健脾化痰活血方对肥胖2型糖尿病胰岛素敏感性的影响

发布时间：2019-06-03 04:18

【摘要】：目的:本研究旨在观察健脾化痰活血方对肥胖型2型糖尿病胰岛素敏感性的影响。方法:本次临床观察所有病例均选自2015年3月至2016年3月于营口中医院内分泌科门诊就诊的肥胖型2型糖尿病患者,分为中药组和对照组各30例。两组均给予基础治疗,对照组给予盐酸二甲双胍片,中药组在给予盐酸二甲双胍片基础上,加服健脾化痰活血方,6周为一个疗程,观察两个疗程。比较两组治疗前后的空腹胰岛素(Fating plasma insulin,FINS)、胰岛素敏感指数(Insulin sensitivity index,ISI)、胰岛素抵抗指数(HOMA insulin resistance,HOMA-IR)及两组实验室指标的变化等。结果:1符合研究标准病例60例,中药组30例,对照组30例。年龄在35-60岁之间,病程在6个月-15年。两组患者在一般资料差异均无统计学意义(P0.05)。2两组患者治疗后的空腹胰岛素、胰岛素敏感指数、胰岛素抵抗指数比自身治疗前下降,且差异均有统计学意义(P0.05)。3两组患者治疗后的空腹血糖(Fasting plasma glucose,FPG)、2小时餐后血糖(2-hour postprandial glucose,2h PG)及糖化血红蛋白(Glycosylated hemoglobin,Hb A1C)比自身治疗前下降,且差异均有统计学意义(P0.05)。4两组患者治疗后的体重指数(Body mass index,BMI)、甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC),比自身治疗前下降,且二者差异有统计学意义(P0.05)。5两组在空腹胰岛素、胰岛素敏感指数、胰岛素抵抗指数、BMI、餐后2小时血糖、糖化血红蛋白、TG、TC治疗前后差值的比较,差异有统计学意义(P0.05)。两组患者在空腹血糖治疗前后差值的比较无统计学意义(P0.05)。6两组患者症状积分治疗前后差值的比较,二者差异有统计学意义(P0.05)。7两组综合疗效比较,中药组显效11例,占36.67%;有效14例,占46.67%;无效5例,占16.66%,总有效率占83.34%。对照组显效6例,占20%;有效13例,占43.33%;无效11例,占36.67%,总有效率占63.33%,二者总有效率比较,差异有统计学意义(P0.05)。8两组患者安全性指标比较,血常规、尿常规、心电图、肝功、肾功及主要不良反应中均未发现异常。结论:1健脾化痰活血方联合盐酸盐酸二甲双胍片,对增强胰岛素敏感性,改善胰岛素抵抗效果显著。2健脾化痰活血方联合盐酸盐酸二甲双胍片能够有效改善肥胖型2型糖尿病湿热困脾兼血瘀证患者的临床症状。3健脾化痰活血方联合盐酸二甲双胍片对患者BMI、血糖、血脂等有良好的干预作用。
[Abstract]:Objective: to observe the effect of Jianpi Huatan Huoxue recipe on insulin sensitivity in obese type 2 diabetes mellitus. Methods: all the patients with obese type 2 diabetes mellitus were selected from March 2015 to March 2016 in Endocrinology Department of Yingkou traditional Chinese Medicine Hospital. They were divided into traditional Chinese medicine group (n = 30) and control group (n = 30). Both groups were given basic treatment, the control group was given metformin Hydrochloride tablets, and the traditional Chinese medicine group was given metformin Hydrochloride tablets on the basis of Jianpi Huatan Huoxue recipe, 6 weeks as a course of treatment, observe the two courses of treatment. Fasting insulin (Fating plasma insulin,FINS, insulin sensitivity index (Insulin sensitivity index,ISI), insulin resistance index (HOMA insulin resistance,HOMA-IR) and laboratory indexes were compared between the two groups before and after treatment. Results: 1 there were 60 cases in accordance with the research standard, 30 cases in traditional Chinese medicine group and 30 cases in control group. The age is between 35 and 60 years old, and the course of disease is from 6 months to 15 years. There was no significant difference in general data between the two groups (P 0.05). 2 the fasting insulin, insulin sensitivity index and insulin resistance index of the two groups were lower than those before treatment. There was significant difference between the two groups (P 0.05). 3 fasting blood glucose (Fasting plasma glucose,FPG), 2-hour postmeal blood glucose (2-hour postprandial glucose,2h PG) and glycosylated hemoglobin (Glycosylated hemoglobin,Hb A1C) in the two groups were lower than those before treatment. There were significant differences between the two groups (P 0.05). 4 the body mass index (Body mass index,BMI), triglyceride (Triglyceride,TG) and total cholesterol (Total cholesterol,TC) of the two groups after treatment were lower than those before treatment. There was significant difference between the two groups (P 0.05). 5 the differences of fasting insulin, insulin sensitivity index, insulin resistance index, postmeal blood glucose of BMI, glycosylated hemoglobin and TG,TC before and after treatment were compared between the two groups. The difference was statistically significant (P 0.05). There was no significant difference between the two groups before and after fasting blood glucose treatment (P 0.05). 6 the difference of symptom score between the two groups before and after treatment was statistically significant (P 0.05). 7 the comprehensive curative effect of the two groups was compared. In the traditional Chinese medicine group, 11 cases (36.67%) were markedly effective. 14 cases (46.67%) were effective, 5 cases (16.66%) were ineffective, and the total effective rate was 83.34%. In the control group, 6 cases (20%) were markedly effective, 13 cases (43.33%) were effective, and 13 cases (43.33%) were effective. 11 cases (36.67%) were ineffective, the total effective rate was 63.33%. There was significant difference in the total effective rate between the two groups (P 0.05). 8 the safety indexes of the two groups were compared, such as blood routine, urine routine, electrocardiogram, liver function. No abnormality was found in renal function and main adverse reactions. Conclusion: 1 Jianpi Huatan Huoxue recipe combined with metformin Hydrochloride tablets can enhance insulin sensitivity. The effect of Jianpi Huatan Huoxue recipe combined with metformin Hydrochloride tablets can effectively improve the clinical symptoms of obese type 2 diabetes mellitus patients with dampness-heat deficiency spleen and blood stasis syndrome. 3 Jianpi Huatan Huoxue recipe can effectively improve the clinical symptoms of obese type 2 diabetes mellitus patients with dampness-heat stagnation and blood stasis syndrome. 3 Jianpi Huatan Huoxue recipe Treatment of BMI, with metformin Hydrochloride tablets Blood sugar, blood lipids and so on have a good intervention effect.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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