摘要
目的:分析合并2型糖尿病(T2DM)对非酒精性脂肪性肝病(NAFLD)患者中医证型演变及肝功能、糖脂代谢的影响。方法:选取2020年10月~2021年10月在本院确诊的180例NAFLD患者,根据是否合并T2DM分为T2DM+NAFLD组(n=68)和NAFLD组(n=112)。记录每位患者中医证型,检测并记录患者糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后血糖(PBG)、空腹C肽(FCP)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)、总胆红素(TBil)、谷丙转氨酶(ALT)及谷草转氨酶(AST)水平。结果:NAFLD患者以湿热内蕴证和肝肾阴虚证为主,T2DM+NAFLD组患者气阴两虚证和脾胃湿热证比例明显增加,有统计学意义(P<0.05);T2DM+NAFLD组患者HbA1c、FBG、PBG和FCP水平明显高于NAFLD组患者,差异有统计学意义(P<0.05);T2DM+NAFLD组患者LDL-C、TG和TC水平明显高于NAFLD组患者,HDL-C含量明显低于NAFLD组患者,差异有统计学意义(P<0.05);T2DM+NAFLD组患者TBil、ALT和AST水平明显高于NAFLD组患者,差异有统计学意义(P<0.05)。结论:NAFLD患者以湿热内蕴证和肝肾阴虚证为主,合并T2DM的NAFLD患者中医证型会向气阴两虚证和脾胃湿热证偏移,同时引起糖脂代谢水平和肝功能降低。
Objective:To analyze the effects of combined with type 2 diabetes mellitus(T2 DM)on evolution of TCM syndromes,liver function and glucose-lipid metabolism for patients with non-alcoholic fatty liver disease(NAFLD).Methods:A total of 180 patients with NAFLD confirmed in the hospital were enrolled between October 2020 and October 2021.According to presence or absence of T2 DM,they were divided into a T2 DM+NAFLD group(n=68)and a NAFLD group(n=112).TCM syndromes in different patients were recorded.The levels of glycosylated hemoglobin A1 c(HbA1 c),fasting blood glucose(FBG),postprandial blood glucose(PBG),fasting C-peptide(FCP),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),total cholesterol(TC),total bilirubin(TBil),glutamic-pyruvic transaminase(ALT)and glutamic oxalacetic transaminase(AST)were detected and recorded.Results:The main TCM syndromes are dampness-heat syndrome and liver-kidney Yin deficiency syndrome in NAFLD patients.The proportions of cases with Qi-Yin deficiency syndrome and spleen-stomach damp-heat syndrome were significantly increased in the T2 DM+NAFLD group(P<0.05).The levels of HbA1 c,FBG,PBG and FCP were significantly higher in the T2 DM+NAFLD group than the NAFLD group(P<0.05).The levels of LDL-C,TG and TC in the T2 DM+NAFLD group were significantly higher than those in the NAFLD group,while HDL-C level was significantly lower than that in the NAFLD group(P<0.05).The levels of TBil,ALT and AST in the T2 DM+NAFLD group were significantly higher than those in the NAFLD group(P<0.05).Conclusion:The main TCM syndromes are dampness-heat syndrome and liver-kidney Yin deficiency syndrome in NAFLD patients.In NAFLD patients with T2 DM,the TCM syndromes shifted to Qi-Yin deficiency syndrome and dampness-heat syndrome of spleen and stomach,which will reduce glucose-lipid metabolism and liver function.
作者
寇化洪
郭天禄
朱琳
KOU Huahong;GUO Tianlu;ZHU Lin(Traditional Chinese Medicine Hospital of Zitong County,Zitong Sichuan 622150,China)
出处
《四川中医》
2022年第9期81-84,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
2型糖尿病
非酒精性脂肪性肝病
中医证型演变
肝功能
糖脂代谢
Type 2 diabetes mellitus
Non-alcoholic fatty liver disease
Evolution of TCM syndrome
Liver function
Glucose-lipid metabolism
