ± 9.06) U/L,(5.00 ± 0.60) mmol/L,(1.70 ± 0.40) mmol/L,(4.63 ± 2.36) μg/L,(6.20± 1.6) respectively,significantly different from that before treatment ((84.62 ± 14.88) U/L,(49.12 ± 16.56)U/L,(5.70 ± 1.60) mmol/L,(2.78 ± 0.50) mmol/L,(14.78 ± 3.68) μg/L,(7.6 ± 2.1),t =14.255,11.272,8.371,9.941,8.102,37.626,P ＜ 0.01).The levels of serum ALT,AST,TC,TG,LP and ISI of patient were no significant difference before treatment,but after treatment,these indexes in combined therapy group were the lowest among 4 groups (P ＜ 0.05).And there were no significant difference among control group,compound glycyrrhizin group,puerarin group (P ＞ 0.05).Conclusion Compound glycyrrhizin combined with puerarin is proved to be an effect treatment method for NAFLD through decreasing serum leptin,improving insulin resistance.
