CAJ | 학술논문

目的：观察不同治则中药复方或西药联合行为干预治疗糖代谢异常的非酒精性脂肪性肝炎（NASH）的疗效。方法：将119例糖代谢异常的非酒精性脂肪性肝炎患者随机分为单纯行为干预组（A 组）、行为干预加吡格列酮组（B 组）、行为干预加中药组（C 组），3组患者均治疗16周。观察3组患者治疗前后空腹血糖（FBG）、早餐后2h 血糖（2hBG）、糖化血红蛋白（HbA1c）），血脂[TC、TG、高密度脂蛋白（HDL－C）、低密度脂蛋白（LDL－C）、肝功能（ALT、AST、γ－GT）]的变化。结果：B 组和 C 组患者治疗后 FBG、2hBG、HbA1c 下降均有统计学意义（P ＜0．05），而 A 组仅 HbA1c 下降有显著性意义（P ＜0．05）；B 组患者治疗后血脂仅 HDL－C 下降有统计学意义（P ＜0．05），C 组患者 TC、 TG、LDL－C 下降差异有显著性意义（P ＜0．05）；3组患者肝功能改善均有显著性意义（P ＜0．05）。3组间比较2hBG、血脂、ALT 下降有显著性意义（P ＜0．05）。 B 组与 A 组治疗后血糖水平差异有统计学意义（P ＜0．05），C 组与 A 组治疗后肝功能、TG 下降差异有显著性意义（P ＜0．05），C 组较 B 组 TC下降有统计学意义（P ＜0．05）。结论：行为干预、吡格列酮和中药复方均可有效地改善 NAFLD 患者的糖代谢异常、肝功能、降低肝脏脂肪含量，中药复方在改善血脂方面优于其他两组。
목적：관찰불동치칙중약복방혹서약연합행위간예치료당대사이상적비주정성지방성간염（NASH）적료효。방법：장119례당대사이상적비주정성지방성간염환자수궤분위단순행위간예조（A 조）、행위간예가필격렬동조（B 조）、행위간예가중약조（C 조），3조환자균치료16주。관찰3조환자치료전후공복혈당（FBG）、조찬후2h 혈당（2hBG）、당화혈홍단백（HbA1c）），혈지[TC、TG、고밀도지단백（HDL－C）、저밀도지단백（LDL－C）、간공능（ALT、AST、γ－GT）]적변화。결과：B 조화 C 조환자치료후 FBG、2hBG、HbA1c 하강균유통계학의의（P ＜0．05），이 A 조부 HbA1c 하강유현저성의의（P ＜0．05）；B 조환자치료후혈지부 HDL－C 하강유통계학의의（P ＜0．05），C 조환자 TC、 TG、LDL－C 하강차이유현저성의의（P ＜0．05）；3조환자간공능개선균유현저성의의（P ＜0．05）。3조간비교2hBG、혈지、ALT 하강유현저성의의（P ＜0．05）。 B 조여 A 조치료후혈당수평차이유통계학의의（P ＜0．05），C 조여 A 조치료후간공능、TG 하강차이유현저성의의（P ＜0．05），C 조교 B 조 TC하강유통계학의의（P ＜0．05）。결론：행위간예、필격렬동화중약복방균가유효지개선 NAFLD 환자적당대사이상、간공능、강저간장지방함량，중약복방재개선혈지방면우우기타량조。
Objective:To observe the curative effect of the traditional Chinese medicine or western medicine treatment combined behav-ioral intervention in treatment of abnormal glucose metabolism in non-alcoholic fatty liver.Methods: One hundred and nineteen patients with abnormal glucose metabolism in nonalcoholic fatty liver were randomly divided into behavioral intervention group (group A), pioglitazone group (group B), traditional Chinese medicine group (group C), were treated for 16 weeks.blood glucose levels, blood lipids, liver enzyme levels were observed before and after treatment.Results:Only HbA1c glucose levels were significantly decreased in Group A (P <0.05), FBG, 2hBG, HbA1c were statistically significantly decreased in group B and group C (P <0.05);Only HDL-c in group B had decreased sta-tistically significant ( P<0.05), only HDL-c decrease in group C was not statistically significant (P >0.05); liver enzymes to improve in the three groups were statistically significant (P <0.05).The decrease of lipids,2hBG and ALT in three groups was significant (P <0.05). The decrease of blood glucose levels in group B compared with in group A group A were significant (P <0.05); liver enzymes, TG in group C compared with group A decreased significantly (P <0.05); TC decrease in group C compared with group B was statistically significant (P<0.05).Conclusion: The behavioral intervention, pioglitazone and traditional Chinese medicine can be effective in improving glucose metab-olism in NAFLD,liver fat content and the liver enzyme; Traditional Chinese medicine compound is better than the other two groups in im-provement of blood lipid spectrum.