锦连合剂对老年2型糖尿病炎症因子的临床研究

发布时间：2018-02-11 21:33

本文关键词： 锦连合剂 2型糖尿病炎症因子CRP TNF-α IL-6　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究背景：目前2型糖尿病(T2DM)的发病率居高不下,已成为危害人类健康的重大疾病之一,其发病人群以中老年人为主。通过辨证论治的方法,中医在治疗T2DM上成效显著。T2DM发病有炎症学说、胃肠型学说、胰岛素抵抗(IR)学说等,近来炎症发病说备受重视,该学说认为T2DM是一种亚临床炎症性疾病,相关的炎症因子如C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素—6(IL-6)等在T2DM的研究中正日趋深入。目的：通过观察具有清热解毒、益气养阴,活血化瘀功效的锦连合剂对老年T2DM患者血清炎症因子水平的调节,探讨中医药从炎症角度治疗T2DM的效果,为临床治疗T2DM提供新思路和新方法。方法：采用随机数字表法,将60例中医辨证分型为“阴虚热盛兼气虚血瘀”的老年T2DM患者,分为治疗组30例和对照组30例。2组患者均给予T2DM健康教育、T2DM饮食并常规应用西药格列美脲降血糖。治疗组在此基础上加服锦连合剂,每日1剂,水煎服,分2次口服,两组疗程均为1个月。观察治疗前后患者血清CRP、TNF-α、IL-6水平的变化,及临床症状、血糖、血脂等T2DM相关指标的变化,并进行综合疗效评价。结果：本研究显示,T2DM患者血清CRP、TNF-α、IL-6、血糖及血脂水平均较正常人明显升高。两组患者在治疗疾病的综合疗效方面,治疗组显效8例,有效20例,无效2例,总有效率为93.3%；对照组有3例显效,20例有效,7例无效,总有效率为76.7%。在中医证候的改善上治疗组与对照组相较效果更为显著,P0.05。治疗后两组患者的空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbAlC)、CRP、TNF-α及IL-6水平比较P0.01；表明治疗组在改善血糖、调节炎症因子水平方面更有效果。治疗后两组患者总胆固醇(TC)与甘油三酯(TG)水平比较P0.05,说明治疗组在调节血脂上较对照组也有一定优势。结论：锦连合剂可明显改善老年T2DM患者症状、体征,降低血糖、血脂水平,明显降低血清炎症因子水平,改善IR,对老年T2DM有良好的治疗效果。
[Abstract]:Background: the incidence of type 2 diabetes mellitus (T2DM) is high at present and has become one of the major diseases endangering human health. TCM has achieved remarkable results in the treatment of T2DM. There are inflammatory theories, gastrointestinal theory, insulin resistance IRI theory and so on. Recently, the theory of inflammatory pathogenesis has received much attention, which holds that T2DM is a subclinical inflammatory disease. The related inflammatory factors, such as C-reactive protein (CRP), tumor necrosis factor- 伪 (TNF- 伪), interleukin-6 (IL-6), are becoming more and more important in the study of T2DM. Effect of Jinlian mixture of activating Blood Circulation and removing Blood stasis on Serum inflammatory Factor level in elderly patients with T2DM, to explore the effect of TCM on treating T2DM from the angle of inflammation, to provide new ideas and methods for clinical treatment of T2DM. Methods: random digital table method was used to treat T2DM. 60 cases of elderly patients with T2DM were classified as "Yin deficiency and heat and qi deficiency and blood stasis". 30 patients in the treatment group and 30 patients in the control group were given T2DM health education diet and conventional western medicine glimepiride to reduce blood glucose. The two groups were treated for one month. The changes of serum CRPnTNF- 伪 IL-6, clinical symptoms, blood glucose, blood lipid and other related indexes of T2DM were observed before and after treatment. Results: the results showed that the serum levels of CRPnTNF- 伪 IL-6, blood glucose and blood lipids in patients with T2DM were significantly higher than those in normal controls. In the treatment group, 8 cases were effective, 20 cases effective and 2 cases ineffective. The total effective rate was 93. 3% in the control group, and 7 cases in the control group. The total effective rate was 76.7.The improvement of TCM syndromes in the treatment group was more significant than that in the control group (P 0.05). After the treatment, the fasting blood glucose of the two groups was significantly higher than that of the control group (P 0.05). The fasting blood glucose of the two groups was compared with that of the control group (P 0.01). The levels of FBG, 2h PBGG, HbAlCU CRPN- 伪 and IL-6 in the treatment group were compared with those in the control group (P 0.01). After treatment, the levels of total cholesterol (TCC) and triglyceride (TG) in the two groups were higher than those in the control group (P0.05), which indicated that the treatment group also had some advantages in regulating blood lipid. Conclusion: Jinlian mixture can be more effective than the control group in regulating blood lipids. To improve the symptoms of elderly patients with T2DM, Physical signs, blood glucose, blood lipid, serum inflammatory factor level, improve IR, the elderly T2DM has a good therapeutic effect.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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