| Objective:To study the influence of insulin resistance(IR),blood lipid,blood glucose and the effects of clinical symptoms by using traditional chinese medicine granules prescription of soothing liver and invigorating spleen on patients with type 2 diabetes mellitus(T2DM) and non-alcoholic fatty liver disease(NAFLD). And dicusses the mechanism of the method combining the latest traditional Chinese and western medicine research,then provides new thought and method for the treatment of T2DM with NAFLD.Method:The patients with the syndromes of liver qi depression and spleen deficiency in T2DM with NAFLD,which were collected from December 2014 to January 2016, were divided into experimental group and control group according to the randomized controlled method,30 cases in each group.Control group was received lifestyle intervention treatment and western medicine foundation treatment, while the experimental group was accepted chinese medicine granules prescription of soothing liver and invigorating spleen on the basis of treatment of the control group,both groups should be treated with 2 months.And the chinese medicine granules should be dissolved in 200 ml water,take 100ml twice a day,morning and evening.The patients were assessed the clinical symptoms,glycated hemoglobin (HbAlc), blood lipid (TG, TC, LDL-C, HDL-C), liver function (AST, ALT).The level of plasma glucose and insulin(INS) were detected in two groups at the time point of o minute,30minutes and 120 minutes before and after the international standard gucose tolerance experiment and calculated the insulin resistance index(HOMA-IR),early insulin secretion index (EISI).120 min area under the curve (AUCINS), 120 min glucose area under the curve (AUCIBG),and so on.All data were analyzed by the SPSS 17.0 statistics software to assess the differences between the two groups before and after intervention.Results:①The chinese medicine symptom integral in both groups has reduced obviously(P<0.01 ),the experimental group surpassed the control group(P<0.01).And the traditional symptoms of clinical efficacy total effective rate are 86.67% and 66.67%,respectively,the amelioration of the experimental group is superior to the control group’s(P<0.05).②Two groups of patients with fasting plasma glucose(FPG),2h Postprandial blood glucose(2 hPG),120 minAUCIBG and HbAlc lever has significantly decreased than before(P<0.01),the experimental group is batter than the Contro lgroup(P<0.05).③The HOMA-IR of the two groups is obviously decreased (P<0.01), compared with pre-treatment.And the experimental group has an advantage than the control group(P<0.01).The EISI of experimental group improved significantly compared with the pre-treatment, and the difference was statistically significant (P<0.01),the EISI of control group also has a rise(P<0.05),however there was no significant difference between two groups, (P>0.05).there was also no significant difference between two groups of 120min AUCINS.④The experimental group in reducing TC, LDL-C, increasing HDL-C, compared with control group has obvious advantages (P<0.05);The TG of two groups were significantly decreased compared with before treatment(P<0.01), but there was no statistically significant difference between two groups.⑤The experimental group compared with control group has significant advantages in reducing ALT, AST (P< 0.01).⑥Safety observation indicators:during the study, both groups had no significant adverse reactions.Conclusion:The traditional chinese medicine granules prescription of soothing liver and invigorating spleen can improve insulin resistance significantly, blood sugar and lipid levels, protect the liver function of the patients with the syndrome of liver qi depression and spleen deficiency in T2DM with NAFLD and have obvious advantages to relieve the clinical symptoms, and but no obvious side effects, better security, worth clinical extensive application. |
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