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[目的]探讨黄连素联合胰岛素增敏剂对非酒精性脂肪肝(NAFLD)疗效及对患者体内氧化应激的影响。[方法]76例明确诊断NAFLD患者随机分为对照组与观察组,每组各38例。对照组予以常规治疗,观察组在对照组基础上加用黄连素及胰岛素增敏剂吡格列酮。分别观察2组患者治疗总有效率间差异。同时检测并比较2组患者治疗前后血甘油三酯(TC)、血总胆固醇(TG)、低密度脂蛋白(LDL)、空腹血糖(GLU)、谷氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、超敏C反应蛋白(hs-CRP)、血清肿瘤坏死因子-α(TNF-α)、白介素-18(IL-18)、丙二醛(MDA)及超氧化物歧化酶(SOD)间差异。观察治疗过程中药物相关不良反应以评价治疗安全性。[结果]治疗2个月后观察组患者和对照组患者AST分别为[(31.21±7.43)U/L和(39.19±8.08)U/L,P<0.05];治疗2个月后观察组患者和对照组患者hs-CRP分别为[(2.08±0.51)mg/L和(3.27±1.12)U/L,P<0.05]。治疗2个月后观察组患者和对照组患者TNF-α分别为[(15.28±4.91)pg/ml和(18.72±8.01)pg/ml,P<0.05];治疗2个月后观察组患者和对照组患者IL-18分别为[(109.08±19.24)pg/ml和(133.29±13.92)pg/ml,P<0.05]。治疗2个月后观察组患者MDA为(5.11±1.04)μmol/L,显著低于对照组的(7.09±2.42)μmol/L(P<0.05);治疗2个月后观察组患者SOD为(129.18±22.06)U/L,显著高于对照组的(88.29±20.01)U/L(P<0.05)。2组患者治疗过程中药物相关不良事件发生率间未见显著差异(P>0.05)。[结论]黄连素联合胰岛素增敏剂可显著提高NAFLD的临床疗效且安全性良好,降低体内炎症反应及氧化应激水平可能是其潜在机制。
[Objective] To explore the effect of berberine plus insulin sensitizer on non-alcoholic fatty liver disease (NAFLD) and its effect on oxidative stress in patients. [Method] 76 patients with definite diagnosis of NAFLD were randomly divided into control group and observation group, 38 cases in each group. The control group was given routine treatment. The observation group was given piriridin and insulin sensitizer pioglitazone on the basis of the control group. The difference between the two groups in total effective rate was observed. At the same time, the levels of triglyceride (TC), total cholesterol (TG), low density lipoprotein (LDL), fasting blood glucose (GLU), glutamate aminotransferase (ALT) AST, hs-CRP, TNF-α, IL-18, MDA and superoxide dismutase Differences in the content of dismutase (SOD). Observe drug-related adverse events during treatment to evaluate treatment safety. [Results] The AST in observation group and control group were [(31.21 ± 7.43) U / L and (39.19 ± 8.08) U / L, respectively, 2 months after treatment; Hs-CRP in the control group were [(2.08 ± 0.51) mg / L and (3.27 ± 1.12) U / L, respectively; P <0.05]. The levels of TNF-αin the observation group and control group were [(15.28 ± 4.91) pg / ml and (18.72 ± 8.01) pg / ml respectively after 2 months of treatment, P <0.05] IL-18 in the control group was [(109.08 ± 19.24) pg / ml and (133.29 ± 13.92) pg / ml respectively, P <0.05]. After 2 months treatment, the MDA in the observation group was (5.11 ± 1.04) μmol / L, which was significantly lower than that in the control group (7.09 ± 2.42) μmol / L (P <0.05) 129.18 ± 22.06) U / L, which was significantly higher than that of the control group (88.29 ± 20.01) U / L (P <0.05). There was no significant difference between the two groups in the incidence of drug-related adverse events during treatment (P> 0.05). [Conclusion] Berberine combined with insulin sensitizer can significantly improve the clinical efficacy and safety of NAFLD, and reduce the inflammatory reaction and oxidative stress in vivo may be its underlying mechanism.