中西医结合肝病杂志2026，Vol.36Issue(4)：418-422,5.DOI:10.3969/j.issn.1005-0264.2026.004.005
大柴胡汤合桂枝茯苓丸对2型糖尿病合并非酒精性脂肪性肝病患者胰岛素抵抗及肝纤维化指标的影响
Effect of Dachaihu and Guizhi Fuling decoction on insulin resistance and fibrosis in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease
摘要
Abstract
Objective:To observe the clinical effect of Dachaihu and Guizhi Fuling Decoction on type 2 diabetes mellitus(T2DM)patients with nonalcoholic fatty liver disease(NAFLD),and its influence on insulin resistance and fibrosis indicators.Methods:One hundred patients with T2DM complicated with NAFLD were randomly divided into a control group and an observation group,with 50 cases in each group.The control group was given metformin hydrochloride tablets and silibinin capsules orally,while the observation group was given Dachaihu and Guizhi Fuling Decoction in addition to the control group.Evaluate the clinical efficacy of two groups after 12 weeks of treatment.Observe the changes in traditional Chinese medicine(TCM)syndrome scores before and after treatment.Measure the levels of fasting blood glucose(FBG),2-hour postprandial glucose(2 h BG),glycated hemoglobin(HbA1c),live function(alanine aminotransferase[ALT],aspartate aminotransferase[AST]),liver fat and stiffness(controlled attenuation parameter[CAP],liver stiffness measurement[LSM]]),in two groups of patients.Observe the changes in insulin resistance[fasting C-peptide(FCP),fasting insulin(FINS),2-hour postprandial C-peptide(2-hour CP),2-hour postprandial insulin(2-hour INS)],pancreatic beta cell function[pancreatic beta cell function index(HOM A-β),insulin resistance index(HOMA-IR)]and fibrosis indicators[type Ⅳ collagen(Ⅳ-C),hyaluronic acid(HA),lamin(LN)]levels of patients.Results:Compared with before treatment,the scores of TCM symptoms in both groups decreased significantly after treatment(P＜0.05).The levels of FBG,2 hBG,HbA1c,HOMA-IR and ALT,AST,CAP,LSM,TC,TG,Ⅳ-C,HA,LN were significantly reduced,while the levels of FCP,FINS,2-hour CP,2-hour INS,and HOMA-β were significantly increased(P＜0.05).The comparison between groups showed that the total effective rate of the observation group after treatment was significantly higher than that of the control group(P＜0.05).In terms of relieving TCM symptoms,reducing blood sugar,liver fat,fibrosis levels and improving liver function,the treatment group was superior to the control group(P＜0.05).Conclusion:Dachaihu and Guizhi Fuling Decoction has good hypoglycemic and hepatoprotective effects in patients with T2DM complicated with NAFLD.It can effectively control blood glucose and lipid levels,improve insulin resistance,liver fatty and fibrosis.Combined with Western medicine treatment,the curative effect was further improved.关键词
2型糖尿病/非酒精性脂肪性肝病/大柴胡汤/桂枝茯苓丸/胰岛素抵抗/肝纤维化Key words
type 2 diabetes/non-alcoholic fatty liver disease/Dachaihu decoction/Guizhi Fuling pill/insulin resistance/hepatic fibrosis分类
医药卫生引用本文复制引用
武朝英,高若愚,刘琼..大柴胡汤合桂枝茯苓丸对2型糖尿病合并非酒精性脂肪性肝病患者胰岛素抵抗及肝纤维化指标的影响[J].中西医结合肝病杂志,2026,36(4):418-422,5.基金项目
河北省中医药管理局科研计划项目(No.2023386) （No.2023386）
