乌梅丸合八珍汤加减治疗肥胖2型糖尿病气阴两虚夹痰瘀证临床观察
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摘要
目的:观察乌梅丸合八珍汤加减治疗肥胖2型糖尿病气阴两虚夹痰瘀证的临床疗效。方法:将选取符合纳入标准的60例肥胖2型糖尿病气阴两虚夹痰瘀证患者按照随机数字法分为观察组、对照组,各30例。在糖尿病常规治疗基础上,观察组给予西医(盐酸二甲双胍)治疗,同时应用乌梅丸合八珍汤加减治疗。对照组采用常规西药(盐酸二甲双胍)治疗。疗程为8周,比较两组患者治疗前后空腹血糖(FPG),餐后2 h血糖(2 h PG),糖化血红蛋白(HbA1c),总胆固醇(TC),三酰甘油(TG),体质量指数(BMI)水平、安全性指标(三大常规、肝肾功能)及临床症状的变化情况,并评价两组患者临床疗效。结果:观察组症状评分有效率为93. 3%(28/30),明显高于对照组的73. 3%(22/30)(P <0. 05)。与本组治疗前比较,治疗后两组患者FPG,2 h PG,HbA1c水平均明显降低,且观察组治疗后FPG,2 h PG,HbA1c明显低于对照组(P <0. 05);两组患者治疗后TC,TG,BMI水平及中医证候积分均明显降低(P <0. 05),且观察组治疗后TC,TG,BMI水平及中医证候积分低于对照组(P <0. 05)。结论:乌梅丸合八珍汤对治疗肥胖2型糖尿病气阴两虚夹痰瘀证患者安全有效,且能降低患者血糖,血脂,BMI水平及减轻患者临床症状具有显著的疗效,值得推广。
Objective: To observe the clinical efficacy of Wumeiwan combined with Bazhentang in the treatment of obesity type 2 diabetes with Qi and Yin deficiencies,phlegm and stasis. Method: Totally 60 patients with type 2 diabetes mellitus were randomly divided into observation group and control group,with 30 cases in each group. Observation group was given Wumeiwan combined with modified Bazhentang in addition to Western medicine( metformin hydrochloride). The control group was treated with traditional Western medicine( metformin hydrochloride). The course of treatment is eight weeks. Fasting blood sugar( FPG),2 hPG( 2 h PG),glycosylated hemoglobin( HbA1c),total cholesterol( TC),triglycerin( TG),body mass index( BMI),safety indicators( three major routine,liver and kidney functions) and clinical symptoms before and after treatment between two groups were compared. The clinical efficacy of two groups was evaluated. Result: The observation group had an effective rate of 93. 3%( 28/30),which was significantly higher than 73. 3%( 22/30) of the control group,with statistically significant differences( P < 0. 05). Compared with before treatment,the levels of FPG,2 h PG and HbA1c were significantly lower in two groups after treatment,and the treatment group was lower than control group( P < 0. 05). The levels of TC,TG,BMI and TCM syndromes were significantly reduced after treatment in two groups( P < 0. 05),and the levels of TC,TG,BMI and TCM syndromes were significantly lower than those in control group. The differences were statistically significant( P < 0. 05). Conclusion: Modified Wumeiwan combined with Bazhentang is safe and effective in treating patients with type 2 diabetes mellitus with Qi and Yin deficiencies,phlegm and stasis,and can reduce blood sugar,blood lipid,BMI level and relieve clinical symptoms of patients,and so worth promotion.
Objective: To observe the clinical efficacy of Wumeiwan combined with Bazhentang in the treatment of obesity type 2 diabetes with Qi and Yin deficiencies,phlegm and stasis. Method: Totally 60 patients with type 2 diabetes mellitus were randomly divided into observation group and control group,with 30 cases in each group. Observation group was given Wumeiwan combined with modified Bazhentang in addition to Western medicine( metformin hydrochloride). The control group was treated with traditional Western medicine( metformin hydrochloride). The course of treatment is eight weeks. Fasting blood sugar( FPG),2 hPG( 2 h PG),glycosylated hemoglobin( HbA1c),total cholesterol( TC),triglycerin( TG),body mass index( BMI),safety indicators( three major routine,liver and kidney functions) and clinical symptoms before and after treatment between two groups were compared. The clinical efficacy of two groups was evaluated. Result: The observation group had an effective rate of 93. 3%( 28/30),which was significantly higher than 73. 3%( 22/30) of the control group,with statistically significant differences( P < 0. 05). Compared with before treatment,the levels of FPG,2 h PG and HbA1c were significantly lower in two groups after treatment,and the treatment group was lower than control group( P < 0. 05). The levels of TC,TG,BMI and TCM syndromes were significantly reduced after treatment in two groups( P < 0. 05),and the levels of TC,TG,BMI and TCM syndromes were significantly lower than those in control group. The differences were statistically significant( P < 0. 05). Conclusion: Modified Wumeiwan combined with Bazhentang is safe and effective in treating patients with type 2 diabetes mellitus with Qi and Yin deficiencies,phlegm and stasis,and can reduce blood sugar,blood lipid,BMI level and relieve clinical symptoms of patients,and so worth promotion.
