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1、提要目的:观察以健脾化痰活血法为主要原则组方的健脾化痰汤对糖尿病合并非酒精性脂肪肝的临床疗效及其作用机制。方法:采用随机、对照的方法将60例患者随机分成治疗组（30例）和对照组（30例），治疗组在常规降糖的基础上给予健脾化痰汤。对照组在常规降糖的基础上给予苯扎贝特200mg,qd，口服，控制血脂。观察时间为2个月，主要观察指标有血糖、血脂、糖化血红蛋白、肝功、体重指数、腹部彩超、中医临床症状等。结果:治疗组空腹及餐后两小时血糖、糖化血红蛋白、甘油三脂、总胆固醇、高密度脂蛋白、谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶、体重指数、中医临床症状积
2、分等较前明显改善，与对照组比较具有显著性差异。试验期间患者依从性较好，未见不良反应。结论:健脾化痰活血法联合生活方式的改变可以降低糖尿病合并非酒精性脂肪肝患者的血糖、血脂，降低体重指数、提高患者高密度脂蛋白水平；还可以明显改善患者的临床症状，延缓糖尿病和脂肪肝的进展，提高患者的生活质量，而且用药安全。由此可见中医药辨证论治的有效性，运用中医药治疗糖尿病合并非酒精性脂肪肝具有广阔的前景。关键词健脾化痰汤；糖尿病；非酒精性脂肪肝；临床研究TheClinicalResearchofJianPiHuaTanTangonDiabeticPatie
3、ntswithNon-alcoholicFattyLiverDiseaseSpecialty:InternalMedicineofTraditionalChineseMedicineAuthor:ZhaoLinTutor:Prof.XuYunshengAbstractObjective:Toobservetheclinicaltreatmenteffectandmechanismofactionofjianpihuatantangwhosemainprinciplesofprescriptionarejianpihuatanhuoxue
4、ondiabetescombinednon-alcoholicfattyliver。Methods:Therewere60patientswhowererandomlydividedintotreatmentgroup(30cases)andcontrolgroup(30cases).Thetwogroupsweregivenmetforminenteric-coatedtablets0.25tid,oral.Andtreatmentgroupwasgivenjianpihuatantang;controlgroupwasgivenBe
5、zafibrate200mg,qd,oral.Duringtwomonths'timeofobservation,themainobservationIndicatorsareclinicalsymptoms,bloodsugar,bloodlipids,glycatedhemoglobin,liverfunction,bodymassindex,abdominalultrasonography.Results:Asaresulttreatmentgroupfastingandtwohourspostprandialbloodgluco
6、se,glycosylatedhemoglobin,triglycerides,totalcholesterol,highdensitylipoprotein,alanineaminotransferase,aspartateaminotransferase,glutamylendopeptidase,bodymassindex,clinicalsymptomsshowsignificantimprovementoverthepreviousandobviousdifferencecomparedwiththecontrolgroup.
7、Duringthetest,thepatientsshowgoodcomplianceandnoadversereactions.Conclusion:Jianpihuatanhuoxuefacanreducethebloodsugarofdiabeticpatientswithnon-alcoholicfattyliverdisease,bloodlipids,lowerbodymassindex,patientswithhigh-densitylipoproteinlevels,improveinsulinresistance;ca
8、nalsosignificantlyimprovethepatientclinicalsymptoms,delayingtheprogressofdiabetesandfattyliver,improvet
