“首辨阴阳,再辨六经”论治惠州地区2型糖尿病的临床观察
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摘要
目的:探讨立足"首辨阴阳,再辨六经"论治惠州地区2型糖尿病的临床疗效。方法:选取惠州地区2型糖尿病患者120例,随机分为对照组、观察组,对照组采取常规治疗,观察组在对照组治疗的基础上立足"首辨阴阳,再辨六经"论治,检测两组治疗前后空腹血糖(FPG)、餐后2h血糖(G-2h)、糖化血红蛋白(Hb A1c)、空腹胰岛素(FINS)、胰岛素敏感性指数(IAI)、简明健康调查表(SF-36)、2型糖尿病患者生活质量评定量表(DMQLS)及中医症候评分。结果:治疗后,对照组FPG、G-2h、Hb A1c较治疗前显著改善(P<0.05),观察组FPG、G-2h、Hb A1c、FINS、IAI、SF-36评分、DMQLS评分较治疗前亦显著改善(P<0.05);同时,观察组FINS、IAI、SF-36评分、DMQLS评分、中医临床疗效均显著优于对照组(P<0.05,P<0.01)。结论:立足"首辨阴阳,再辨六经"论治惠州地区2型糖尿病,有效控制血糖的同时可修复胰岛β细胞功能,提高胰岛素敏感性,改善临床症状及生活质量,值得在该地区进一步推广应用和深入研究。
To explore the clinical efficacy of 'the first of syndrome differentiation is yin and yang, then is the six meridians' to treat type 2 diabetes in Huizhou. Methods: A total of 120 patients with type 2 diabetes in Huizhou were randomly divided into the control group, the observation group. The control group was treated routinely. The observation group was treated according to the principle of 'the first of syndrome differentiation is yin and yang, then is the six meridians', based on the treatment of the control group. Fasting blood glucose(FPG), postprandial 2 h blood glucose(G-2 h), glycosylated hemoglobin(Hb A1 c), fasting insulin(FINS), insulin sensitivity index(IAI), and the Short Form(SF-36), development and evaluation of quality of life scale(DMQLS) and TCM symptom scores were observed before and after treatment. Results: After treatment, FPG, G-2 h and Hb A1 c in the control group were significantly improved compared with those before treatment(P<0.05). The FPG, G-2 h, Hb A1 c, FINS, IAI, SF-36 and DMQLS scores in the observation group were also significantly improved compared with those before treatment(P<0.05); in the meanwhile, the FINS, IAI, SF-36 score, DMQLS score, and TCM symptom improvement in the observation group were better than the control group(P<0.05, P<0.01). Conclusion: Based on the 'the first of syndrome differentiation is yin and yang, then is the six meridians' to treat type 2 diabetes in Huizhou, blood glucose can be effectively controlled while repairing islet β-cell function, and insulin sensitivity, clinical symptoms and quality of life can also be improved. It is worth further promoting, application and in-depth research in this region.
To explore the clinical efficacy of 'the first of syndrome differentiation is yin and yang, then is the six meridians' to treat type 2 diabetes in Huizhou. Methods: A total of 120 patients with type 2 diabetes in Huizhou were randomly divided into the control group, the observation group. The control group was treated routinely. The observation group was treated according to the principle of 'the first of syndrome differentiation is yin and yang, then is the six meridians', based on the treatment of the control group. Fasting blood glucose(FPG), postprandial 2 h blood glucose(G-2 h), glycosylated hemoglobin(Hb A1 c), fasting insulin(FINS), insulin sensitivity index(IAI), and the Short Form(SF-36), development and evaluation of quality of life scale(DMQLS) and TCM symptom scores were observed before and after treatment. Results: After treatment, FPG, G-2 h and Hb A1 c in the control group were significantly improved compared with those before treatment(P<0.05). The FPG, G-2 h, Hb A1 c, FINS, IAI, SF-36 and DMQLS scores in the observation group were also significantly improved compared with those before treatment(P<0.05); in the meanwhile, the FINS, IAI, SF-36 score, DMQLS score, and TCM symptom improvement in the observation group were better than the control group(P<0.05, P<0.01). Conclusion: Based on the 'the first of syndrome differentiation is yin and yang, then is the six meridians' to treat type 2 diabetes in Huizhou, blood glucose can be effectively controlled while repairing islet β-cell function, and insulin sensitivity, clinical symptoms and quality of life can also be improved. It is worth further promoting, application and in-depth research in this region.
