| 150 | 4 | 9 |
| 下载次数 | 被引频次 | 阅读次数 |
目的:研究保肝降脂汤辅助治疗对非酒精性脂肪肝病患者肝功能、胰岛素敏感性的影响。方法:选择南充市中心医院及遂宁市中心医院新诊断的非酒精性脂肪肝病患者并随机分为接受保肝降脂汤联合常规西医药物治疗的观察组、接受常规西医药物治疗的对照组。治疗前及治疗后2周,测定血清中肝损伤指标、炎症反应标志物、氧化应激标志物的含量以及外周血中胰岛素信号分子的表达量。结果:两组组内治疗后2周时的血清ALT、AST、γ-GT、TBIL、Chemerin、Wnt5a、β-catenin、MDA、NO含量低于治疗前,血清APN、Ghrelin、T-AOC、SOD含量以及外周血IRS1、IRS2、GLUT4表达量高于治疗前且与对照组比较,观察组治疗后2周时的血清ALT、AST、γ-GT、TBIL、Chemerin、Wnt5a、β-catenin、MDA、NO含量较低,血清APN、Ghrelin、T-AOC、SOD含量以及外周血IRS1、IRS2、GLUT4表达量较高。结论:保肝降脂汤辅助治疗非酒精性脂肪肝病能够减轻肝功能损伤并改善胰岛素敏感性。
Abstract：Objective:To study the effect of the adjuvant Baogan Jiangzhi decoction therapy on liver function and insulin sensitivity in patients with nonalcoholic fatty liver disease.Methods:Patients who were newly diagnosed with nonalcoholic fatty liver disease in Nanchong Central Hospital and Suining Central Hospital between March 2015 and October 2017 were selected and randomly divided into the observation group who accepted Baogan Jiangzhi decoction combined with conventional western medicine treatment and the control group who accepted conventional western medicine treatment.The contents of liver damage indexes,inflammatory response markers and oxidative stress markers in serum as well as the expression of insulin signaling molecules in peripheral blood were measured before treatment and 2 weeks after treatment.Results:ALT,AST,γ-GT,TBIL,Chemerin,Wnt5a,β-catenin,MDA and NO contents in serum of both groups 2 weeks after treatment were significantly lower than those before treatment(P<0.05)whereas APN,Ghrelin,T-AOC and SOD contents in serum as well as IRS1,IRS2 and GLUT4 expression in peripheral blood were significantly higher than those before treatment(P<0.05),and compared with those of control group,ALT,AST,γ-GT,TBIL,Chemerin,Wnt5a,β-catenin,MDA and NO contents in serum of observation group 2 weeks after treatment were lower whereas APN,Ghrelin,T-AOC and SOD contents in serum as well as IRS1,IRS2 and GLUT4 expression in peripheral blood were higher.Conclusion:Adjuvant Baogan Jiangzhi decoction therapy for nonalcoholic fatty liver disease can reduce liver function injury and improve insulin sensitivity.
1 Arab JP,Arrese M,Trauner M.Recent Insights into the Pathogenesis of Nonalcoholic Fatty Liver Disease[J].Annu Rev Pathol,2018,24(13):321-350.
2 Shigiyama F,Kumashiro N,Furukawa Y,et al.Characteristics of hepatic insulin-sensitive nonalcoholic fatty liver disease[J].Hepatol Commun,2017,1(7):634-647.
3 Gonzalez-Cantero J,Martin-Rodriguez JL,Gonzalez-Cantero A,et al.Insulin resistance in lean and overweight non-diabetic Caucasian adults:Study of its relationship with liver triglyceride content,waist circumference and BMI[J].PLoS One,2018,13(2):e0192663.
4 Da Silva HE,Teterina A,Comelli EM,et al.Nonalcoholic fatty liver disease is associated with dysbiosis independent of body mass index and insulin resistance[J].Sci Rep,2018,8(1):1466.
5 Arrese M,Cortés V,Barrera F,et al.Nonalcoholic fatty liver disease,cholesterol gallstones,and cholecystectomy:new insights on a complex relationship[J].Curr Opin Gastroenterol,2018,34(2):90-96.
6 易玉芳,陈春莲.非酒精性脂肪肝病合并胰岛素抵抗患者血清chemerin hs-CRP水平的研究[J].重庆医学,2017,46(2):172-174.
7 Chen L,Zhao X,Liang G,et al.Recombinant SFRP5protein significantly alleviated intrahepatic inflammation of nonalcoholicsteatohepatitis[J].Nutr Metab(Lond),2017,15(14):56.
8 Popov VB,Jornayvaz FR,Akgul EO,et al.Second-generation antisense oligonucleotides againstβ-catenin protect mice against diet-induced hepatic steatosis and hepatic and peripheral insulin resistance[J].FASEB J,2016,30(3):1207-1217.
9 梁利波,王霞,何訸,等.肥胖及超重人群中血清Wnt5a水平与肝脏脂肪变和纤维化程度的相关性研究[J].四川大学学报(医学版),2017,48(1):7-11.
10 Ezquerro S,Méndez-Giménez L,Becerril S,et al.Acylated and desacyl ghrelin are associated with hepatic lipogenesis,β-oxidation and autophagy:role in NAFLD amelioration after sleeve gastrectomy in obese rats[J].Sci Rep,2016,23(6):39942.
11 Lin X,Zhang Z,Chen JM,et al.Role of APN and TNF-αin type 2diabetes mellitus complicated by nonalcoholic fatty liver disease[J].Genet Mol Res,2015,14(2):2940-2946.
12 Xu H,Zhou Y,Liu Y,et al.Metformin improves hepatic IRS2/PI3K/Akt signaling in insulin-resistant rats of NASH and cirrhosis[J].J Endocrinol,2016,229(2):133-144.
13 Boden G,Homko C,Barrero CA,et al.Excessive caloric intake acutely causes oxidative stress,GLUT4carbonylation,and insulin resistance in healthy men[J].Sci Transl Med,2015,7(304):304re7.
14 Borrelli A,Bonelli P,Tuccillo FM,et al.Role of gut microbiota and oxidative stress in the progression of non-alcoholic fatty liver disease to hepatocarcinoma:Current and innovative therapeutic approaches[J].Redox Biol,2018,15:467-479.
15 Shimomura Y,Takaki A,Wada N,et al.The Serum Oxidative/Anti-oxidative Stress Balance Becomes Dysregulated in Patients with Non-alcoholic Steatohepatitis Associated with Hepatocellular Carcinoma[J].Intern Med,2017,56(3):243-251.
16 Casoinic F,Sampelean D,Buzoianu AD,et al.Serum Levels of Oxidative Stress Markers in Patients with Type 2Diabetes Mellitus and Non-alcoholic Steatohepatitis[J].Rom J Intern Med,2016,54(4):228-236.
17 Wang B,Yang RN,Zhu YR,et al.Involvement of xanthine oxidase and paraoxonase 1in the process of oxidative stress in nonalcoholic fatty liver disease[J].Mol Med Rep,2017,15(1):387-395.
基本信息:
DOI：10.13210/j.cnki.jhmu.20180327.009
中图分类号:R575.5
引用信息:
[1]强红梅,唐军伟,赵荣,等.保肝降脂汤辅助治疗对非酒精性脂肪肝病患者肝功能、胰岛素敏感性的影响[J].海南医学院学报,2018,24(06):707-710.DOI:10.13210/j.cnki.jhmu.20180327.009.
基金信息:
四川省中医药科学技术研究专项(2016Q088)~~
2018-03-27
2018-03-27
2018-03-27