| Objective: This study aims to previous studies on the basis of further explore effective to remove turbidity decoction in the treatment of type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD)in the clinical curative effect and mechanism of action,and explore its to the influence of TNF alpha,HCY,TSH level,for the clinical prevention and treatment of this disease and to provide reference for new drug research and development of traditional Chinese medicine.Methods: A total of 60 patients with T2DM complicated with NAFLD who met the diagnosis of spleen deficiency and blood stasis and Turbidity in the outpatient department and wards of the geriatric endocrinology department of Anhui Provincial Hospital of Traditional Chinese Medicine from December 2019 to February 2021 were randomly divided into control group(30 cases)and observation group(30 cases)(basic treatment + Gegenqinlian Quzhuo Decoction).The two groups were observed for 3months with 4 weeks as a course of treatment.The indexes of TNF-α,Hcy,TSH,liver function,blood glucose,liver color ultrasound,blood lipid,Chinese medicine syndrome score and so on were reexamined 4,8 and 12 weeks after treatment.Adverse reactions in the treatment process of the two groups of subjects were recorded and dealt with in time.SPSS21.0 was used to analyze the difference in efficacy and safety between the two groups.Results:(1)Efficacy: The total effective rate of the observation group was 93.33%,and the total effective rate of the control group was 66.67%(P<0.05);(2)TCM syndrome score: TCM syndrome score of the two groups decreased compared with that before treatment(P<0.05),and the decrease degree of the observation group was more significant than that of the control group(P<0.01);(3)Physical examination indexes: the BMI level of the two groups decreased after treatment(P<0.05),and the decrease degree of the observation group was more significant than that of the control group(P<0.01);(4)Blood glucose indexes: After treatment,FPG,HbA1c,fins,2hPG and HOMA-IR levels of the two groups were decreased,which were significantly different from those before treatment(P<0.05),and the decrease degree of the observation group was better than that of the control group(P<0.05);(5)Blood lipid indicators: The levels of TC,TG and LDL-C in the two groups decreased,while HDL-C increased(P<0.05).The improvement of blood lipid in the observation group was better than that in the control group(P < 0.05);(6)Liver function: The levels of alt,AST and GGT in the two groups decreased after treatment(P<0.05),and the improvement degree in the observation group was better than that in the control group(P<0.05);(7)The liver B-type ultrasound grade:The grade of B-type liver ultrasound showed no significant improvement before and after treatment in the control group(P>0.05),while the grade of B-type liver ultrasound in the observation group decreased after treatment(P<0.05).There was statistical significance in the improvement of B-ultrasound grading between the two groups(P<0.05).(8)After treatment,the levels of TNF-a,Hcy and TSH in the two groups were lower than those before treatment(P<0.05),and the decrease degree in the observation group was better than that in the control group(P<0.05);(9)Adverse reaction: 2 cases of anorexia and 1 case of nausea occurred in the control group;2 cases of mild diarrhea occurred in the treatment group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05);Conclusion: Gegenqinlian Quzhuo Decoction has outstanding efficacy in regulating glucose and lipid metabolism,enhancing insulin sensitivity and improving liver function,which may be related to regulating the expression of related factors,reducing the levels of TNF-a,Hcy,TSH and improving insulin resistance. |
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