清血解毒合剂对2型糖尿病患者胰岛素抵抗及相关促炎因子的影响

发布时间：2018-06-28 22:42

本文选题：促炎因子 + 2型糖尿病　；参考：《湖北中医药大学》2015年硕士论文

【摘要】：目的胰岛素抵抗(IR)作为2型糖尿病(T2DM)的核心发病机制,其形成的原因目前尚未研究清楚。本实验旨在通过在T2DM患者常规降糖方案的基础上联合应用清血解毒合剂以观察白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)、空腹血清胰岛素(Fins)等指标的变化,用以分析清血解毒合剂对促炎因子的影响及与2型糖尿病胰岛素抵抗的关系。方法随机选取2013年7月至2015年2月武汉市中西医结合医院(武汉市一医院)内分泌科住院部2型糖尿病患者60例,证型均为阴虚火旺兼夹血瘀证。按照随机原则分为常规治疗组及联合治疗组,每组各30例,两组2型糖尿病患者在年龄、性别及病程上均无明显差异(PO.O5)。常规治疗组给予常规降糖方案治疗八周,联合治疗组在常规降糖方案的基础上联合应用清血解毒合剂治疗八周,清血解毒合剂为武汉市一医院药剂科制备,规格为200 ml/瓶,服用方法:每次30ml,每日3次。治疗前后分别检测两组患者的IL-6、IL-8、TNF-α、hs-CRP、Fins及中医证候评分、临床证候疗效。结果1.常规治疗组及联合治疗组治疗前后Fins及IRI均较前下降,但联合治疗组差异性较常规治疗组更大(P0.01)。2.两组患者治疗前后IL-6、IL-8、TNF-α、hs-CRP等炎症因子在体内的浓度均较前下降,有统计学意义(P0.05),治疗八周后联合治疗组在IL-6、IL-8、TNF-α、hs-CRP等促炎因子的组内差异(P0.01)优于常规治疗组(P0.05)。3.常规治疗组及联合治疗组治疗前后Hb A1C、FPG及2 h PG均较前下降(P0.01),但两组间未见明显差异(P0.05)。4.常规治疗组在治疗过程中出现低血糖患者2例,联合治疗组治疗过程中出现低血糖患者1例,两组间未见明显差异,无统计学意义(P0.05)。5.经过八周治疗后,联合治疗组在中医证候评分及临床证候疗效方面较常规治疗组差异性更大(P0.05),差异具有统计学意义。6.安全性观察:研究过程中两组患者均未见肝、肾功能,血、尿常规均未见明显变化。结论1.清血解毒合剂在直接有效降低2型糖尿病患者体内炎症因子表达浓度的同时,可明显改善其胰岛素抵抗程度2.清血解毒合剂可明显改善消渴患者口燥咽干、渴喜冷饮等临床症状。3.清血解毒合剂不会对2型糖尿病血糖波动性产生影响,不会引起低血糖。4.清血解毒合剂合剂安全有效,无毒副作用。
[Abstract]:Objective insulin resistance (IR) is the core pathogenesis of type 2 diabetes (T2DM). The cause of its formation is not yet clear. The purpose of this experiment is to observe interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF- a), hypersensitivity C by the combination of clearing blood and detoxifying mixture on the basis of routine hypoglycemic scheme in T2DM patients. The changes of reactive protein (hs-CRP) and fasting serum insulin (Fins) were used to analyze the effect of clearing blood and detoxification mixture on proinflammatory factors and the relationship with insulin resistance of type 2 diabetes. Methods 6 patients with type 2 diabetes in the Department of endocrinology of the Department of Endocrinology, Wuhan city (a hospital) from July 2013 to February 2015, were randomly selected. In 0 cases, the syndrome types were both yin deficiency and fire stagnation and blood stasis syndrome. According to the random principle, the routine treatment group and the combined treatment group were divided into 30 cases in each group, and there was no significant difference in age, sex and course of disease between the two groups of type 2 diabetic patients (PO.O5). The routine treatment group was given the routine hypoglycemic regimen for eight weeks, and the combined treatment group was based on the routine hypoglycemic plan. Combined use of Qing Xue Jiedu mixture for eight weeks, the Qing Xue Jiedu mixture was prepared in the pharmacy department of a hospital in Wuhan, with a specification of 200 ml/ bottles and 3 times a day, 30ml, IL-8, TNF- a, hs-CRP, Fins and TCM syndrome scores and clinical symptoms before and after treatment. The results were 1. routine treatment group and combined treatment. Fins and IRI were lower before and after treatment, but the difference in the combined treatment group was greater than that in the conventional treatment group (P0.01). The concentrations of IL-6, IL-8, TNF- a, hs-CRP and other inflammatory factors in the.2. two group were all decreased in the body before and after the treatment, and were statistically significant (P0.05). After eight weeks of treatment, the combined treatment group was in IL-6, IL-8, TNF- alpha, and other inflammatory factors. Intra group difference (P0.01) was superior to conventional treatment group (P0.05), Hb A1C, FPG and 2 h PG before and after treatment in.3. routine treatment group and combined treatment group were lower than before (P0.01), but there was no significant difference between the two groups (P0.05).4. conventional treatment group in the treatment process of 2 cases of hypoglycemia, 1 cases of hypoglycemia in the combined treatment group and two groups. No significant difference was found, no statistically significant (P0.05).5. after eight weeks of treatment, the combined treatment group in TCM syndrome score and clinical syndrome effect is more different than the conventional treatment group (P0.05), the difference has statistical significance.6. safety observation: the study process of no liver, renal function, blood, urine routine is not clear Conclusion 1. clear blood and detoxification mixture can effectively reduce the concentration of inflammatory factors in type 2 diabetic patients, and can obviously improve the degree of insulin resistance, 2. clear blood and detoxification mixture can obviously improve the dry pharynx of the patients with thirst, and the clinical symptoms such as thirst and cold drink and other clinical symptoms.3. clearing blood and detoxifying mixture will not affect the blood glucose fluctuation in type 2 diabetes mellitus The effect of sex will not cause hypoglycemia..4. blood clearing and detoxicating mixture mixture is safe and effective, with no toxic side effects.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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