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目的观察二甲双胍联合降脂、生活方式干预治疗对非酒精性脂肪性肝病患者治疗效果。方法对2007年8月至2009年10月在广东省揭阳市红十字会慈云医院门诊确诊100例NAFLD患者。随机分治疗组和对照组各50例,治疗组给予二甲双胍、降脂、运动、饮食控制。对照组应用运动、生活方式干预,治疗观察6个月。比较两组治疗前后肝酶学、肝脏超声、体质量指数、血脂、血糖、胰岛素以及HOMA胰岛素抵抗指标变化。结果治疗组有效率为90%,对照组有效率为56%,两组差异有统计学意义(P<0.05)。肝酶学、肝脏超声、体质量指数、血脂、血糖、胰岛素以及HOMA胰岛素抵抗指标改善情况治疗组优于对照组(P<0.05)。结论对NAFLD患者在进行饮食、运动治疗同时予以二甲双胍、降脂药治疗,改善NAFLD症状及肝酶学及胰岛素抵抗疗效优于单纯的节食减重治疗。
Objective To observe the effect of metformin combined with lipid-lowering and lifestyle intervention on patients with non-alcoholic fatty liver disease. Methods From August 2007 to October 2009, 100 cases of NAFLD were diagnosed at the Ciyun Hospital of Red Cross Society of Jieyang in Guangdong Province. Randomly divided treatment group and control group of 50 cases, the treatment group were given metformin, lipid-lowering, exercise, diet control. Control group exercise, lifestyle intervention, treatment observed for 6 months. Liver enzymes, liver ultrasound, body mass index, lipids, blood glucose, insulin and HOMA insulin resistance were compared between the two groups before and after treatment. Results The effective rate was 90% in the treatment group and 56% in the control group, with significant difference between the two groups (P <0.05). Liver enzymes, liver ultrasound, body mass index, blood lipids, blood glucose, insulin and HOMA insulin resistance indicators improved the treatment group than the control group (P <0.05). Conclusions Metformin and lipid-lowering drugs are used in patients with NAFLD during diet and exercise therapy to improve the symptoms of NAFLD and the effect of liver enzymology and insulin resistance is better than simple diet and weight loss treatment.