引文
[1]翁建平.对糖尿病流行病学、循证医学及基础研究的探索[J].中山大学学报:医学科学版,2010,31(2):166-171,178.
[2]杨凌辉,邹大进.肥胖致胰岛素抵抗的机制[J].中华内分泌代谢杂志,2002,18(3):82-84.
[3]陈威妮,刘志龙,张弛,等.中药治疗2型糖尿病随机对照试验的系统评价[J].中国中医药信息杂志,2012,19(1):21-24,28.
[4]单亮亮,邓小敏,郭超峰,等.基于“五脏柔弱”探讨五味消渴方治疗2型糖尿病的理论研究[J].辽宁中医杂志,2018,45(5):951-953.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-497.
[6]中华医学会内分泌学分会肥胖学组.中国成人肥胖症防治专家共识[J].中华内分泌代谢杂志,2011,27(9):711-717.
[7]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:21.
[8]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[9]张娜.不同胰岛素及联合用药方案对于糖尿病治疗的临床效果[J].吉林医学,2015,36(4):667-668.
[10]窦梅,马爱国.胰岛素抵抗主要原因及机制的研究进展[J].国外医学:卫生学分册,2009,36(3):174-179.
[11]李通平,陈秋. 2型糖尿病易感基因与肥胖关系的研究进展[J].西南军医,2014,16(6):673-675.
[12]赵昱,陈良,董柳,等.开郁清热方对肥胖2型糖尿病肝胃郁热证患者β细胞功能的影响[J].北京中医药大学学报,2013,36(7):488-492,496.
[13]赵平鸽,刘晓.地黄多糖的提取纯化及其对糖尿病小鼠血糖的影响研究[J].海峡药学,2010,22(9):29-32.
[14]李曼曼,张百霞,何帅兵,等.基于“中药作用机理辅助解析系统”的金钗石斛降糖作用机制研究[J].中国中药杂志,2015,40(19):3709-3712.
[15]黄琦,廖鑫,吴芹,等.金钗石斛生物总碱对糖尿病大鼠血糖及肝脏组织IRS-2 mRNA,IGF-1 mRNA表达的影响[J].中国实验方剂学杂志,2014,20(19):155-158.
[16]王利红,唐文照,辛义周.黄连中生物碱成分及药理作用研究进展[J].山东中医药大学学报,2015,39(4):389-392.
[17]薛涛,夏朝霞,邬丽莎,等.人参降糖作用的研究进展[J].中国现代中药,2014,16(5):428-432.
[18]李璐,王永香,王秀海,等.地龙及其复方治疗糖尿病肾病的机制研究进展[J].中国实验方剂学杂志,2017,23(7):227-234.
[2]杨凌辉,邹大进.肥胖致胰岛素抵抗的机制[J].中华内分泌代谢杂志,2002,18(3):82-84.
[3]陈威妮,刘志龙,张弛,等.中药治疗2型糖尿病随机对照试验的系统评价[J].中国中医药信息杂志,2012,19(1):21-24,28.
[4]单亮亮,邓小敏,郭超峰,等.基于“五脏柔弱”探讨五味消渴方治疗2型糖尿病的理论研究[J].辽宁中医杂志,2018,45(5):951-953.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-497.
[6]中华医学会内分泌学分会肥胖学组.中国成人肥胖症防治专家共识[J].中华内分泌代谢杂志,2011,27(9):711-717.
[7]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:21.
[8]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:233-237.
[9]张娜.不同胰岛素及联合用药方案对于糖尿病治疗的临床效果[J].吉林医学,2015,36(4):667-668.
[10]窦梅,马爱国.胰岛素抵抗主要原因及机制的研究进展[J].国外医学:卫生学分册,2009,36(3):174-179.
[11]李通平,陈秋. 2型糖尿病易感基因与肥胖关系的研究进展[J].西南军医,2014,16(6):673-675.
[12]赵昱,陈良,董柳,等.开郁清热方对肥胖2型糖尿病肝胃郁热证患者β细胞功能的影响[J].北京中医药大学学报,2013,36(7):488-492,496.
[13]赵平鸽,刘晓.地黄多糖的提取纯化及其对糖尿病小鼠血糖的影响研究[J].海峡药学,2010,22(9):29-32.
[14]李曼曼,张百霞,何帅兵,等.基于“中药作用机理辅助解析系统”的金钗石斛降糖作用机制研究[J].中国中药杂志,2015,40(19):3709-3712.
[15]黄琦,廖鑫,吴芹,等.金钗石斛生物总碱对糖尿病大鼠血糖及肝脏组织IRS-2 mRNA,IGF-1 mRNA表达的影响[J].中国实验方剂学杂志,2014,20(19):155-158.
[16]王利红,唐文照,辛义周.黄连中生物碱成分及药理作用研究进展[J].山东中医药大学学报,2015,39(4):389-392.
[17]薛涛,夏朝霞,邬丽莎,等.人参降糖作用的研究进展[J].中国现代中药,2014,16(5):428-432.
[18]李璐,王永香,王秀海,等.地龙及其复方治疗糖尿病肾病的机制研究进展[J].中国实验方剂学杂志,2017,23(7):227-234.