引文
[1]李桂平,赖玉林,邱爱婷,等.惠州市2型糖尿病流行病学调查.药物流行病学杂志,2015,24(11):654-657
[2]周仲瑛.中医内科学.北京:中国中医药出版社,2007:409-410
[3]World Health Organization.Definition,diagnosis and classification of diabetes mellitus and its complications.In:Report of a WHO Consultation.WHO/NCD/NCS/99.2.Geneva:WHO,1999
[4]李光伟,潘孝仁,Lillioja S,等.检测人群胰岛素敏感性的一项新指数.中华内科杂志,1993,32(10):656-660
[5]孙振球.医学统计学.北京:人民卫生出版社,2002:53
[6]王乐三,孙振球,蔡太生,等.2型糖尿病患者生活质量量表的研制与考评.中南大学学报(医学版),2005,30(1):21-27
[7]林明欣,朱章志,朱建平,等.从“神,形,纳,眠,便”初探论治糖尿病.中华中医药杂志,2014,29(12):3683-3685
[8]国家中医药管理局.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:233-237
[9]陈利强,骆秀婷,岳文静.广东惠州地区职工糖尿病患病情况调查与研究.河北医学,2016,22(2):329-332
[10]林明欣,朱章志,樊毓运,等.朱章志教授论治消渴病之“温阳三法”浅探.中华中医药杂志,2012,27(6):1598-1601
[11]耿华,林明欣,韩蕊,等.“首辨阴阳,再辨六经”论治糖尿病前期医案浅析.世界中医药,2014,9(8):1044-1047
[12]马春玲,阮永队,付昕,等.从六经辨证之三阴病论治糖尿病前期的临床研究.中华中医药杂志,2015,30(4):1334-1337
[13]林明欣.论治糖尿病之“二纲六目”模式构建及临床应用.广州:广州中医药大学,2013
[14]林明欣,赵英英,朱章志.立足“首辨阴阳,再辨六经”浅析糖尿病论治.中华中医药杂志,2011,26(5):1119-1122
[15]林明欣,谢欣颖,朱建平,等.论治糖尿病之“通阳三法”初探.中华中医药杂志,2014,29(9):2896-2898
[16]张斌,郭刚,汪蓓蕾,等.老年2型糖尿病患者糖化血红蛋白水平与血糖及胰岛素敏感性的关系.中国老年学杂志,2017,37(6):1378-1380
[17]汪何,吕雄,江丹,等.三芪丹颗粒改善2型糖尿病胰岛素敏感性的临床研究.中华中医药杂志,2011,26(8):1749-1751
[18]刘峰,赖燕容,朱章志.从“神、形、纳、眠、便”判断糖尿病治疗效果.辽宁中医药大学学报,2012,9(9):145-147
[19]谢琨,吴晶.中国糖尿病患者生命质量的荟萃分析.现代医学,2014,42(12):1462-1468
[2]周仲瑛.中医内科学.北京:中国中医药出版社,2007:409-410
[3]World Health Organization.Definition,diagnosis and classification of diabetes mellitus and its complications.In:Report of a WHO Consultation.WHO/NCD/NCS/99.2.Geneva:WHO,1999
[4]李光伟,潘孝仁,Lillioja S,等.检测人群胰岛素敏感性的一项新指数.中华内科杂志,1993,32(10):656-660
[5]孙振球.医学统计学.北京:人民卫生出版社,2002:53
[6]王乐三,孙振球,蔡太生,等.2型糖尿病患者生活质量量表的研制与考评.中南大学学报(医学版),2005,30(1):21-27
[7]林明欣,朱章志,朱建平,等.从“神,形,纳,眠,便”初探论治糖尿病.中华中医药杂志,2014,29(12):3683-3685
[8]国家中医药管理局.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:233-237
[9]陈利强,骆秀婷,岳文静.广东惠州地区职工糖尿病患病情况调查与研究.河北医学,2016,22(2):329-332
[10]林明欣,朱章志,樊毓运,等.朱章志教授论治消渴病之“温阳三法”浅探.中华中医药杂志,2012,27(6):1598-1601
[11]耿华,林明欣,韩蕊,等.“首辨阴阳,再辨六经”论治糖尿病前期医案浅析.世界中医药,2014,9(8):1044-1047
[12]马春玲,阮永队,付昕,等.从六经辨证之三阴病论治糖尿病前期的临床研究.中华中医药杂志,2015,30(4):1334-1337
[13]林明欣.论治糖尿病之“二纲六目”模式构建及临床应用.广州:广州中医药大学,2013
[14]林明欣,赵英英,朱章志.立足“首辨阴阳,再辨六经”浅析糖尿病论治.中华中医药杂志,2011,26(5):1119-1122
[15]林明欣,谢欣颖,朱建平,等.论治糖尿病之“通阳三法”初探.中华中医药杂志,2014,29(9):2896-2898
[16]张斌,郭刚,汪蓓蕾,等.老年2型糖尿病患者糖化血红蛋白水平与血糖及胰岛素敏感性的关系.中国老年学杂志,2017,37(6):1378-1380
[17]汪何,吕雄,江丹,等.三芪丹颗粒改善2型糖尿病胰岛素敏感性的临床研究.中华中医药杂志,2011,26(8):1749-1751
[18]刘峰,赖燕容,朱章志.从“神、形、纳、眠、便”判断糖尿病治疗效果.辽宁中医药大学学报,2012,9(9):145-147
[19]谢琨,吴晶.中国糖尿病患者生命质量的荟萃分析.现代医学,2014,42(12):1462-1468