从邪伏散膏论治糖尿病前期（脾虚痰湿证）临床观察

发布时间：2018-06-08 02:30

本文选题：糖尿病前期 + 脾虚痰湿证　；参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:本研究从邪伏散膏病机假说论治糖尿病前期脾虚痰湿证,旨在验证益气健脾,化痰祛湿通络,清热透邪法治疗糖尿病前期脾虚痰湿证的有效性和安全性,为糖尿病早期干预,提早预防提供新思路,为控制糖尿病的发展提供新方法。方法:选取长春中医药大学附属医院本部、二部门诊及糖尿病疗区住院符合辨证分组要求的糖尿病前期患者共60例,采用随机对照法分组,治疗组、对照组各30例。治疗组给予基础治疗即严格的饮食、运动疗法加上加味六君子汤口服,对照组给予基础治疗加阿卡波糖片口服,观察治疗前后中医症状、空腹及餐后2小时血糖、糖化血红蛋白、腰臀比、体重指数、空腹血清胰岛素、胰岛素抵抗指数、胰岛素敏感指数、β细胞功能指数的变化,4周为1个疗程,连续观察3个疗程。结果:从邪伏散膏论治糖尿病前期脾虚痰湿证60例,治疗组总有效率90.00%,对照组总有效率73.33%;两组在降低空腹及餐后2小时血糖、糖化血红蛋白方面均疗效显著(P0.01);降低腰臀比、体重指数方面治疗组明显优于对照组,有显著差异(P0.01);中医症状方面:治疗组临床症状肥胖、神疲乏力、少气懒言、便溏、纳呆、面色不华、腰膝酸软、头胀肢沉、小便多、舌、脉象改善优于对照组,有显著差异(P0.01),畏寒肢冷、头晕耳鸣改善优于对照组,有明显差异(P0.05);改善胰岛素抵抗指数、胰岛素敏感指数方面治疗组明显优于对照组,有显著差异(P0.01)。结论:加味六君子汤治疗糖尿病前期脾虚痰湿证降糖效果与阿卡波糖无明显差异;且在改善临床症状、胰岛素抵抗等多项观察指标方面优于阿卡波糖;初步研究得出其降糖机制可能与改善胰岛素抵抗有关,体现了“治未病”理论的指导性意义,降低了糖尿病的发病率,疗效显著,且随访复发率低。
[Abstract]:Objective: to treat the syndrome of spleen deficiency and phlegm dampness in early stage of diabetes mellitus from the hypothesis of pathogenic Fu San ointment, in order to verify the efficacy and safety of invigorating qi and invigorating spleen, eliminating phlegm and removing dampness and clearing away heat and clearing away pathogenic factors in treating the syndrome of spleen deficiency and phlegm dampness in early stage of diabetes mellitus. To provide new ideas for early intervention and early prevention of diabetes mellitus and to control the development of diabetes mellitus. Methods: a total of 60 pre-diabetic patients were selected from the hospital of Changchun University of traditional Chinese Medicine, two outpatients and the diabetes treatment area. The patients were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The treatment group was given basic treatment, namely strict diet, exercise therapy plus Jiawei Liujunzi decoction, while the control group was given basic treatment plus acarbose tablets orally. The symptoms of traditional Chinese medicine, fasting and 2 hours postprandial blood glucose were observed before and after treatment. The changes of glycosylated hemoglobin, waist-hip ratio, body mass index, fasting serum insulin, insulin resistance index, insulin sensitivity index and 尾 cell function index were observed for 3 consecutive courses. Results: 60 cases of spleen deficiency and phlegm dampness syndrome were treated with Xiefu San plaster, the total effective rate of treatment group was 90.00m, the total effective rate of control group was 73.33.The effect of both groups in reducing fasting and postprandial blood glucose and glycosylated hemoglobin was significant (P 0.01); The treatment group was obviously superior to the control group in body mass index (BMI), there was significant difference (P0.01) in TCM symptoms: in the treatment group, the clinical symptoms were obesity, fatigue, indolence, loose stools, indolence, pale complexion, sore waist and knee, head swelling and limb sinking, more urination, tongue, The improvement of pulse was better than that of control group (P 0.01), cold of cold limbs, dizziness and tinnitus were better than that of control group (P 0.05), the improvement of insulin resistance index in treatment group was better than that in control group, and there was significant difference between treatment group and control group (P 0.01). Conclusion: the effect of Jiawei Liujunzi decoction on reducing blood sugar of spleen deficiency and phlegm dampness syndrome before diabetes is not significantly different from that of acarbose, and it is superior to acarbose in improving clinical symptoms and insulin resistance. The preliminary study shows that the mechanism of hypoglycemic effect may be related to improving insulin resistance, which reflects the guiding significance of the theory of "cure without disease", reduces the incidence of diabetes mellitus, and has a significant curative effect, and the recurrence rate of follow-up is low.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1

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