Clinical Study On Treating Type2Diabetes Mellitus With Nonalcoholic Fatty Liver Disease By Removing Heat And Dampness

ObjectivesTo study the the clinical characteristics of damp-heat retention spleen pattern and the effect of removing heat and dampness on type2diabetes mellitus(T2DM) combined with nonalcoholic fatty liver disease(NAFLD) patients, and to explain the therapeutic mechanism of removing heat and dampness method, so as to provid an evidence for the prevention and treatment of T2DM combined with NAFLD.MethodsWe used prospective randomized controlled method in this paper,71T2DM combined with NAFLD patients agreed to diagnostic code and inclusion criteria were collected and randomly divided into experimental group and control group, experimental group was36cases, and control group was35cases. Diabetes education, dietary, and conventional hypoglycemic agents were given to both groups, decoction made up of removing heat and dampness herbal medicines was given additionally to patients in experimental group, one dose a day and taking in two times, the course of treatment was3months. Changes of symptoms, blood glucose, blood lipid, fasting insulin, body-mass index and B-mode ultrasonography of liver were observed before and after treatment, and clinical effect was assessd after treatment.Results1. Based on blood sugar and TCM symptom scores, the total efficacy of experimental group was89.9%,15cases were significantly effective,17cases were effective,4cases were ineffective. In control group total efficacy was60.0%,3case were significantly effective,18cases were effective,14cases were ineffective. There was significantly difference between the two groups(P<0.05). 2. Fatty liver improve rate in experimental group was25%, while it was11.4%in control group; there was no differences between the two groups after3months treatment; There was significantly difference after treatment than before in experimental group(P<0.01).3. After three months of treatment, BMI, FBG, PBG, HbAIc, Ln (HOMA-IR) and GGT were significantly reduced in each group(P<0.01), HbAlc、Ln(HOMA-IR) and GGT levels were dropped much more in the experimental group, compared with control group(P<0.01); TG level was significantly reduced in the experimental group after treatment (P<0.01), while in control group there was no difference after treatment than before.4. T2DM combined with NAFLD patients with damp-heat retention spleen pattern were always with short duration, they had serious insulin resistance, obesity and metabolic disorders. Ln(HOMA-IR) was positive correlation with the grade of TCM symptoms, fatty liver classification and TG level.5. Traditional Chinese medicine application rule:Removing heat and dampness was important in early treatment of T2DM combined with NAFLD, and protecting yin liquid was also used in later period, strengthening the spleen and replenishing qi was used throughout the whole treatment process.ConclusionT2DM combined NAFLD patients with damp-heat retention spleen pattern were always with short duration, they had serious insulin resistance, obesity and metabolic disorders. Ln(HOMA-IR) was positive correlation with the grade of TCM symptoms, fatty liver classification and TG level. Removing heat and dampness Method was better than hypoglycemic agents only. It could obviously improve glucolipid metabolism disorders and insulin resistance, and reduce weight. It was effective and safe to the treatment of T2DM combined with NAFLD. It was important to treat T2DM combined with NAFLD based on damp-heat.