Clinical Study On The Correlation Between FGF21,APN And TNF-? Levels In Patients With Type 2 Diabetes Mellitus Combined With Non-alcoholic Fatty Liver Disease

Objective : To observe the function of Gegen Qinlian Decoction after treating the patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease,comparing the changes of clinical symptoms and fat factors before and after treatment,to evaluate the therapeutic effect of Gegen Qinlian Decoction.Methods:The 60 patients who with T2 DM and NAFLD were divided into treatment group and control group randomly,each with a total of 30 cases.The control group was given conventional treatment of hypoglycemic and lipid regulating.On the basis of the control group,the treatment group was given Gegen Qinlian Decoction for 8weeks.Comparing the changes between before and after treatment on the indexes of FGF21?APN?TNF-??FPG?FINS?HOMA-IR?TG?TC?LDL-C?HDL-C?ALT?AST?GGT?Liver B-mode ultrasonography ?BMI?WHR and the TCM symptoms score,at the same time,the safety index was detected.Results:(1)Comparison of clinical efficacy: the total effective rate of the treatment group was 93.3%,while the control group was 66.7%,its difference was obviously significant(P<0.01);(2)Comparison of the TCM syndrome score: two groups after treatment of TCM syndrome scores decreased(P<0.01);the treatment group decreased more obviously(P<0.05);(3)After treatment,the levels of serum FGF21 and TNFwere decreased in the two groups(P<0.05,P<0.01);serum APN levels were significantly increased in the the two groups after treatment(P<0.01);Compared with the control group,the treatment group of the serum FGF21,TNF-? was decreased more significant(P<0.05,P<0.01),the treatment group of the serum APN was increased more signifigant,(P <0.01);(4)These two groups of FPG,FINS declined obviously after treatment(P<0.01),the treatment group decreased more significant(P<0.01,P<0.05);(5)These two groups of HOMA-IR declined distinctly after treatment(P<0.01),the treatment group declined more obviously(P<0.01)than it in the control group;(6)These two groups of TC?TG and LDL-C have declined significantly after treatment(P<0.01),HDL-C was increased obviously(P<0.01).The treatment group' TC declined more obviously(P<0.01),the treatment group'HDL-C increased group more obviously(P<0.01),the difference of TG?LDL-C between the treatment group and control group was not statistically significant(P>0.05);(7)After treatment,the liver ultrasound division of treatment group were significantly better than before treatment(P<0.01),the control group of liver ultrasound division than before treatment had no significant change(P>0.05),the difference of these two group was statistically significant(P<0.05).(8)ALT?AST?GGT of the two groups didn't change after treatment(P>0.05);(9)After the treatment BMI,WHR of the two groups didn't have evident differences(P>0.05);(10)The analysis of safety index: There were no obvious adverse reactions in the treatment group and the control group.Conclusion:The Gegen Qinlian Decoction is good at the treatment of the patients with type 2 diabetes mellitus combined with nonalcoholic fatty liver disease through reducing the insulin resistance,improving the metabolism of glucose and lipid,regulating the content of fat factor.And through the detection of safety indicators,the Gegen Qinlian Decoction is been confirmed safty.